Consequences of prostate enlargement | Prostate Enlargement

Consequences of prostate enlargement

A benign enlarged prostate (BPH) can exist without causing any symptoms. However, it can develop into an obstacle to urine flow, because the prostate lies directly against the opening of the bladder and the urethra runs through the prostate at its beginning. This leads to so-called lower urinary tract symptoms (LUTS).

These are initially caused by the obstruction of the urethra (obstructive disorders): a reduced urine flow (measured by uroflowmetry) until dribbling, the need to press, multiple stoppages of the urine stream and, after urination, a residual urinary sensation as well as after-flow of urine. These symptoms can be more or less pronounced. In the long run, however, the bladder tries to overcome the obstacle by emitting more stimuli.

An irritable bladder develops. This leads to so-called irritative disorders: The frequency of the urge to urinate is increased overall (pollakiuria), at night there are disturbances in sleep due to the urge to urinate (more than twice a night, nocturia), urination can be difficult (dysuria) or associated with pain (alguria). Another stressful consequence is the sudden urge to urinate, which can lead to incontinence.

The constant residual urine and the increased pressure in the bladder lead in the long term to a remodelling of the bladder wall. At first the muscles thicken, in the further course of time there is a strong overstretching and a conversion into connective tissue. This leads to an overflowing bladder: small amounts of urine are released unintentionally, because when new urine arrives, the bladder’s stretching capacity is already exhausted.

In addition, the bladder can become swollen, which promotes the development of bladder stones. The constant residual urine is a good condition for the proliferation of bacteria, and urinary tract infections are frequent, which can rise to the kidneys. The kidneys can also be permanently damaged by the backwater.

Further complications are blood admixtures (haematuria) in the urine. Small quantities can be attributed to infections, large quantities are usually caused by bursting veins during pressing. Acute urinary retention can also occur.

This is characterized by severe pain in the lower abdomen with simultaneous inability to urinate. This is an acute emergency, because both bladder and kidney can be damaged. It is treated by a relieving puncture or a bladder catheter.

A connection between benign prostate hyperplasia (BPH) and malignant prostate cancer (prostate carcinoma) is controversially discussed in the scientific community. In general, however, both diseases must be distinguished from each other.