Urination symptoms associated with benign prostatic hyperplasia (BPH) include difficulty in starting to urinate; a weak or intermittent urinary stream, or both; a sudden, strong desire to urinate (urinary urgency); an increased frequency of urination; frequent nighttime urination (nocturia); and a sensation that the bladder is not empty after urinating (evidenced by straining to urinate).
When urinary retention occurs, and as the bladder becomes more sensitive to retained urine, a man may become incontinent because he is unable to respond quickly enough to urinary urgency. A bladder infection or stone can cause burning or pain during urination. Blood in the urine (hematuria) may also be a sign of BPH, but most men with BPH do not experience it.
When urinary retention is an emergency
Sometimes a man with BPH suddenly becomes unable to urinate at all, even though his condition is responding to treatment. This problem, called acute urinary retention, requires immediate medical attention in a hospital emergency department. It is easily treated with catheterization-the passing of a tube through the urethra and into the bladder to allow the urine to drain.
Acute urinary retention may be triggered by an extended delay in urination, a urinary tract infection, alcohol intake, or use of certain drugs such as antidepressants, decongestants, and tranquilizers.
Acute urinary retention often occurs unexpectedly, and it is impossible to accurately predict whether a man with only modest urinary tract symptoms will develop the condition. Although retention will often resolve after a short period of “bladder rest” with catheterization, some men who experience acute urinary retention will need to undergo surgery to remove excess prostate tissue.