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Many men experience problems urinating, such as slow urine stream, straining to urinate, or frequent urge to urinate. Fortunately there are solutions to help alleviate symptoms. Your urinary exit, or urethra, is like a pipe. Most men with voiding issues have some form of blockage. Like your shower drain at home, if the pipe is clogged, drainage is slow. There are a number of very common causes for this blockage. Men can develop benign prostatic hyperplasia, or BPH, as they age. The prostate enlarges in a non-cancerous way, blocking the interior of the urethra and clogging the pipe. If urination is bothersome, many men seek relief through medicines or minimally invasive surgery.
Depending on the size of your prostate, your symptoms, and your underlying medical history, you and your urologist can select the best option for your situation. Men can develop scar tissue in the urethra that narrows the pipe, a condition called urethral stricture disease. This can happen anywhere along the urethra, including the very tip. Medicine hasn't been shown to reverse scar tissue, but sometimes dilating the narrow area heals the stricture. Urethra dilations don't work well, however, and surgery is usually required. We reconstruct the pipe with healthy tissue from elsewhere, a process called urethroplasty. Our physicians have specific training and experience to provide effective outcomes from this type of specialized surgery.
If the blockages in the pipe are long-standing, it can start to affect the bladder or even the kidneys. If this is suspected, getting urodynamic testing to understand how your bladder works may be the next best step. For men with a history of nervous system disorders, such as Parkinson's disease, spinal trauma, or multiple sclerosis, urodynamics is performed to ensure bladder health is optimized with the appropriate medication or treatment. No matter the cause, Johns Hopkins urologists are here to help evaluate and guide you, with individualized treatment and management plans tailored to your specific issues, improving your quality of life. .