Understanding Urinary Problems in Men: A Guide by Dr. Anthony Dedea

By Dr. Anthony Dedea is Co-Owner/Physician of Dedea, M.D. Family Medicine.

As men age, urinary issues become more common. These problems can manifest as difficulty starting urination, a weak stream, frequent urges to go, and pain during urination. Urinary problems can significantly affect daily life, but they are manageable with medical care. Recognizing symptoms and seeking timely treatment can lead to effective management and relief. Understanding the causes and treatments can help manage these issues effectively.

Common Causes
1. Enlarged Prostate (BPH):
• As men get older, their prostate can enlarge, pressing on the urethra and making urination difficult. This condition, known as benign prostatic hyperplasia (BPH), can lead to a weak stream and frequent nighttime bathroom trips. Over time, the disruption of the sleep cycle can lead to other health conditions such as fatigue. BPH is one of the more common conditions seen in primary care.
2. Urinary Tract Infections (UTIs):
• Symptoms include a burning sensation during urination, frequent urges to urinate, and cloudy or foul-smelling urine.
3. Prostatitis:
• This inflammation or infection of the prostate causes painful urination and pelvic pain, often due to bacterial infection.
4. Urethral Stricture:
• Scarring from injury, infection, or surgery can narrow the urethra, resulting in a weak stream and difficulty emptying the bladder.
5. Bladder Stones:
• Hardened deposits of minerals in the bladder can obstruct urine flow and cause pain.

Symptoms to Watch For
• Difficulty starting to urinate
• Weak or stop-and-start urine flow
• Frequent urination, especially at night
• Urgent need to urinate
• Pain or burning during urination
• Blood in the urine
• Feeling like you can’t completely empty your bladder

Diagnosing urinary problems involves a thorough evaluation by a physician, which may include:
• Medical History and Physical exam to understand the type of symptoms, duration, and health background.
• Urinalysis: To check for signs of infection or blood in the urine.
• Prostate-Specific Antigen (PSA) Test: To screen for prostate issues.
• Ultrasound: To visualize the bladder, kidneys, and prostate.
• Cystoscopy: A procedure using a thin scope to view the inside of the urethra and bladder.

Treatment Options
1. Medications:
• Drugs to relax the prostate for BPH.
• Antibiotics for bacterial infections.
• Pain relievers for symptom relief.
2. Lifestyle Changes:
• Reducing caffeine and alcohol intake.
• Scheduling bathroom visits to train the bladder.
• Pelvic floor exercises to strengthen muscles involved in urination with the help of physical therapy.
3. Minimally Invasive Procedures:
• Urethral dilation or stenting for strictures.
• Transurethral resection of the prostate (TURP) for BPH.
4. Surgery:
• For severe cases of BPH or bladder stones that do not respond to other treatments.

When to Seek Help
Persistent or severe urinary symptoms should be addressed with a visit to your doctor. Early diagnosis and treatment can prevent complications and improve quality of life. Regular check-ups are crucial for monitoring prostate health and addressing any emerging issues.