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The Prostate and Bladder Connection

Male Bladder and Prostate

In around 2000, a significant shift in the approach to male lower urinary symptoms (LUTS) occured as knowledge of LUTS expanded. In 2001, the International Continence Society categorized the term overactive bladder (OAB) to describe the increasingly more prevalent symptom picture of urinary urgency, with or without day frequency, night frequency and incontinence due to urgency, or not reaching the toilet in time.

Men often attribute their LUTS to the prostate but this is only half the story. Male urinary symptoms of difficulty emptying/voiding, such as hesitancy, intermittency, weak stream, dribbling and feeling that bladder hasn’t fully emptied are likely symptoms due to prostate enlargement.

The symptom of nocturia (getting out of bed at night for the toilet, the most bothersome symptom) may be due to the prostate but may equally be due to a bladder storage problem of overactive bladder (OAB). Symptoms of OAB also include increased urinary urgency, frequency and accidents if the toilet isn’t reached in time.

Association between male LUTS, OAB and BPH

A male LUTS approach that focusses only on the prostate, neglecting the bladder, is inadequate with the current knowledge of bladder involvement. This also explains why many men find their prostate formula does not provide the complete array of results they were expecting. Many formulations target the prostate but some can target both the bladder and prostate for a comprehensive approach to male LUTS. 

The Prostate

The prostate plays a vital role in the male reproductive system so it is essential for men to take care of prostate health. The prostate is a walnut-sized gland, situated between the penis and the bladder. It wraps around the urethra, (which allows urine to flow out of the body), and during ejaculation it contracts to close the opening between the bladder and urethra, to release semen. 

The Bladder

The main role of the bladder is to store urine. It is about the size of a pear when empty and can expand to grapefruit size when full. The bladder is layers of smooth muscle that expand and relax as the bladder fills, and then contract when it receives instructions to empty. This is co-ordinated with nerve impulses that are triggered by pressure on the bladder wall as it fills with urine, the pelvic floor muscles underneath the bladder, and the urinary sphincter, which remains closed until you tell the bladder to empty. With a healthy bladder this process is under your conscious control. 

What are LUTS?

LUTS, ‘Lower Urinary Tract Symptoms’, describes problems of the bladder, prostate and urethra. LUTS affect more than half of men over the age of 50. So these are common problems.

LUTS are divided into three groups: problems storing urine, passing urine (voiding) and painful symptoms. Some LUTS originate from the prostate, and some from the bladder.

Storage LUTS include excessive urinary frequency (more than 8 times in a 24-hour period), urgency or rushing for the toilet; bladder accidents if you don’t reach the toilet in time, and nocturia or getting out of bed at night for the toilet. Storage LUTS are often due to an overactive bladder (OAB).

Voiding LUTS include weak urinary stream, stop-start urination, dribbling at the end of urination and the feeling that the bladder hasn’t fully emptied. Voiding LUTS are commonly due to a benign enlargement of the prostate gland (BPH).

As most men with LUTS have a combination of storage and voiding issues, both bladder and prostate support is essential.