Urinary problems are common during all stages of a man's life. These are stressful events which disrupt the voiding and storage functions of the bladder. This week we take a look at symptoms men experience as a result of problems in the lower urinary tract.

Frequency

This is the need to pass urine less than two hours after urinating. This problem may be associated with infections of the genitary tract, especially if the man experiences burning pain during urination. Men with large prostates often suffer from urinary frequency.

Incomplete emptying

This is the sensation of not emptying your bladder completely after you finish urinating. This symptom is caused by bladder outflow obstruction by an enlarged prostate or by poor neurologic function of the bladder. A man who experiences this problem should visit his doctor.

Intermittency

The need to stop and start again several times when urinating is called intermittency. This frustrating problem is common in men with enlarged prostates, which prevent the bladder from emptying efficiently.

Urgency

The difficulty a man experiences when he tries to postpone urination is called urgency. This occurs when waves of contractions present in the bladder's detrusor muscle at inappropriate times, causing a build-up of pressure in the bladder and leading to urine leakage. Ugency may also be due to large prostates, but sometimes the cause is unknown.

Weak stream and straining

A weak stream occurs when the stream during urination is passed with little force. Straining describes the man's need to strain or push when beginning urination. These symptoms occur when there is bladder-outlet obstruction.

Post-urination dribbling

This is the trickling of a small amount of urine after the man completes urination. Up to 25 per cent of men may have this as a normal occurrence. However, it may be linked to serious problems if it is a new occurrence in an adult man. This problem is caused by urine trapped in the urethra. Massaging the penis from the pubic area forward will help to relieve this problem.

Nocturia

This describes the frequency with which a man is forced to awaken from his sleep to urinate. This occurs in medical conditions such as diabetes, hypertension and problems with the bladder's detrusor muscle. Enlarged prostates will also cause this problem.

Incontinence

Most males achieve control of their urine by age four. The loss of the ability to control urine flow from the bladder into the penis is called incontinence. Urge incontinence may be due to bladder instability and bladder outlet obstruction. This is manifested as urgency, frequency and nocturia. Stress incontinence is due to weakness of the distal-uretral sphincter which forms a contracting ring at the neck of the bladder. This problem occurs when the sphincter is damaged during surgery on the prostate. Men complain of leaking urine when they cough, laugh or stand up quickly.

Visit a health-care provider

These problems cause physical and emotional distress for men of all ages. Any of these symptoms should cause men to visit their health-care provider promptly. The man will be required to complete tests to determine the cause of the symptoms. Once a cause or diagnosis is identified, treatment may involve behaviour modification, medication or surgery.

Dr Pauline Williams-Green is a family physician and president of the Caribbean College of Family Physicians. Email: yourhealth@gleanerjm.com.