How Irritative Symptoms Develop
The obstructive symptoms described above may not be too troublesome. However, the bladder has to work harder to overcome the obstruction and, after a while, this can affect the way it behaves. Some men develop irritative symptoms. They need to pass urine very often (frequency), with a feeling of getting caught short (urgency) that can become so bad that wetting occurs. If these symptoms continue during the night (nocturia), loss of sleep also becomes a problem.
This can be a great nuisance, not only to the man himself, who may have to avoid long journeys and need to plan shopping trips around the local public lavatories, but also to his family, friends and colleagues, who may not always be sympathetic.
In fact, friends and relatives are often more aware of the problem than the sufferer himself, who slowly adjusts his activities to cope with the symptoms and accepts them as part of life.
Often a patient is sent to seek treatment by his wife, whose sleep is continually interrupted by his trips to the bathroom.
Chronic Retention of Urine
Painless retention (chronic retention) of urine occurs over months or years as the bladder slowly fills up until it may reach four or five times its normal size. Men are not usually aware this is happening, but sometimes the overfull bladder leaks urine, causing wetness. In a few cases, the pressure in the bladder can rise and this can damage the kidneys. This is fairly rare, but although most men with prostate disorders are very unlikely to develop kidney failure, proper treatment in the early stages will cure it completely, so it is important that tests are done to rule it out.
If the bladder cannot empty properly, any urine that is left in it may become infected or might form crystals that grow into bladder stones. If the urine becomes infected, it may cause a burning sensation, called ‘dysuria’, when it is passed.
A prostate operation may be needed for repeated infections but sometimes they are a symptom of prostatitis.
Sometimes a large prostate can bleed, but bleeding is more likely to be due to some other cause and must always be investigated. Very occasionally, repeated troublesome bleeding is a reason for operating on the prostate.