Prostatism is a urinary tract disorder primarily seen among older men, where enlargement of the prostate gland leads to complete or partial urinary obstruction. This condition is more properly known as lower urinary tract symptoms (LUTS), and while it is common in older men, those who experience difficulty urinating should not assume it is a normal part of aging. It can sometimes be a sign of malignancy, and it is important to receive a medical evaluation.
In patients with prostatism, the prostate gland swells and starts to press on the urethra. Some patients start to retain urine, which can cause discomfort in the bladder as well as lead to inflammation and infections. Others may only be able to urinate with difficulty. Prostatism often causes the urge to urinate while only producing a dribble. Patients can start to have trouble with weak, intermittent streams of urine, leading to problems like urinating on clothing or the floor by accident.
Prostate enlargement does tend to occur naturally with age, but it can also be the result of cancer. A doctor can perform an evaluation to find out what is going on and determine the best treatment option. Some prostate cancers grow very slowly, and if a man is very old, the doctor may recommend not treating it, as the patient will likely die of other causes before the cancer becomes a problem. In young patients or patients with more aggressive cancers, surgery, radiation, and chemotherapy may be available treatment options.
In an examination of a patient with prostatism, the doctor may request a urine sample to check for inflammation and will perform a physical examination to determine the extent of the enlargement. Medical imaging studies are sometimes useful for evaluating the patient’s condition. The doctor will also take a history, taking special note of any family history of prostate problems, as this could influence decisions about treatment recommendations. If no treatment appears to be necessary, the doctor will want to monitor the patient for any changes.
Prostatism can be frustrating for patients. Problems with bladder control may require the patient to wear a diaper in case of accidents, and some patients find this humiliating or unpleasant. The risk of making messes in the bathroom can also be a cause for concern. The loss of control can also contribute to unpleasant personal odors unless a man is attentive about genital hygiene and caring properly for underclothes and pants.