ACUTE URINE RETENTION
In this busy, busy world of ours, many men are working so hard and going so fast that they don’t take time for regular physical checkups. Some never think about prostate problems until it’s almost too late.
Again the symptoms of BPH can slip up on a busy man. He simply figures that by sixty-three he should be urinating more often and he’s heard other men talk about needing to get up at night once or twice. He thinks nothing of it.
Then one day he needs to urinate but can’t. He stands there waiting and then straining but he can’t pass even a few drops and he’s hurting like crazy. Soon the pain is so agonizing that he calls his doctor or rushes down to a hospital emergency room to find out what’s the matter.
A catheter drains the urine from the distended bladder and relieves the problem. Some patients with acute urine retention might be holding as much as a quart of urine. Most patients will look much better within minutes and feel fine in an hour or so.
A sudden attack of acute urine retention can happen to almost any man who has some obstruction already in his urethra. There are also conditions that can bring on such attacks.

Prolonged exposure to the cold, especially if you are not used to it can sometimes bring on such an attack. Drinking alcohol by someone not used to it. The sudden use of antihistamines is also a culprit in this case.
Such an attack is usually enough for the patient to have his prostate checked critically by an urologist who will advise him if any treatment or surgery is needed — as well as suggestions about how to prevent such an attack in the future.
So, there is your primer on BPH, its symptoms and some details about the problems it brings up. Now, is there a way to live with these problems during that time when the doctor recommends no major treatment is needed. We’ll look at that in the next chapter.

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WHAT PROBLEMS CAN EXTREME PROSTATE
ENLARGEMENT CAUSE?
Silent Prostatism. Sometimes the prostate will enlarge and there are none of the usual symptoms. The urethra continues to close but somehow the man simply doesn’t realize the problem or decides that he’s just getting old and the “water works” sometimes doesn’t work right for him.
If this condition builds and builds, more and more urine can be left in the bladder that can’t be expelled in urination. This can result in a serious problem. The patient will become excessively tired and feel weak, he will be irritable and could suddenly collapse or even lapse into a coma.
When large amounts of urine are left in the bladder and it isn’t strong enough to expel the liquid through a narrowing urethra, serious damage can occur. This can lead to a serious backflow pressure of the urine on the kidneys. At the most serious, such a problem can cause kidney failure and a quick death.
In cases like this the patient needs to get to a hospital quickly so a catheter can be used to drain the bladder. With the emptying of the bladder, the patient will feel much better almost at once. Then the doctors will watch to see if any permanent damage was done to the kidneys and if so what additional treatment might be needed.
Depending on the seriousness of the situation, the patient’s normal kidney function should come back after a week to three months. At that time the prostate should be checked for size to see if prostate surgery or some other treatment is required.
CONGESTION OF THE PROSTATE
Sometimes after normal BPH symptoms in a patient, an urologist will find only a moderately enlarged prostate but one that is mildly congested. There often is no sign of infection. Typically there might be a minor amount of urine that can’t be drained from the bladder during urination.
Often there will be some form of obstruction at the bladder outlet which also restricts bladder emptying.
At this point there is no major problem for the patient and he would be put on a maintenance program to have his prostate checked regularly.
As the prostate grows and the bladder muscles are forced to work harder and harder to push the urine through the narrowing urethra, the bladder can become fatigued. In some cases the bladder will simply quit functioning and urine buildup occurs in the bladder.
This can form a place where bacteria can grow and multiply rapidly. When this happens the patient feels a burning pain when he urinates. Sometimes the urine will have a bad odor and traces of blood can show in the urine.
A danger here is urinary infection, which is usually signalled in the patient by a burning sensation when urinating, chills or fever and the intensification of his regular BPH symptoms.
Here, as in other early symptoms of BPH, the patient may go for several years without any more serious problems than his minor BPH problems.
On the other hand the congestion may increase, and if this happens the patient’s urologist may suggest a prostate massage. Here the prostate is massaged digitally through the rectum and the congested fluid is expelled. This makes the heaviness vanish and a more normal life returns.
The urologist may suggest that a patient have regular prostate massages to relieve the congestion. Or it may be relieved by regular ejaculations through intercourse or masturbation.
Some urologists never recommend repeated prostatic massages. But all suggest in situations like this that the patient should avoid long periods of exposure to intense cold weather, should avoid most spicy foods, should sharply reduce the use of alcoholic beverages, should avoid antihistamines, and they recommend the patient to take warm baths often.
Any shift or intensifying or change in symptoms of the BPH should be reported to the patient’s physician or urologist at once.

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