It’s a man thing

The older man complaining of waterworks troubles is something of a comic cliché - you could almost say it's the male equivalent of the middle-aged woman having hot flushes.

But in either case, it’s not at all funny if it’s happening to you.

Urination problems in men of a certain age are, however, surprisingly common. Experts estimate around six out of 10 aged 60 or older suffer from them. And the most common cause is prostate enlargement, or benign prostatic hyperplasia (BPH).

The prostate gland is a walnut-sized gland found in the pelvis, between the penis and bladder. Wrapped around the urethra (the tube that carries urine from the bladder down through the penis), the prostate’s function is to produce prostatic fluid, which is found in semen. So when this gland becomes enlarged due to an overgrowth of cells, it puts pressure on both the bladder and the urethra. This in turn causes problems such as difficulty in starting to urinate, weak urine flow, frequent urges to pass urine (since the bladder isn’t emptied fully) and dribbling before and after urinating. Other symptoms include pain on urination (or dysuria) as well as blood in the urine (hematuria).

What causes BPH?

Experts still aren’t sure why some men suffer from prostate enlargement while others don’t. However, one thing most are agreed on is the fact that it has something to do with the changes in hormone levels that come with ageing. And while many of the symptoms of BPH are similar to those of some types of prostate cancer, experts also agree that it doesn’t increase your risk of developing prostate cancer (in fact, men with BPH have a similar risk of developing prostate cancer as men without BPH).

That said, however, if you do experience any urination problems, always consult your GP, since it’s important to rule out prostate cancer as well as prevent complications of BPH such as urinary tract infections. If you’re not sure what to do, ask your pharmacist for advice.

Tests and treatments

There are several tests your GP can perform or organise that can diagnose the extent of the problem. If your symptoms are mild, you may not need any treatment at all – you may, however, receive regular check-ups, just to keep an eye on things. Various prescription medicines are used to treat moderate-to-severe prostate enlargement, including finasteride or dutasteride. Called 5-alpha-reductase inhibitors, these drugs block the effects of a hormone called dihydrotestosterone. Using these prescription drugs may shrink the size of an enlarged prostate gland by up to a third.

On the downside drugs such as finasteride and dutasteride may produce side-effects such as erection difficulties and reduced sex drive. However, they tend to only be used in the short term – typically for six months – after which any side-effects disappear.

Other medicines called alpha blockers are used to treat BPH too. These help your bladder muscles relax, making it easier to urinate. If your symptoms fail to respond to BPH drug treatments, then the other option is surgery – though this is usually only recommended to men experiencing severe prostate enlargement symptoms.

Prevention strategies

If you haven’t suffered any waterworks problems yet, is there anything you can do to prevent them? Unsurprisingly, the fitter and healthier you are, the smaller your risk of developing BPH. Some experts also believe eating lots of dairy foods and red meat may increase your risk for BPH, as may being overweight or not getting enough exercise.

Eating a healthy, balanced diet can help keep your weight down. Aim to get at least five portions of fruit and vegetables in your diet every day, and opt for non-red meat protein sources, such as chicken, fish and beans/pulses. Health experts also believe 30 minutes of moderate-intensity exercise a day, five days a week, may help reduce your risk of developing BPH by up to half – which is as good an excuse to get active on a regular basis as any.

Prostate resource:

PROSTATE UK www.prostateuk.org

MEN’S HEALTH FORUM www.malehealth.co.uk

PROSTATE CANCER CHARITY www.prostate-cancer.org.uk