Bladder muscle and the interrupted intermittent stream

Most men, whose urinary stream is interrupted, are not aware that they have a common symptom of prostate enlargement. The prostate enlarges both outwardly and inwardly, compressing the urinary passageway, which runs through the prostate. It is through this passageway that urine must pass to leave the bladder and exit the body.

Progressive enlargement of the prostate, over a period of years gradually compresses that passageway making it increasingly difficult for urine to pass. At first, the bladder is able to handle the resistance to the flow of urine by contracting more powerfully; after all, the wall of the bladder consists of muscle and increasing the workload on a muscle will increase the strength of its contraction. That’s the way muscles react in the body; exercise them and they grow stronger and bigger.

But there is a limit; no muscle can grow bigger and stronger forever. When a weight lifter exercises too much, he stands the danger of becoming “muscle-bound.” Each muscle fiber may be bigger and stronger but its range of motion is shortened. The same thing happens in the bladder. The bladder pushes out all the urine it can with its shortened muscle fibers. Then it takes a rest, during which time, the muscle fibers regain their ability to contract and the stream starts again. What the person notices is an interrupted or intermittent urinary stream.

Treatment for this problem, meaning treatment for benign enlargement of the prostate, can consist of medical treatment, minimally invasive non-surgical treatment and surgical treatment.

Medical treatment may work well and consists of drugs that can shrink the prostate and other drugs that can relax the special type of muscle present in the prostate.

Another condition, overactive bladder is often associated with benign prostate enlargement and may require another class of drugs. A lifetime of daily drug therapy is expensive, bothersome and may be complicated not only by adverse side effects such as erectile or ejaculatory dysfunction, painful breast enlargement but also by possible drug interactions with medications the patient may require for other conditions.

Furthermore, medical treatment may be successful at first and then lose effectiveness. Surgical treatment should always be reserved as the court of last resort. This includes open surgery requiring a skin incision and the TURP (Roto-Rooter) and various laser surgeries, which are all done through the urinary passageway in the penis. All these surgical procedures require anesthesia and must be done in a hospital setting or equivalent.

Before undergoing surgery with its risks of anesthesia, hospitalization, catheterization, bleeding, blood transfusions, infection, erectile dysfunction and urinary incontinence, consider the advantages of the minimally invasive, one time office-based TherMatrx microwave treatment of the prostate. There is no anesthesia or hospitalization required and the results are long lasting. That is why I have recommended it for my patients for the past eight years.

Have a Question? Call Dr. Okun at 718-241-6767

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