The prostate gland is part of the urinary system and is located immediately below the bladder. Urine passes from the bladder though the central portion of the prostate into the urethra (urine tube) to leave the body. The bladder muscle has to contract to push the urine through the prostate so that the urine can pass into the urethra to leave the body. The bladder muscle strength is limited and no medication exists to increase bladder muscle strength.
In the majority of men starting at age 40, the prostate gland starts growing and can squeeze on the prostatic urethra (urine channel) in the prostate and impact on the caliber of the urine stream. The changes that some men experience may include:
1. slowing urine stream
2. getting up at night to urinate
3. hesitancy to start the stream
4. frequency and / or urgency
There are a variety of medications that exist to ease some of the symptoms listed above. The medications include alpha blockers, which act to relax the intensity of nerve stimulation to the prostate and bladder neck thus relaxing the prostate and resulting in increased force of urine stream, decreased hesitancy and less getting up at night to urinate. Alternatively, anticholinergic medications act on the bladder to decrease the frequency with which the bladder squeezes and sends a signal to go to the bathroom. These medications can impact on quality of life within a few days, and when used can alleviate symptoms in many men and improve quality of life. Careful questioning from a doctor can reveal which medication may be best suited for an individual.
When medications fail, a catheter can be used to get the urine out in several different manners. Additionally, there are a variety of surgical procedure that exist which can impact on the prostate and result in decreased symptoms and improved flow, most of which are outpatient procedures which are performed with a telescope with some form of anesthesia.