Guest post featuring Franklin C. Lowe, MD, MPH , Associate Director, Department of Urology, Mount Sinai St. Luke’s and Mount Sinai Roosevelt
There are changes and challenges that come with getting older. Some may be hard to detect but can affect your quality of life. As men move through middle age, it becomes more likely their prostates will grow and could cause problems related to urination. According to Dr. Franklin C. Lowe , a urologist and the Associate Director of the Department of Urology at St. Luke’s and Roosevelt Hospitals, prostate-related problems can range from annoying to debilitating.
Why prostate health matters
The prostate is a walnut-sized internal gland that surrounds the urethra, the tube that connects the bladder to the penis. Its primary function is to provide semen for reproductive purposes, but because of its location, prostate conditions can also affect urinary function. “Enlargement causes compression of the urethra as well as obstruction at the bladder neck, or the opening of the bladder to the urethra,” says Dr. Lowe. “As a result, the bladder muscle thickens, becomes less flexible and is frequently a contributing factor to the urinary symptoms men have as they get older.”
A quality of life issue
Symptoms of an enlarged prostate fall into two categories: obstructive, or voiding, which prevents easy urination; and irritative/storage, which relates to urinary frequency and urgency.
Obstructive/voiding symptoms:
- Inability to empty the bladder
- Weak stream
- Hesitancy, or difficulty starting to urinate
- Dribbling after urinating
Irritative/storage symptoms:
- Frequent urinations, particularly at night
- Urgent need to urinate
- Incontinence
When men come in for a prostate exam, they are asked to identify which symptoms they have, how often they notice them and how their quality of life is affected.
Sooner or later, Dr. Lowe says, most men will have an enlarged prostate. “Men usually start to notice symptoms in their late 40s or early 50s. By age 60, about 60 percent of men will have significant prostate problems, and by age 80, that number jumpst to 80 percent,” he says.
An easier problem to treat
A generation ago, men with significant prostate problems had no choice but surgery to remove the gland. These days, solutions are much less invasive. In fact, medications, such as the following, can help many men feel a lot better.
Alpha blockers relax the bladder neck in the prostatic capsule, allowing easier urination.
5-alpha-reductase inhibitors are hormonal agents that block conversion of testosterone to dihydrotestosterone, or DHT, which can decrease the size of the prostate by 20 to 25 percent.
Overactive bladder, or OAB, drugs can help relax the bladder and reduce irritative symptoms. “Many men like these drugs because they have additional benefits for their sexual function,” Dr. Lowe says.
All men should think about their prostate gland as they age, and monitor any problems through an annual check-up with their primary care physician. Men over 50 should be regularly screened for prostate cancer with the PSA blood test.
Talk with your primary care doctor if you’re having any prostate problems so you can be referred to a urologist. For more information visit the