Prostate Signs and Symptoms and Their Meaning
Having a bigger enlarged prostate doesn't necessarily mean your symptoms will be worse than a less enlarged gland. Some men having only slightly enlarged prostates have significant symptoms, while on the other hand, some men with very enlarged prostates may have only minor urinary symptoms. In fact, only about half the men with prostate gland enlargement have symptoms that become noticeably bothersome enough to make them seek medical treatment. In some men, symptoms may eventually stabilize at a tolerable level, and may even improve spontaneously over time.
Benign prostatic hypertrophy symptoms can be classified as storage symptoms or voiding symptoms. Storage symptoms include urinary frequency, urgency or the need to urinate that cannot be put off, incontinence, and frequent urination at night or nocturia.
Voiding symptoms include urinary stream problems, hesitancy difficulty to get the stream to begin, intermittency when the stream starts and stops intermittently, straining to void, and dribbling. Pain or disuria is usually not present.
The degree of these storage and voiding symptoms are evaluated using the International Prostate Symptom Score or IPSS questionnaire, designed to assess the severity of BPH. The International Prostate Symptom Score is an eight-question tool used to screen for, rapidly diagnose, track the symptoms of, and suggest management of the symptoms of the disease. The IPSS questionnaire was created in1992 by the American Urological Association and is made up of 7 symptom questions and 1 quality of life question.
The IPSS questionnaire was originally designed to be easily self-administered by the patient, but of course it can be used in both urology clinics as well as the clinics of primary care physicians for the diagnosis of BPH. As important, the IPSS can be performed repeatedly to compare the progression of symptoms and their severity over months and years, and to suggest treatment methods when indicated. The IPSS questionnaire will be shown in the chapter on diagnosis.
The common signs and symptoms of BPH
Urinary Obstruction . . .
A weak urinary stream or hesitancy in starting urination, or the need to strain to get urine to flow are often early symptoms of urinary obstruction. Also an intermittent urinary stream, one that starts and stops several times during a given urination may also be an early sign of urinary obstruction. Dribbling or having difficulty in stopping urination, characteristically with excessive dripping at the end of the urine flow is another symptom of urinary obstruction. Often there is a sense of not being able to completely empty the bladder, and worse, not being able to start urinating at all. Most common cause of these benign causes of urinary obstruction is Benign Prostatic Hyperplasia or Hypertrophy.
A review of signs to look for include:
Weak urinary stream
Prolonged emptying of the bladder
Abdominal straining to start and continue urination
Hesitancy or having to wait unusually long for the stream to start
Irregular need to urinate sometimes just minutes apart
Incomplete bladder emptying and feeling that there is more urine still to come
Post-urination dribble, just keeps on with uncontrollable dripping
Frequent urination, having to go an inordinate number of times, especially at night, known as nocturia.
Urgency, or having to go right now to avoid loosing control
Incontinence, or the involuntary leakage of urine
Disuria, or painful urination
Problems in ejaculation of semen
Any of these signs or symptoms remaining over a period of days or weeks should alert you to the possibility of your developing BPH and encourage you to seek medical consultation. Untreated BPH can lead to some serious problems to be discussed in following chapters. Early intervention can avoid these problems.
For more info read Coping With BPH - Benighn Prostatic Hypertrophy.