Better understand why you have difficulty urinating

Benign prostatic hyperplasia, also known as prostatic adenoma, is the most common cause of male urinary problems. This non-cancerous condition mainly affects men over the age of 50 and results in an enlargement of the prostate. The person concerned will then experience various problems: incontinence, urinary thrust, weakness of the urinary jet, delayed drops, urgent need to urinate, etc.

The proper functioning of the bladder is essential to the urination process. When the bladder has contraction problems, it is not surprising to see urinary problems appear.

Dysfunctional bladder contraction can be explained in three ways:

• Hypocontractility of the bladder: The bladder is distended and contracts poorly. This is the main cause of dysuria;
• An overactive bladder: the bladder contracts too frequently and involuntarily;
• An acontractile bladder: the bladder is all flaccid and no longer contracts. This situation facilitates urinary incontinence by overflow.

Because of their longer urethra, men are less prone to urinary tract infections than women. However, when they do occur, they can be more serious and just as painful.

Urinary tract infections are caused by the presence of bacteria. Depending on where they develop, there are four types of infections:

• Urethritis: is the presence and proliferation of germs in the urethra;
• Prostatitis: Prostatitis is when the urinary infection and/or inflammation affect the prostate. There are two types of prostatitis: acute prostatitis and chronic prostatitis. Prostatitis is often accompanied by fever, urinary burning, presence of blood in the urine, bladder emptying in bursts and frequent and urgent urges to urinate;
• Cystitis: Cystitis is a urinary infection located in the bladder. It is however very rare in men;
• Pyelonephritis: This is an inflammation of the kidney caused by an infection of bacteria. It does not occur on its own, but rather is the result of urethritis or cystitis. The infection starts in the bladder or urethra and then spreads to the kidney.

Prostate cancer represents a large part of male cancers (25%). Generally, the urinary disorders that result from it do not appear until very late. Since the cancer is silent in its early stages, symptoms or difficulties in urinating only occur when the cancer is already at an advanced stage.

When the urethra is blocked, the evacuation of urine becomes very difficult. If it is not unblocked quickly, urinary disorders start to appear. 

Urethral obstruction can be caused by urethral stenosis (narrowing of the urethral canal), an internal element (blood clot) or an external element (sand, crystals, etc.).

However, some causes of urinary disorders (benign prostatic hypertrophy, urethritis or prostate cancer) can also lead to urethral obstruction.

Like prostate cancer, kidney cancer usually has no symptoms in its early stages. It can only be identified through tests. However, blood in the urine can be a sign that kidney cancer is well established.

As people age, nearly 40% of people with diabetes begin to experience urinary problems. However, these people often have the annoying habit of not informing their doctor. This can be either out of modesty, negligence or ignorance.

Diabetes attacks the nerves of the bladder, which then becomes hypoactive or overactive. It also makes patients particularly vulnerable to urinary tract infections.

Some medications can cause difficulty in urinating in men. More precisely, it is a question of the side effects linked to their taking. This case concerns mainly the following categories:

• Muscle relaxants;
• Nasal decongestants;
• Antidepressant medications;
• Diuretic drugs.

The treatments concerned can lead to a decrease in the control of micturition and therefore to urinary incontinence. The symptoms observed are: urinary incontinence by pushing, by overflow, by impetuosity but also urinary retention. 

Although the bladder weakness caused by these medications is usually temporary, it is always wise to talk to your doctor. 

Trauma to the bladder and urethra can also explain the presence of urinary disorders. In fact, these traumas are actually urethral and bladder injuries. Apart from urinary incontinence, these traumas can lead to urinary retention, dysuria and blood in the urine.

Urination problems can be caused by an unstable emotional state, or the reason for their persistence. Two main psychological causes are often responsible:

• Depression: incontinence problems can affect people with a (very) fragile psychological state. These people have a severe lack of self-confidence and only have a distorted image of themselves and their bodies as portrayed by society and those around them. This loss of self-confidence, coupled with a state of renunciation, eventually impacts the pelvic floor. This leads to a loss of bladder control. Urinary difficulties such as leakage or retention begin to appear;
• Stress and anxiety: Since the emotional side is closely linked to the physical side, it is normal that instability of the former has repercussions on the latter. A person who is constantly stressed and/or anxious will feel the slightest tension in the bladder. They will then feel the need to urinate frequently and urgently, even if the bladder is not really full.

Various illnesses can cause difficulty in urinating in men (Parkinson’s disease, multiple sclerosis, strokes, etc.). Indeed, a properly functioning bladder depends on the cervical nervous system and the spinal cord. When these control points are affected by a neurological disorder, it is therefore logical to see urinary disorders. Of course, the type of urinary difficulties observed depends on the affected part, the ailment in question and the person concerned.

Generally, when the spinal cord is affected, the patient may suffer from urinary retention (complete or partial), frequent urination (urinary frequency), leakage, nocturia or the urge to urinate.

On the brain side, the urinary disorders noticed are practically the same (with less urinary retention). The frequency of urinary infections also increases drastically.