When the lumen of the urethra is narrowed, it may present with

• Difficulty in the starting of urination
• Weak urine stream
• Starting and stopping of the urine stream
• Dribbling at the end of urination
• Increased frequency and urgency of urination
• Multiple visits to the toilet at night
• The feeling of incomplete urination

These symptoms usually interfere with the patient’s quality of life and sleep. If there is chronic obstruction by the prostate, urine can chronically be retained, which can damage the kidneys and bladder. It can also result in urinary tract infections and stones as well.

Besides asking you for these symptoms, the doctor will also do a prostate examination.

The doctor might order some urine studies, an ultrasound and some blood tests to look at the kidney function and the level of Prostate-Specific Antigen (PSA) in the blood.

The doctor will advise you on some lifestyle changes such as not to drink too much water at night, to empty your bladder before you sleep, to limit your consumption of caffeine and alcohol and to empty your bladder as thoroughly as possible with each urination. Your doctor will also advise you to avoid certain medications including cough syrups as it might result in acute retention of urine.

The medications used to treat BPH include:

Alpha-blockers

• These medications relax the muscles of the bladder neck and prostate and thus urine can flow more easily through the urethra.
• Side effects include low blood pressure, headaches and giddiness.

5 alpha reductase inhibitors (5 ARIs)

• These medications prevent the formation of 5DHT, a hormone that causes the prostate to grow.
• Long term use can shrink the prostate, thus relieving symptoms.
• Side effects include erectile dysfunction, ejaculatory dysfunction and loss of libido.

Phosphodiesterase inhibitors (PDE5-Is) – Cialis

• Cialis is also used to treat erectile dysfunction. It increases nitric oxide concentration in smooth muscle, facilitating both erections of the penis and bladder neck and prostatic relaxation and subsequent bladder emptying.
• Side effects include headaches, palpitations, flushing and muscle aches

If medications do not work or symptoms worsen, that is an indication for referral to a Urologist for an operation known as transurethral resection of the prostate (TURP). This surgery is usually done under general anaesthesia and removes the part of the prostate intruding into the urethra. No cuts are made and it is done through the penis.

It is important to note that you shouldn’t have to live with the symptoms above. BPH is easily manageable and treating it can improve the quality of your life significantly. Speak to our doctors today to discuss your symptoms!