You may have a range of bothersome urinary symptoms including:
Urinary urgency and/or frequency during the day
Waking multiple times at night to pass urine
Slow urine flow
Sense of incomplete bladder emptying
Urine leakage / incontinence
Investigating the cause of your symptoms
You will be assessed in clinic and often require one or more of the following tests:
flow rate assessment
bladder scan
urine dip test / urine microscopy and culture
PSA blood test (in men)
flexible cystoscopy
You may also be asked to fill out an IPSS questionnaire (click for download link) on arrival.
These tests will help distinguish whether you have a problem with a narrowing of the urinary tract, often due to an enlarged prostate, or a problem with storing urine in the bladder, usually a condition known as overactive bladder, or both. Sometimes you may need further tests such as an ultrasound scan, or a CT scan, depending on your history and other test results.
In men over 50, a PSA test may be recommended if you have not had a recent test with your GP. An abnormal PSA reading may indicate prostate cancer as well as an enlarged prostate.
Treating your urinary symptoms
Often lifestyle advice is sufficient to improve your quality of life. This may involve doing a bladder diary, cutting out certain habits or drinks.
Medication to target the underlying cause of your symptoms will often help. Different tablets are available to "relax" or "shrink" the prostate, thereby improving the flow. Other tablets can "relax" your bladder to reduce bladder urgency. Potential side effects of the tablets will be explained to you.
If your symptoms are still bothersome, or tests indicate otherwise, you may require definitive surgical management including Holmium laser enucleation surgery (HoLEP), TURP or prostate artery embolisation. These treatments aim to widen the path through the prostate and allow better flow as urine leaves the bladder. This will in turn allow better bladder emptying and improved symptoms.
