Is it Overactive Bladder or Enlarged Prostate?

by Jay Motola, M.D. Health Professional

Bladder issues don’t just affect women. Men may often experience a sudden urge to go, slower urinary stream or increased urinary frequency. But often, overlapping symptoms cause confusion as to what the problem really is. So how can you tell the difference? This guide from urologist Dr. Jay Motola may help.

What is overactive bladder (OAB)?

OAB is characterized by a strong “gotta go” sensation. It may happen at any time of the day or may always be present. If you can make it to the bathroom in time, the symptom you are experiencing is urinary urgency. Some people cannot, and leak small amounts of urine, known as urge incontinence.

What is enlarged prostate?

BPH (benign prostatic hyperplasia) causes the prostate to enlarge and compress on the urethra. Symptoms can include urinating frequently during the day or night, weak flow of urine, and recurring urinary tract infections. Treatment is available, but many men choose not to get it. BPH most often occurs after age 40 andcan affect up to 50 percent of men. It can affect as many as 80 percent of men in their 70s.

Overlapping symptoms

Both OAB and BPH share the common complaint of urinary urgency, which has caused some confusion and even some cases of misdiagnosis. Patients with irritating urinary urge frequency or urge incontinence may be said to have symptoms of OAB, when really their symptoms are caused by BPH, or vice versa.

Why the two can be misdiagnosed

Younger males with irritative symptoms may often be diagnosed with BPH, when really it’s a result of prostatitis - an infection with symptoms similar to BPH, but difficult to diagnose. Addressing symptoms of BPH in patients without surgical history is also fairly new. Miscommunicating symptoms or leaving out details may also cause confusion during a consultation.

What you can do

The best thing to do is** create a bladder diary to log your symptoms**, and bring it to your doctor. If the onset of symptoms is acute or sudden, it’s less likely to be BPH. Gradual onset of symptoms, and weak or slow urine flow is more likely to be BPH, or related condition. OAB is usually associated with more urinary tract infections, although there is some overlap.

Final tip

Your doctor may tell you that you have LUTS (lower urinary tract symptoms). This is usually an umbrella term for all symptom types associated with BPH. If you come across this term, you may want to discuss BPH with your doctor.

Jay Motola, M.D.
Meet Our Writer
Jay Motola, M.D.

Jay Motola, MD, is a board-certified urologist and attending physician, Department of Urology, Mount Sinai West, and Assistant Professor of Urology, Icahn School of Medicine at Mount Sinai. Dr. Motola is a summa cum laude, Phi Beta Kappa graduate of Boston University, and earned his medical degree at the State University of New York at Stony Brook.