Enlarged prostate symptoms

The prostate is a gland which sits under the bladder in men. It also surrounds the urethra – the tube through which urine passes out of the bladder when you urinate.

As the prostate enlarges, it presses against and puts pressure on the bladder. This has the effect of ‘irritating’ the bladder, giving rise to what doctors call ‘irritative symptoms’.

At the same time, an enlarged prostate can also ‘squeeze’ the urethra, making it more difficult for urine to flow out of the bladder. This gives rise to ‘obstructive symptoms’.

In general, symptoms of an enlarged prostate affect men from the age of 45 onwards. So, if you are in your 30s, it is unlikely that you will suffer from an enlarged prostate, even if you experience some of the symptoms described on this page.

Putting pressure on the bladder has the effect of stimulating the nerves present in the bladder wall. This sends signals to your brain, fooling you into thinking your bladder is ‘full’ when it really isn’t.

This is the reason that men with an enlarged prostate feel:

• A need to urinate frequently; and when they do, not a lot of urine comes out
• A need to get up a few times in the night to urinate
• That they can’t get to the toilet in time – this is known as ‘urgency’
• That they can’t empty the bladder properly

Lastly, men with an enlarged prostate may also experience loss of libido or sexual function. The reasons for this are unknown, but it is thought that pressure and irritation of the bladder and surrounding structures could play a part. What is interesting is that when symptoms of prostate enlargement improve, so can sexual function.

Obstructive symptoms occur when the enlarged prostate squeezes the urethra, obstructing flow of urine out of the bladder. This effect is similar to having a blockage in your garden hose. Obstructive symptoms of an enlarged prostate are:

• Poor urine stream
• Weak urine stream
• Difficulty getting started when needing to urinate
• Stopping and starting rather than having a steady stream
• Dribbling at the end of urination

If you think you have symptoms of an enlarged prostate, the first thing you should do is to get the diagnosis confirmed by your doctor.

Either before or after a diagnosis is made, you should seek your doctor’s opinion if you experience any of the following symptoms:

• Pain on urination. This usually points to a bladder infection
• Blood in your urine. Although an enlarged prostate can sometimes be the cause of blood in the urine, other (more serious) causes should be ruled out urgently
• Unexplained fever
• Stop passing water completely.