Urology
Benign prostatic hyperplasia: understanding urinary symptoms
The prostate can enlarge with age and obstruct the flow of urine. This enlargement is benign, but urinary symptoms can have several causes that need to be distinguished.
Written by the Polycrabat Sevamed team · Published on
In brief
- Benign prostatic hyperplasia is common with age: a weak stream, frequent urges or waking at night to urinate may lead to a consultation, but other causes are possible.
- A sudden inability to urinate, severe pain or fever requires prompt assessment, sometimes draining the bladder before long-term treatment.
- PSA does not measure the severity of symptoms; the choice between monitoring, medicines, a procedure or embolisation depends on the discomfort, the anatomy and the patient’s expectations.
Which signs should be investigated?
A weak stream, difficulty starting to urinate, a feeling of incomplete emptying, frequent urges or waking at night to urinate may lead to a consultation. A sudden inability to urinate, severe pain or fever requires prompt assessment. Similar symptoms can also be related to an infection, a bladder disorder or other diseases. These situations may require draining the bladder before long-term treatment.
What does the assessment include?
The doctor assesses the discomfort experienced, the treatments taken and any warning signs. Depending on the context, the doctor may suggest a urine test, a clinical examination, an assessment of residual urine after urination, an ultrasound or other tests. PSA testing is discussed according to the situation; it does not directly measure the severity of symptoms.
What treatment options are there?
Monitoring and changes in habits may be enough if the discomfort is moderate. Medicines can make urination easier or act on the size of the prostate, with benefits and side effects that need to be explained.
When should a procedure or embolisation be discussed?
An endoscopic procedure, surgery or, in certain selected patients, prostate artery embolisation may be discussed. Medicines, endoscopic surgery and embolisation do not have the same benefits, time to take effect or side effects.
Useful questions to ask
- Do my symptoms come from the prostate, an infection, a bladder disorder or another disease?
- Which tests (urine test, residual urine after urination, ultrasound, PSA) are useful in my case?
- Among monitoring, medicines, a procedure or embolisation, which option matches my symptoms, and with what side effects?
Frequently asked questions
Does PSA measure the severity of urinary symptoms?
No. It provides different information and is discussed according to the context.
Is embolisation intended for all patients?
No. It requires patient selection and a discussion of the alternatives.
This content provides general medical information. It does not replace a consultation or a personalised decision by your care team. In case of serious or sudden symptoms, contact the emergency services in your country or a doctor without delay.
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How to choose with the doctor?
The choice depends on the anatomy, the severity of the symptoms, expectations and the expertise available: it takes into account the prostate, the bladder, other diseases and the person’s priorities.