Urinary Tract Symptoms in Men and How to Treat Them

What is meant by urinary tract symptoms?

Lower urinary tract symptoms (LUTS) describe a series of symptoms related to the disturbance in urine storage in the bladder and subsequent disposal through the act of urination. Common symptoms include:

1. Getting up at night to pass urine frequently
2. Having to visit the loo too ofter during the day time
3. Having to push hard for urine to come out
4. Very slow flow of urine
5. Feeling of incomplete bladder emptying at the end of passing urine
6. Urinary leakages

What can cause these symptoms and what age group is most at risk?

LUTS can happen as a result of a wide-range of conditions that affect the bladder, prostate or the urethra (water-pipe) and can manifest themselves in any age group. However, their prevalence is more in men above the age of 50 years, as a result of prostate enlargement that can be seen most commonly around this age. Prostate enlargement causes narrowing of the bladder outlet and restriction in the urine flow, hence urinary symptoms occur.

What should I do if I develop urinary symptoms?

It is important that men consult their primary care physician if these symptoms are persistent and affecting their quality of life. The GP will ensure that other causes of urinary symptoms are ruled out before they are attributed to benign prostatic enlargement. The GP might also request a prostate blood test (PSA) which is a marker for prostate cancer.

What happens next if my symptoms are purely the result of prostatic enlargement?

It is likely that the GP will advise on some lifestyle changes such as a reduction in the intake of caffeinated drinks (which act as bladder stimulant) especially in those men whose sleep is affected by the number of times they get up to pass urine at night. It is not unusual that simple measures can be all what is needed to resolve these symptoms.

Will medications work?

Medical therapy can be started especially in men with slow flow and in those men whose quality of life is markedly disturbed by these symptoms. The most commonly prescribed medicine is called Tamsulosin which relaxes the prostate and increase the flow of urine. Patients need to be aware that this treatment only improves symptoms modestly and that there are side effects that come with this such as dizziness and blocked nose.

What if medications don’t work?

When medicines are not very effective in controlling symptoms or there are troublesome side effects, surgery can be offered to relieve the blockage. There are plenty of surgical options available that range from minimally invasive options such as UroLift or Rezum to more invasive options such as TURP and endoscopic enucleation of the prostate. The latter operations will remove part of the prostate tissue resulting in widening of the prostatic urethra and subsequent improvement in the urinary flow. It is important to remember that the more invasive the prostate operation is, the more is the risk of side effects that that come with it. Therefore, it is essential that the patient is carefully counselled by the treating urologist about all the available options, including the possible complications, to enable the patient to make an informed decision

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