Complaints & connections · borters.ch
Size does not decide — the burden does. And before everything is ascribed to the prostate, the heart, the sugar and the medication list belong looked at.
Also known as: BPH · benign prostatic hyperplasia
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
The prostate goes on growing slowly from about forty. That is not an illness but the normal case — it becomes troublesome only when the growth presses inward and narrows the path of the urethra. Decisive and often surprising: the size says little about how strong the complaints are. A small prostate can disturb a great deal, a large one not at all. Two groups of complaints can be told apart, and they need different things. In storing, the bladder announces itself too often and too urgently, at night as well. In emptying, it takes a while to start, the stream is weak, it dribbles afterwards, the feeling of complete emptying is missing. Before everything is ascribed to the prostate, a look at the alternatives is worthwhile: passing water at night often comes from a weak heart, from water tablets taken in the evening, or from blood sugar that is too high. And a series of common medicines clearly worsens emptying — remedies against allergy, decongestant nasal sprays and cold preparations, antispasmodics and opioids. Treatment follows the burden, not the centimetres; waiting is an expressly permitted choice. The most helpful preparation for the appointment is a bladder diary over two days.
A benign enlargement raises the PSA by itself — so a high value proves nothing. The order is what matters: repeat calmly first, and if it is confirmed, put the MRI before the tissue sample.
The benign enlargement does not hurt. If pressure at the perineum, pain on sitting or on ejaculation are added, that is a different matter.
Time, amount, urgency, what was drunk and when. That answers in one minute what otherwise takes several appointments — above all whether it is too much urine or too often.
Antihistamines, decongestant nasal and cold remedies, antispasmodics, some antidepressants and opioids worsen emptying. Often leaving something out brings more than adding anything.
Hold back in the last two hours before bed, but drink normally during the day. Drinking less overall is not a good idea, because concentrated urine irritates the bladder further. Alcohol and coffee in the evening also matter a lot here.
The common alpha blockers change the iris and make cataract surgery harder if they are not known about. Even ones stopped long ago belong mentioned.
Someone who stores water in the legs by day passes it at night. That explains a good part of the night-time waking — and is not improved by treating the prostate.
An ultrasound measurement after passing water, painless and done in two minutes. It separates the harmless situation from the one needing treatment better than any description.
Alpha blockers relax the muscle in prostate and bladder neck — the stream improves within days, the prostate stays the same size. 5-alpha-reductase inhibitors do shrink it, but they need six to twelve months.
From fifty, about half of men are affected, and from eighty almost all. The prostate grows slowly over decades; the symptoms depend less on its size than on which way it grows.
Hesitancy at the start, a weak stream, dribbling afterwards: these are the emptying signs. They speak most for the narrowing.
The commonest and least specific sign. If the legs swell during the day and the water comes at night, the heart is the likelier explanation than the prostate.
That is a storage sign. It comes from the irritated bladder muscle and often needs something other than treating the narrowing itself.
Decongestants and antihistamines can tip an existing narrowing into a complete blockage. It is the commonest avoidable trigger of retention.
If residual urine stays behind, that is a breeding ground. Recurring infections in a man therefore always belong clarified.
It rises with the benign enlargement too, so it is not a pure cancer value. It is not measured shortly after cycling, sex or a urine infection — and drugs of the 5-alpha-reductase inhibitor group halve it, so the value is then read doubled.
If the bladder chronically fails to empty, pressure backs up into the kidneys. A rising creatinine is therefore a reason not to wait any longer.
Passing water often in large amounts with thirst is first a sugar question and only then a prostate question.
Blood or signs of inflammation in the urine belong clarified in their own right and not ascribed to the prostate.
May ease symptoms (moderate evidence).
Against getting up at night the spread matters more than the total: little in the last two hours before sleep, coffee and alcohol left out in the evening.
Pumpkin seed extract showed small improvements in symptom score over 12 months. Lycopene from cooked tomatoes is observationally linked with fewer prostate complaints; that is not proof.
Nettle root and saw palmetto are the classic plant remedies; the studies are inconsistent.
Regular movement goes together with fewer complaints in observational studies.
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