THE PROSTATE GLAND
The prostate is a gland that only men have. It is about the size of a walnut and sits below the neck of the bladder. It wraps around the urethra (urine tube). The prostate makes a milky fluid, which is part of semen. This fluid feeds the sperm.
It is normal for the prostate gland to get bigger as men get older. For some men this can cause bladder problems. The changes to the prostate gland happen over many years.
Poor bladder control can also happen due to other health issues. Men with poor bladder control can be upset and embarrassed by it. Talk to your doctor or continence nurse advisor if you have changes in your bladder control. You should also talk to your doctor about any concerns you have about your prostate gland.
WHAT ARE SOME COMMON PROSTATE PROBLEMS?
- Benign Prostatic Hyperplasia (BPH). This is when the prostate gets gradually larger. This often starts in middle age. About one in four men will need surgery for this problem. There are many successful treatments for prostate problems. BPH does not lead to cancer.
- Prostate Cancer. Prostate Cancer is often found before you have any warning signs. Your doctor may find it with a blood test called a PSA. They may find changes in your prostate with a digital rectal examination. This is a common cancer. There are treatments available which you can discuss with your doctor.
- Prostatitis. Prostatitis is swelling and soreness of the prostate gland. This may be due to a bladder infection. It is more common in young men.
Talk to your doctor if you have any pain or discomfort when you empty your bladder.
HOW DO I KNOW IF I HAVE A PROSTATE PROBLEM?
If you have one or more of the following symptoms, you may have a prostate problem:
- trouble starting the flow of urine
- slow urine stream once started
- needing to pass urine more often through the day or night
- leaking after passing urine or between visits to the toilet
- needing to pass urine again soon after going to the toilet
- feeling an urgent need to pass urine
- burning or pain when passing urine
- blood in urine
- feeling that the bladder is not fully empty after going to the toilet.
Some of these problems may not be due to the prostate. Some medicines may also cause the bladder to store up urine. Your doctor or continence nurse advisor can help you find the cause of your problem.
HOW CAN MY PROSTATE CAUSE BLADDER PROBLEMS?
Narrowing of the urethra (urine tube)
As the prostate grows larger, it may press on the urethra. This can stop the bladder from emptying. Urine may get stored up until it starts to leak out. If this happens, see a doctor straight away.
An overactive bladder and urgency
This can be caused if the bladder has to work extra hard to push the urine through a very narrow urethra. An enlarged prostate restricts the size of the urethra. An overactive bladder can tighten without your control. This can cause an urgent need to pass urine.
After surgery to ease the narrowing of the urethra you may still feel an urgent need to pass urine. Urgency could get worse until the bladder goes back to normal. This can take a few weeks. Surgery for prostate problems could damage the muscles and nerves of the urethra. This can cause poor bladder control. These problems are almost always short-lived. However, major surgery for prostate cancer can lead to long term bladder control problems.
HOW CAN POOR BLADDER CONTROL BE TREATED?
Your doctor or continence nurse advisor will look to find the cause of your poor bladder control. The treatment for your problem will depend on its cause.
The health professional will check for such things as prostate disease, infection and diabetes. They will also want to know what medicines you are taking. Some medicines can cause bladder problems.
There are a few different ways poor bladder control can be treated.
- Talk with your doctor. Together you may decide that you do not need any treatment. Poor bladder control can get better with time. It can improve with simple changes to your daily habits. See ‘Good Bladder Habits for Everyone’.
- Medicines.There are a number of medicines that can help with bladder control. Ask your doctor about these.
- Prostate surgery. If your prostate is the problem, then surgery can remove all or part of the prostate gland. The type of surgery depends on what is wrong with your prostate gland.
- Bladder training. A bladder training program may help the bladder to hold more urine without leaks or urgent feelings. This also helps those with an overactive bladder.
- Pelvic floor muscle training. Pelvic floor muscle training strengthens the muscles. These muscles control how well the bladder and bowel work. Learn how to train your muscles before surgery and start pelvic floor muscle training as soon as you can after surgery. See ‘Pelvic Floor Muscle Training for Men’.
- Continence products. There are a wide range of continence products to help cope with urine leaks.
Make sure you know enough about:
- what the problem is
- what your treatments options are
- how well they work
- what might go wrong.
With your doctor’s help you can choose the treatment that is best for you.
You are not alone. Poor bladder and bowel control can be cured or better managed with the right treatment. If you do nothing, it might get worse.
Phone expert advisors on the National Continence Helpline for free:
- information about local services.
1800 33 00 66* (8am–8pm Monday to Friday AEST)
To arrange for an interpreter through the Translating and Interpreting Service (TIS National), phone 13 14 50 Monday to Friday and ask for the National Continence Helpline. Information in other languages is also available from continence.org.au/other-languages
For more information: continence.org.au, pelvicfloorfirst.org.au, health.gov.au/bladder-bowel
* Calls from mobiles are charged at applicable rates.