UNDERSTANDING BPH AND HOW IFS DIAGNOSED: URINARY RETENTION

Mar
30
2009

UNDERSTANDING BPH AND HOW IFS DIAGNOSED: URINARY RETENTION

Urinary retention—difficulty in emptying the bladder completely, or in urinating at all—also can be triggered by many things, including consuming alcohol; having prostatitis; and taking such medications as antihistamines, antidepressants, tranquilizers, or decongestants. It could even mean prostate cancer, although in most cases, prostate cancer is regrettably “silent,” producing no symptoms until it becomes considerably advanced. Two other symptoms, however—trouble starting urination, and a slow or weak stream— almost always signal obstruction.

The lower urinary tract can also be affected by neurological disorders such as diabetes mellitus; multiple sclerosis; Parkinson’s disease; and spinal stenosis, pressure on the spinal cord that impairs the brain’s ability to communicate with the bladder. These and other diseases can give rise to obstructive and irritative symptoms like those in BPH. (Parkinson’s disease makes it particularly tricky to treat the symptoms of BPH. For more on this, see Chapter 10.) The term “neurogenic bladder” refers to a bladder affected by such conditions.

So, because other conditions can mimic the obstruction produced by BPH, a good medical history is vital even if you have what seems like a classic case. An injury to the urethra (from an episode of gonorrhea many years ago, perhaps, or from having a catheter inserted into the bladder during a surgical procedure, such as a coronary artery bypass) can produce a urethral stricture—a scar that narrows the urethra—that has nothing to do with the prostate, yet produces urinary problems just as BPH does. Blood in the urine, or pain in the bladder or penis could point to a bladder tumor; it could also indicate that a stone has developed in the bladder, prostate, or kidney. And having a history of other urologic problems—recurrent tract infections or prostatitis, for example— could mean one of these old adversaries has returned, in a different guise.

You will also be asked to score your symptoms on a questionnaire (such as the one in table 9.1). Be honest; your answers will help your doctor determine whether your symptoms are mild, moderate or severe, and the impact they’re having on your life.

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