Poor urine flow can be due to obstruction to flow such as a stricture urethra (narrowing in the urine tube) or prostatic enlargement. Occasionally this can be due to weak bladder musculature.
This is a normal process of ageing whereby the prostate enlarges in size. It can obstruct the flow of urine by impinging on the urethra.
BPH treatment is aimed at improving the lifestyle of the person involved and treatment is only necessary if the symptoms are moderate to severe. Mild symptoms require lifestyle modifications. A consultation with a Urologist is required to discuss this further.
For moderate and severe symptoms –
Several options include – urolift procedure, transurethral surgery and Greenlight laser ablation to remove the enlarged portion of the prostate.
Surgery for the treatment of BPH, by either TURP or open prostatectomy, only removes a part of the prostate gland; the section around the urethra that is blocking urine flow is removed. Prostate cancer is often treated by a radical prostatectomy where the whole prostate gland is removed.
Alpha blockers (Prazosin, Tamsulosin, Alfuzosin, Terazosin) – giddiness, dizziness, nasal congestion, retrograde ejaculation (semen goes back in the bladder rather than out the urethra on ejaculation), fatigue, precipitation of narrow angle glaucoma.
Caution – avoid if undergoing cataract surgery in the near future. Please refer to specific drug pamphlet for drug interactions and further useful information.
5 Alpha Reductase Inhibitors (Finasteride, Dutasteride) – fatigue, tiredness, decrease in libido decrease in ejaculate, erectile dysfunction, breast tenderness.
Caution – needs regular PSA assessment. This drug reduces the PSA levels and prostate cancer can occur at lower levels of PSA. Please refer to specific drug pamphlet for drug interactions and other useful information.
Combination therapy – alpha blocker along with 5 ARI.