Prostate and urinary symptoms

What usually happens

If you suddenly cannot pass urine at all and your bladder feels painfully full, that needs same-day help — go to an emergency department rather than waiting for an appointment.

These symptoms usually are not cancer. An enlarged prostate and prostate cancer are different things, and the enlargement that causes these symptoms is the common, non-cancerous kind. Fear of the answer is the main reason men wait years, and the waiting is the part that costs.

How much it bothers you is the deciding factor. Mild symptoms that do not interfere with your life can reasonably be watched rather than treated — that is a legitimate plan, not a refusal.

There are options between doing nothing and surgery. Fluid timing and bladder habits, several kinds of medication, and procedures form a ladder, and most men never reach the top of it.

At your appointment

We will ask about your stream, starting and stopping, urgency, and how many times you are up at night — and how much each of those actually affects you.

We will usually examine the prostate and discuss a PSA blood test, including what it can and cannot tell you, since it is a test worth understanding before having.

We may ask you to keep a short diary of drinks and bathroom trips. It is more useful than it sounds, and often changes the plan.

We will agree what to try and when to review, including what would make us reassess sooner.

Worth asking

• —Do my symptoms suggest anything other than a normal enlarged prostate?
• —Should I have a PSA test, and what would the result actually mean for me?
• —What can I change myself before considering medication?
• —If I start a medication, what side effects should I know about?