Benign prostate enlargement: symptom check

Normally, the prostate is about the size of a chestnut and weighs 20 to 25 grams. The gland lies below the bladder and surrounds the urethra. With increasing age, the glandular tissue of the prostate grows and increases in size.  From the age of 75, almost all men have an enlarged prostate.

This cell proliferation is not malignant and initially harmless - not to be confused with a prostate carcinoma - and is therefore also known as benign prostate hyperplasia (BPH). Nevertheless, benign prostate hyperplasia can severely impair the quality of life of those affected and lead to complications and long-term consequences. A checklist should help you to recognise the first signs and to see a doctor if necessary.  

Signs and symptoms of benign prostate enlargement

In benign prostate hyperplasia, the cells of the prostate gland that directly surround the urethra are usually exactly enlarged. As a result, it becomes increasingly constricted and discomfort occurs when urinating, the so-called micturition symptoms.

Attenuated urinary stream: Already in the early stage of benign prostate enlargement, urine flow is obstructed. The bladder can no longer empty without problems and tries to compensate for this by building up muscles. Typical symptoms are therefore a weak or interrupted urine stream.  It takes much longer to go to the toilet.

Frequent urge to urinate - even at night: Since the bladder can no longer be completely emptied at once, those affected have the urge to go to the toilet all the time; often at night as well. This not only considerably restricts everyday life, but also disturbs the night's rest time and again. In the long run, this can lead to physical and mental stress. 

Strong urge to urinate: Sometimes there can be a sudden strong urge to urinate with unintentional leakage of urine (so-called urge incontinence), which is often perceived as particularly stressful by those affected. 

Unpleasant dribbling after urination: Dribbling after urination is also a frequent sign of benign prostate enlargement. 

Impaired urination: Due to the narrowing of the urethra, the bladder muscles must overcome increased resistance. Many affected persons therefore have to press additionally when urinating. 

Residual urine feeling in the bladder: The feeling of constantly "having to" is often a sign that residual urine has accumulated in the bladder. The amount of urine remaining in the bladder can be determined by an ultrasound examination. 

Late effects and complications

Benign prostatic hyperplasia should be examined by a doctor and treated if necessary. This is because an enlarged prostate can under certain circumstances lead to serious consequential damage. 

Inflammation of the bladder:  If residual urine remains in the bladder due to incomplete bladder emptying, there is a risk that germs will develop in the bladder and cause an infection. 

Damage to the kidneys: If the remaining urine remains untreated for a longer period of time, the kidney drainage may be impaired or a bladder infection may ascend into the kidneys via the ureter. The result can be the development of chronic kidney damage, which can lead to kidney failure. 

Urinary stones: If residual urine remains in the bladder over and over again, the formation of urinary stones is also favoured. Small urinary stones, which are normally washed out when urinating, remain in the bladder and increase in size. 

Bleeding: Blood vessels in the prostate or bladder can be damaged by increased pressure when going to the toilet; the urine becomes bloody. Anticoagulant drugs (ASA, Marcumar) can additionally increase bleeding. Bladder infections can also lead to blood in the urine. 

Acute urinary retention: If an acute urinary retention occurs, the "full" bladder can no longer be emptied although the affected person feels a clear urge to urinate. The overstretched bladder can sometimes cause very severe pain. In such a case, you should urgently consult a doctor who will empty the urine with the help of a thin catheter as an immediate measure.

Prostate Questionnaire (IPSS)

With the IPSS (International Prostate Symptom Test) developed by the American Urological Association, urologists check whether a patient has symptoms that speak for benign prostate enlargement. This test can also be used to prepare you for a visit to the doctor.

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