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Why do I have to push to urinate?

The need to strain or push in order to urinate can be due to problems with the contractile force of the bladder or problems with obstruction of the bladder outlet and urethra.

everydayhealth.com - Straining to Urinate? - Healthy Living Center - Everyday Health

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The need to strain or push in order to urinate can be due to problems with the contractile force of the bladder or problems with obstruction of the bladder outlet and urethra. Failure to empty due to problems with the contractile force of the bladder may be due to nerve-related disorders such as spinal-cord injury, multiple sclerosis, diabetes, and the like. Failure to empty the bladder due to urethral problems is unusual in women. Some causes of obstruction of the bladder outlet in women include prior vaginal or urethral surgeries, rare strictures of the urethra, and, in rare instances, polyps or cancerous lesions. Urinary symptoms should always be investigated to rule out some of these unusual but serious conditions. In the urologist's office, an evaluation for these symptoms would typically include a detailed history, physical examination including a vaginal speculum examination, urinalysis, and an ultrasound measurement of bladder volume after voiding. The most important thing that this latter test would show is whether or not the bladder is completely empty. If the bladder empties completely it makes neurological problems unlikely. If the bladder retains a lot of urine, further studies with urodynamics, a bladder-pressure study that assesses the contractility of the bladder muscle, would be appropriate.

Q2. My husband has been taking oxycodone for pain management for eight weeks now. He is currently having trouble urinating. I understand this is from the medication, but what can he do to overcome the problem? Would drinking more liquid help?

— Irene, North Carolina

Oxycodone, as well as other narcotic pain medications, can lead to bladder problems. Your husband's difficulty urinating may have resulted because the medication interacts with and blocks some of the nerve signals that cause the bladder to contract. If he cannot be switched to a nonnarcotic pain medicine, then additional evaluation is indicated to assess the severity of his urinary problems. Narcotic pain medicines can also lead to constipation, which, if severe, can prevent normal evacuation of the bladder. It is important to know whether your husband has an underlying predisposition to bladder difficulties. If he has an enlarged prostate, for example, lower urinary tract symptoms that are caused by prostatic enlargement may be exacerbated by a narcotic pain medication. In such cases, additional medication to treat the underlying lower urinary tract symptoms related to prostatic enlargement might improve his situation. It is unlikely that increasing his fluid intake will resolve bladder-emptying problems — this could actually exacerbate them. Any evaluation of a man who has difficulty urinating would also seek other, less common problems, such as chronic prostatic infection, prostate cancer, bladder stones, and the like.

Learn more in the Everyday Health Pain Management Center.

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Can supplements reduce prostate size?

Interestingly, the supplements most commonly used to treat the symptoms of an enlarged prostate (also known as benign prostatic hyperplasia or BPH), do not reduce the overall size of the prostate.

consumerlab.com - Are there supplements that can reduce prostate size?

Answer:

Interestingly, the supplements most commonly used to treat the symptoms of an enlarged prostate (also known as benign prostatic hyperplasia or BPH), do not reduce the overall size of the prostate. As discussed in the Prostate Supplements Review, these two supplements are beta-sitosterol and saw palmetto. Most studies of beta-sitosterol have found significant improvement in perceived symptoms of BPH and in urine flow rate. In addition, benefits seem to persist for months after treatment, according to a follow up study that looked at men one year after treatment. Like the BPH drug finasteride (Proscar), beta-sitosterol may inhibit 5-alpha-reductase activity in the prostate. (Beta-sitosterol is also found in Cholesterol-Lowering Supplements, but the dosing is quite different for that use, so be sure take a product specifically formulated for prostate symptoms.) The other common supplement for BPH is saw palmetto. It shrinks the inner epithelium of the prostate, but not the prostate's overall size. It was initially believed that saw palmetto dietary supplements provided mild to moderate improvement in symptoms of prostate enlargement. However, the evidence of saw palmetto's benefit is conflicting and recent studies have failed to show any benefit over placebo. Other ingredients which may help to reduce symptoms of BPH include Pygeum bark, pumpkin seed and stinging nettle root. (Interestingly, certain colors of maca root have been reported to decrease prostate size in an animal study, but there do not appear to be studies in men to support this.) For more information about these ingredients, including evidence and dosage, plus ConsumerLab.com tests, reviews, and comparisons of marketed products, see the Prostate Supplements Review >>

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