Urinary Retention Should be a Concern for Aging Men
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As men age, prostate tissue grows, which can resulting in obstruction of the urinary tract. By 50 years of age 50% of men will have some degree of BPH and at 85, 75% will have BPH. Common symptoms included decreased force of stream, hesitancy, intermittent stream, dribbling and nighttime waking in order to urinate. In its most severe form, patients can develop kidney problems secondary to incomplete bladder emptying.
When patient have severe BPH, they can go into urinary retention—over a five year period approximately 10% of patients with BPH will go into acute urinary retention. Urinary retention refers to the inability to pass urine. Symptoms include:
o Lower abdominal discomfort
o Sensation of a full bladder without being able to void or only releasing a few drops of urine
o Lower abdominal fullness
Being unable to empty your bladder represents a urologic emergency, as your bladder fills, the increased pressure can in extreme cases cause the bladder to tear as well as have urine reflux back up to the kidneys. The increased pressure in the kidneys can cause problems with their normal blood filtering functions.
How can urinary retention be treated or managed?
If you go into urinary retention, it is important to seek medical treatment. Immediate release of the urine is the first step of treatment—this is accomplished with the insertion of a catheter to allow the urine to be released. At the time of catheter insertion, studies have shown that initiating alpha-blockers increases the likelihood that the patient will not need surgical treatment.
Historically, emergency surgery was considered the standard of care. However, studies showed that immediate surgery was associated with increased complications, morbidity, and mortality. Surgical therapy still remains the definitive treatment. Currently, however, it is recommended that patients wait at least 30 days following an episode of retention.
Treatment of symptomatic BPH is divided into two main types—medical and surgical. Medical therapy includes:
· Alpha-blockers
· 5a-Reductase inhibitors
· Combination of the above two medications
Surgery intervention includes:
§ TUNA ( Transurethral Needle Ablation) Radiofrequency wave heat and destroy excess prostate tissue
§ TUMT (Transurethral Microwave Thermotherapy) Microwaves heat and destroy excess prostate tissue
§ TURP (Transurethral Resection of the prostate) small pieces of excess prostate are physically removed
All these techniques are all performed under direct visualization, and although patients might experience a mild increase in symptoms immediately following the procedure, symptoms should improve over the subsequent weeks.