Frequent urination is attributed by most men to a sick prostate. In middle age, this is only somewhat true.
Primarily then it is chronic inflammation of the prostate gland, the so-called chronic prostatitis.
This disease is characterized by seasonal occurrence. Namely, cold provokes ailments, so it is clear that in winter more people will have problems related to inflammation of the prostate gland. There is a frequent urge to urinate, a thinner and intermittent jet, and a drip at the end of urination. Blunt pain in the perineum, pressure in the lower abdomen , and occasional pain in the testicles is also typical. Chronic prostatitis can be caused by bacteria. In this case, in the ejaculate or swabs of the urethra we will find causative agents such as E-coli, Enterokok, Chlamydia, Ureaplasma, etc. Urine cultures are usually sterile in the process.
In addition to this group of chronic prostatitis, there are also the so-called nonbacterial, in which it is not possible to prove the existence of bacteria, where there is no difference in symptoms. In middle-aged men, frequent urination may, however, also be due to hypertrophy of the bladder neck. It is a muscle at the bottom of the bladder, which as a valve regulates the emptying of the bladder. In this case, all the tests performed will indicate that the prostate is healthy, and the diagnosis will be made on the basis of a uretroscopic (cystoscopic) finding.
In a small number of cases, a narrowing of the urethra can be found as a result of its earlier injury or inflammation.
Frequent urination can also be due to impaired innervation of the bladder. That is, on its way from the urination center in the cortex of the brain to the bladder, nerve fibers can be pressed (usually disc prolapse between the vertebrae) or damaged, as is seen with diabetes, multiple sclerosis or Parkinsonism.
A benign enlargement of the prostate or prostate adenoma, is the most common cause of urination problems in older men. Thin and intermittent jet, urination in two acts, occasional immediate urge to urinate, the sensation of incomplete emptying of the bladder or repeated urination during the night, are some of the symptoms associated with this disease. It rarely occurs before the age of forty, but as many as 75% of men aged over fifty have some of the symptoms.
From the age of 50, one should also think about the possibility of prostate cancer. There are no specific symptoms for prostate cancer (e.g. blood in the urine is not typical!). In the diagnosis of this disease, we are helped to determine PSA (prostate specific antigen). Various diseases of the prostate can cause an increase in PSA, namely a benign increase, inflammation and cancer. Therefore, the finding of an elevated PSA does not necessarily mean that it is a cancer. At the same time, PSA values within the limits do not exclude 100% of cancer, since 10% of patients have prostate cancer and a neat PSA, so this finding should always be supplemented with digitorectal examination and, if necessary, transrectal ultrasound.
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