More often than not growing age is accompanied by urination problems. Every third male Austrian suffers from these health problems, which means that more than 300 000 are afflicted.

How do these problems occur?

Two groups of health troubles can be identified here, the first one comprising so-called irritative symptoms such as the spontaneous desire to void one’s bladder, the one that re-occurs during the night and the incessant one, caused by running water.

The second group includes so-called water retention troubles, among them being the feeling of not having completely voided the bladder after micturition, a weak urinary stream or a considerably long time of urination. Most frequently do they all have a strong negative impact on life. Many of those suffering tend to withdraw from society, let their ways being determined by where a toilet is stay away from cultural life or try to avoid longer journeys by cars or buses. They are prone to get lonely and isolated by keeping up these habits.

Which examination is indicated here?

What is most important here is a broad anamnesis and a minute listing of current medication. Examinations themselves include the measuring of the urinary stream, a urinalysis, an ultra-sonic check-up of the kidneys and the amount of residual urine, which is the amount of urine staying back in the bladder after micturition, the measuring of the prostate size and, last but not least, the determination of the PSA value via blood sampling.

Therapeutic measures

Adjusting drinking habits and medication can often relieve the situation.

Medication

So-called alpha 1 receptor antagonists cause both, the bladder-neck and the prostate to relax. It is the sympathetic nervous system that comes in here. This medication rarely shows by-effects, with the major ones being a reduction of the blood pressure and retrograde ejaculation (the ejaculate goes back into the bladder). Numerous studies have shown that the impact of this medication dwindles gradually in years (only after two years 40 out of a hundred of men experienced this phenomenon).

The second group comprises the so-called 5 alpha reductase inhibitors. This hormonal approach cause the prostate to shrink within months which, in turn, causes the urine stream to increase and the amount of residual urine to decrease. major by-effects include erectile weakness and the disappearance of seminal discharge. Also gynecomastia and chest-pain have been reported.

A new therapeutic approach is Tadalafil, which is commonly used to cure erection problems. Studies have also shown its potential to reduce micturition troubles and has therefore proved a fine therapeutic measure to pick.

Urination disorders are most often accompanied by erection problems.

Various surgical options

If medication does not suffice only surgery remains.

The operation is carried out via the urethra (transurethral resection of the prostate), which is gold standard. This surgical intervention is the most frequent one with men aged 50 and higher and patients stay in hospital for a short time only. Other methods work the same way (laser operation, green light laser, holmium laser, vapour ablation)

After reducing prostate tissue the urinary stream increases while the amount of residual urine dwindles.

These methods are all the same if used by hands of experience.