Real prostatic symptoms should not simply be tolerated as ‘old age’ but some symptoms could be due to other causes. As people get older, all their bodily functions can deteriorate and this includes the bladder. Irritative symptoms, such as frequency or urgency, are most likely to occur in this way.
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One common problem is needing to pass urine in the night. This affects elderly women as much as elderly men, and many men who have prostate operations are disappointed to find that they still have to get up in the night afterwards. Older people tend to sleep less well; they pass urine because they are awake, rather than being woken by the need to pass urine. Sometimes the kidneys are not as good at restricting the amount of urine they make in the night, and some drugs increase the amount of urine.
Some diseases, like diabetes, which may start in old age, can increase urine production and will affect the number of times the bladder needs to be emptied. Some diseases of the nervous system, including strokes and Parkinson’s disease, can affect the bladder.
A change in lifestyle may also cause trouble. After retiring from work, many men drink more tea or coffee than before, or visit the pub at lunchtime. More fluid in means more fluid out – and therefore they need to pass urine more often.
Trouble with your bladder does not have to be an inevitable feature of getting old. However, when it is due to the prostate, a prostate operation is not an infallible cure for every urinary symptom. Sometimes it must be avoided as it might make things worse. Before having any treatment, the condition must be properly assessed.
Blood in the Urine
It is most important that blood in the urine (haematuria) should not be considered a ‘prostate symptom’, because up to a third of the people seen by urologists with this symptom are found to have something potentially serious, such as a tumour in the bladder or (less often) a tumour in the kidney.
Many of these tumours are not frankly cancerous and can be cured. In all cases, the sooner they are diagnosed, the more likely they are to be cured and the easier the treatment will be.
Blood in the urine is investigated by using an X-ray procedure called an intravenous urogram (or sometimes an ultrasound scan) and a cystoscopy. If you see blood in your urine, do not ignore it, even if it goes away. You should see your doctor straight away.
Sometimes, blood that is not visible to the naked eye is found when a urine specimen is tested. Although this is less likely to be due to something serious than visible bleeding, it is still best to have it checked out.