From the age of 50, it is recommended that your doctor monitor your prostate. Sure signs can indicate to you an anomaly or, in any case, that it is time to consult. Doctor Richard Mallet, urologist, vice-president of the French Association of Urology (AFU), helps us identify these symptoms, which is essential to consider.
Summary of Prostate: 11 signs that should alert
1. A weak stream
2. Longer voiding time
3. A feeling of incomplete emptying
4. A need to push to urinate
5. Urinary leaks
6. Frequent urination
7. Several sunrises per night
8. Erectile dysfunction
9. Voiding burns
10. Blood in the urine
11. Back pain and bones
12. Screening: The right reflex
Did you know that one in two men start to have urinary problems from the age of 50? They are 80% after 60 years.
Symptoms related to a prostate problem are essentially a sign of adenoma, a benign enlarged prostate. From 25-30 years, the prostate grows and compresses the urethral canal, which can no longer appropriately evacuate urine. “As the urethra is cramped, the bladder contracts a little harder to try to empty itself explains the urologist. But over time, the obstructive phenomena become more and more present, pushing the bladder to adapt constantly. It will thicken and become more reactive “.
As for the symptoms that may indicate cancer prostate, there is none or very little and very late. “Cancer appears in a more peripheral part of the prostate, at a distance from the urethra and therefore cannot press on it,” specifies the specialist.
A weak stream
Your urine stream is less potent with less flow, and it goes less far than before. It can also be done intermittently. This is sometimes accompanied by unintentional droplets that lag behind after you have finished urinating.
Longer voiding time
As the power is weaker, the bladder takes longer to empty. Usually, the urine flow rate is greater than 15 ml / s, so for a 300 ml bladder, the urination time should be 20 s. There is no point in hurrying, but this lengthening of the urination time reflects the obstruction under the bladder, which may be related to the increase in the volume of the prostatic adenoma.
A feeling of incomplete emptying
This can be very uncomfortable because you may feel that you haven’t really finished or haven’t completely emptied your bladder at the end of your urination. We are talking about post-voiding residues.
This stagnation of urine in the bladder poses an additional risk of UTI.
A need to push to urinate
The phenomenon mainly occurs on the first urine in the morning or when the bladder is very complete. Urine does not come out spontaneously, takes a long time to settle. You have to make an effort to induce urination, which is usually long, stops, and then starts again.
House. They are classic and frequent. Urine cannot flow properly because of the size of the prostate; some of it remains in the bladder, which, after a while, forms an overflow (overflow incontinence). Urgent urinary incontinence can also occur because the bladder has to strain to empty, making it impatient and too reactive with involuntary contractions that generate uncontrollable losses. These phenomena are increased in winter with classic situations such as the urgent need to urinate when the hands are in contact with water or when the key is put in the lock on the front door of the house.
This increase in the frequency of urination, also called pollakiuria, is partly linked to poor bladder emptying. As the bladder is not emptied correctly with each urination, it fills faster, increasing the frequency of the need to urinate. In addition, the bladder must adapt to the obstruction by strengthening itself to be better empty. This is done to the detriment of its dilation capacities with a replacement of its elastic fibers by muscle fibers, which decreases its powers and causes this increase in urinary frequencies.
Be careful; frequent urination can be linked to increased hydration with normal volume urination without a prostate problem.
Several sunrises per night
Not only does urination tend to be more frequent during the day (more than 7 times a day), but it also increases at night. If you get up more than twice a night, it may indicate a prostate problem. We then speak of nocturia, one of the most troublesome symptoms in prostate disease because it induces a loss of quality of sleep.
It is common in men who have a prostate problem, but it has no direct relation to the prostate. Diabetes, obesity, tobacco consumption are instead at the origin of erectile disorder.
Specific treatments to improve the quality of voiding can sometimes cause erectile dysfunction or, more frequently, ejaculation disorders with a drop in sperm volume or even absence.
A urinary tract infection can occur, especially when the bladder emptying is imperfect, causing urinary burns. These burns can appear at the start of urination or even throughout urination during severe infections. In men, this urinary tract infection causes a prostate infection called prostatitis. It can also be accompanied by fever, chills, and increased frequency of urination and urgency.
Blood in the urine
An emission of blood during urination can be of prostatic origin, particularly at the start of the urinary stream. The phenomenon is related to an increase in prostate inflammation or the appearance of additional vessels on the surface in connection with the rise in the adenoma volume.
But beware, blood in the urine is most often related to bladder polyps, especially in patients who smoke. A medical consultation is essential, from the first episode of bleeding, with an exploration using a small camera in the bladder, under local anesthesia, to find the source of the bleeding (cystoscopy) and at least an ultrasound of the urinary tract.
Back pain and bones
These two symptoms can be caused by many diseases that have no connection with the prostate (low back pain, osteoarthritis, etc.).
If, however, they appear in the context of prostate disease, they are witnesses to a tumor that has already developed significantly. Cancer cells may have migrated to the bones. On the other hand, back pain is an obstruction of the kidneys that have started to swell due to the compression of the ureters by the tumor that grows into the bladder.
Screening: The right reflex
Suppose the problems with the evacuation of urine do not generally progress to cancer (only 15% of them). In that case, it is still important to treat them because they can over time lead to a urinary tract infection, a kidney disease … “in terms of quality of life, the more we long to develop a treatment, the more bladder is damaged, and symptoms increase,” laments the urologist Richard Mallet.
If you are over 50 and if symptoms appear, talk to your doctor, who will perform the physical examination (digital rectal exam) himself to check the condition of your prostate. If he is not comfortable, he will entrust the investigation to the prostate specialist, that is to say, the urologist. He will also prescribe a PSA (prostate-specific antigen: a blood marker specific to the prostate). This assay should not be carried out in isolation. Still, it should be part of a global vision comprising a digital rectal examination, an evaluation of the volume of the prostate, and a notion of the evolution of this marker.
Prostate screening is done between the ages of 50 and 75. “Then we assess the “benefit-risk” ratio, explains the specialist. Beyond the age of 75, as prostate cancer progresses slowly, we continue to do the digital rectal examination but without the PSA. There are familial and hereditary forms of prostate cancer that can lead to earlier detection. Screening is therefore proposed for these cases from the age of 45.
We keep in mind that the symptoms indicate a prostate problem. Still, they can also be caused by a completely different condition such as a urinary tract infection, a stricture of the urethra, a tumor of the bladder, stones, infectious or neurological problems.