Urinary symptoms in men

Symptoms that men may experience include poor urinary flow, delay at the start of the urinary flow and post urinary dribbling. Other symptoms include increasing frequency of having to visit the toilet both at night and during the day, together with urgency to get to the toilet.

These symptoms can all be caused by a variety of conditions and some men perceive little bother, whereas others find they significantly impact on the quality of their life. These are the sorts of symptoms we can help to sort out as they may be related to diseases of the prostate, bladder or urethra.

Investigations usually include an assessment of the urinary flow rate and a bladder ultrasound test to check whether the bladder is emptying completely. Occasionally, bladder pressure tests are also required (cystometrogram/ Urodynamics).

Assessment will also involve excluding prostate cancer as well as bladder cancer with examination and blood tests (PSA). Sometimes a telescopic examination of the bladder (flexible cystoscopy) is also advised

Male urine infections are not as common as in women and can happen by chance or be a sign of an underlying illness. We often examine to see if there are signs of a bladder that is not emptying well or a kidney blockage. Infections can also affect the prostate or testis.

Though the initial treatment with antibiotics may resolve a problem it may also be necessary to carry out further tests to prevent problems recurring or to find the cause.

Whilst this is more common in women than men, it may often occur, more commonly as men get older. It is often possible to make a diagnosis and offer tablet treatment and/or physiotherapy as treatments for urine leakage once a diagnosis has been made. Sometimes it is a sign of the bladder not emptying properly and urine leaks as it overflows from the bladder

Haematuria is defined as the presence of blood in the urine. It is either visible (frank) or non-visible (microscopic). It has many causes including: infection in the bladder or kidneys or prostate (often associated with pain or discomfort on passing urine), Stones in the urinary tract, Bursting of a small blood vessel, a tumour (cancer) in the bladder, kidneys or ureters,

Sometimes non-visible haematuria can be caused by some disorders of the kidney usually investigated by a nephrologist.

Most people who pee blood would probably think that this was a little worrying. Sometimes blood in the urine can be the first sign of a really important problem such as a bladder or kidney cancer. These problems are more common in current or ex-smokers but even people with a healthy lifestyle may have them. For many people however it is not associated with any major illness and may go away on its own. Because you as a patient can’t tell if blood in your pee is important or not you are encouraged to report it to your doctor urgently. If you see your GP with this problem they are likely to do a urine test to check for infection and antibiotic treatment may be needed if this is the cause.

Urine problems may also be a sign of prostate or bladder cancer, although for men who are under 40 this is less likely. Prostate patients with prostate-related symptoms may need a PSA blood test with further investigations such as MRI and or biopsies to clarify the situation.

Prostate UK has good background advice but we strongly suggest patients see a specialist to diagnose which prostate problems may be affecting you and advice for treatment if necessary.

We can provide state of the art template biopsies and MRI scanning as a guide to decide if there are any suspicious areas in the prostate if appropriate.

If the cause of the symptoms seems to relate to an enlarged prostate, often treatment with tablets is advised and in the majority of cases this will help the symptoms. For some men this medical therapy will not be enough and for them surgery may give much better relief of their symptoms. This surgery can be carried out using different techniques depending on the size of the prostate and other patient factors.

Usually a TURP (trans-urethral resection of the prostate) achieves the best long-term results, and we usually use bipolar energy to operate with, which is a newer and safer technique.

Most problems which are not related to a cancer diagnosis can be sorted out with medication. If surgery is needed it is usually offered with a short stay of one to two nights in hospital