Steps you can try to control or manage your symptoms
You can try the following steps to try help you manage your symptoms.
- Decrease your caffeine and nicotine intake Caffeine (typically from coffee, tea, chocolate and energy drinks) and nicotine (from tobacco smoking) irritate the bladder, so cutting your caffeine and nicotine consumption can decrease the number of times you need to urinate. Where possible drinking water instead of caffeine containing drinks or fruit juices and fizzy drinks can help.
- Decrease your alcohol intake Alcohol increases your urine production, so cutting your alcohol intake can help reduce frequency of urination. Reducing evening alcohol intake can also help with symptoms of nocturia (waking in the night to pass urine).
- Drink more in the morning, less in the evening If you are waking up more than once a night to urinate then reducing your fluid intake before bed can be helpful. This means drinking most of your fluids early in the day, and not drinking for the two to three hours before you go to bed.
- Remember that fluid intake is vital for your body to function, so it is important that you do not decrease your overall fluid intake. The colour of your urine should be similar to white wine; dark brown urine indicates that you are dehydrated.
- Avoid constipation Constipation can worsen symptoms of bladder outlet obstruction. This is because if the rectum is full it can press on the prostate, which in turn presses on the urethra. Ask your community pharmacist for help treating or avoiding constipation.
Tips to aid urinating
The following are some techniques to help maximise your bladder emptying while urinating:
- For some people, sitting down to urinate can improve the flow of urine and help you to empty your bladder.
- After urinating, wait for 20-30 seconds while leaning forward, and try to pass urine again. This technique can help you to empty your bladder more completely each time you go to the bathroom and reduce urinary frequency
- Try ‘urethral milking’ to get the drops of urine left in the urethra
- Wait a moment after passing urine
- Place two to three fingers directly behind your scrotum and gently massage forward towards the base of your penis.
- This brings forward urine out of your urethra, helping to reduce embarassing leakage after passing urine. This is called post-micturition dribble.
Medications
There are medications that can reduce the size of your prostate and improve your urine flow. These can be taken alone or in combination. As with all medications, they do have side effects and may not be suitable for everyone.
The most common medications are:
- Alpha blockers (e.g. Tamsulosin) This relaxes where the bladder and prostate meet, which can help urine flow.
- 5 alpha reductase inhibitors (e.g. Finasteride) This can stop the prostate growing further, and even reduce its size.
If you are not already taking these medications, you should speak to your GP or urologist to see if you are suitable for them.
Patients with indwelling catheters may not need to take these medications, and the tablets will usually be stopped after your bladder outlet (prostate) surgery. We will explain exactly what a catheter is later. Almost half of men waiting for surgery will be using a type of catheter.