By James Allan and Paul Hughes (Consultant Urologists)
All men have a prostate gland and as we get older our prostate gets bigger, starting off like a walnut and potentially becoming the size of a lemon, or even an orange! What does it do and where is it? Do I really need one?
Your prostate sits at the exit of your bladder, it’s like a small doughnut and your water pipe passes through it as it leads away from your bladder. As your prostate gets bigger the hole in the middle gets smaller and your prostate squashes the water pipe and blocks the flow of urine giving you the symptoms of a blockage.
The bladder is two things, a reservoir and a pump. It is simply a muscular bag that stores urine in a clever way at low pressure. When it is full it lets you know that a call of nature is required and you look for the next opportunity! When socially convenient, you find an appropriate place, relax the sphincter that keeps you dry and the bladder squeezes as a muscle and the pressure pushes the urine out. As a young boy you would be peeing over gates or writing your name in the snow, as an old man you will be careful of your shoes!
Like any muscle, if you make your bladder work against a resistance, or lift weights, then it becomes bigger and stronger, sadly this is true when your prostate gets bigger and blocks your water pipe! So instead of a beautiful thin supple bladder that stores urine perfectly you begin to develop a thickened bulky bladder that is tough like an old boot! It begins to squeeze when you don’t want it to; it cannot relax as much, so it doesn’t hold urine as well and you have to go more often, day and night. So most men develop ‘obstructive’ symptoms like a poor flow, having to wait for the urine to come out, a failure to fully empty and passing more often. They also develop the ‘irritative’ symptoms of a thickened bladder such as a short fuse or urgency, potentially incontinence, frequency or getting up at night.
So does it all sound too familiar? Well this is the month to get down to the doctor and potentially to come and have a chat to us, your Urologists. The next step is to work out why it’s happening, is it simply an older bigger prostate causing a bit of blockage or is it possibly a tumour or prostate cancer? Let’s find out next month!