Around 40% of men over the age of 60 suffer from troublesome urinary symptoms, some of which significantly impact on their quality of life. The risk of developing these symptoms increases with age and is usually due to Benign Prostatic Hyperplasia (BPH). Since the urethra (waterpipe) passes through the prostate, when this gland enlarges, the flow of urine is blocked. To get around this, the bladder muscle works harder than usual so it can force the urine out. This development can cause some or all of these symptoms:
- Frequent visits to the toilet as it is difficult to empty the bladder completely
- A sense of urgency when needing to urinate, and inability to hold it in
- Getting up frequently during the night to pass urine
- Difficulty in starting to urinate, and needing to strain
- A weak urine stream
- Pauses in urine flow
Tests for Enlarged Prostate and Urination Issues in Dubai
Your urologist might recommend these tests to identify or determine the cause if you are having difficulty urinating:
- Urine flow test: This test uses a special device to measure the speed of your flow (it is placed in the bathroom so you have privacy). After the flow test, a bladder scan might be performed to assess the amount of urine you have left in your bladder.
- PSA test: This blood test measures the amount of prostate-specific antigens (PSA) in your urine. PSA is a natural protein that seeps from the prostate into the bloodstream and the levels are elevated if you have an infection or a urinary catheter, or sometimes for no particular reason. Elevated levels might also be normal for you.
- Transrectal ultrasound and biopsy (prostate biopsies): If you have a high PSA reading that is unexplained, we will recommend this scan to check for the presence of prostate cancer. A narrow, lubricated tube will be inserted through the rectum under local anesthetic to allow us to measure the prostate and to take biopsies for analysis.
- Flexible cystoscopy: This is an outpatient test, performed under local anesthetic, where a narrow flexible telescope is passed down the urethra into the bladder.
- Rigid cystoscopy: This is similar to the flexible cystoscopy except it is done under general anesthetic and the telescope used is wider and rigid. It allows us to do any other necessary procedures at the same time, for example, taking a biopsy from the bladder.
- Videourodynamics: This examines the functioning of the bladder – what happens as it fills and empties. It is performed in the spinal X-ray department and involves passing very small tubes into the bladder and back passage under local anesthetic and slowly filling the bladder with fluid while the pressure in your bladder is measured. Once the bladder is full, you are asked to pass the fluid out around the tube.
Treatment for lower urinary tract issues
- Lifestyle changes: Sometimes simple lifestyle tweaks are enough to improve your symptoms. Drink plenty of water and, to help reduce symptoms of urinary frequency and urgency, avoid chocolate and caffeinated items such as tea and coffee, as well as alcohol. Also try not to pass urine just for the sake of it, instead, try to increase the amount of time between relieving yourself. However, it is best not to try to hold it in at night as this might keep you awake.
- Water tablets: Be sure to take these if the urologist has given you some.
- Medication: Your urologist might prescribe tablets to help relax or shrink the prostate, or both.
- Surgery: If your symptoms are severe and medication hasn’t helped, your urologist may recommend a procedure called a trans-urethral resection of the prostate (TURP). With this technique, the central part of the prostate that is obstructing the passage of urine is removed. It also involves passing a rigid telescope through the urethra and into the bladder. The hospital stay is usually a day or two.