What’s causing that need to pee all the time and how to get help

If you’ve been feeling the urge to urinate frequently, you could be suffering from what Mark (not his real name) used to have. The 55-year-old had been experiencing an increasing urge to urinate frequently, which was caused by his bladder being unable to empty completely. 

Mark was diagnosed with a common problem known as benign prostatic hyperplasia (BPH), in which an enlarged prostate blocks urine flow from the bladder. As Mark had found out, the condition is uncomfortable – sufferers are unable to completely empty their bladder, hence feeling the need to urinate more frequently. This causes disrupted sleep, as those affected also find themselves waking up many times during the night to urinate. 

Mark had started medical therapy for his condition but was dissatisfied with the results, especially when he discovered that the treatment was lifelong and that it came with side effects, like retrograde ejaculation. 

He then consulted Dr Tan Yung Khan, Senior Consultant Urologist and Medical Director, Urohealth Medical Clinic, which specialises in integrated urologic patient care, treating urology conditions concerning the prostate, kidneys, bladder and urinary tract. 

Traditionally, treatment for BPH involves either taking oral medication or surgery. Taking oral medication involves drugs that reduce hormones or shrink the prostate over the long term, but with the possible side effects of dizziness, reduced energy and erectile dysfunction. Surgery involves reducing the amount of prostate tissue but carries the risk of sexual dysfunction, like retrograde ejaculation.

Dr Tan Yung Khan and his team at Urohealth Medical Clinic provides integrated urologic patient care, treating urology conditions concerning the prostate, kidneys, bladder and urinary tract. PHOTO: UROHEALTH MEDICAL CLINIC

Dr Tan says, “The side effect of surgery can certainly cause the semen volume to be reduced or even lead to a totally ‘dry’ orgasm. It would certainly affect fertility. And this would be permanent.”

However, medical advancements have led to more minimally-invasive therapies, like Urolift and Rezum water vapour therapy, being introduced to treat the problem. 

After consulting Dr Tan, Mark decided on the treatment Urolift, a minimally-invasive treatment which was approved by the Food & Drug Administration (FDA) in 2013. This procedure does not involve a reduction in prostate size or the removal of prostate tissue. Instead, it involves using small implants to hold the prostate tissue apart, somewhat like holding curtains back, to open up the urethra for a smooth and unimpeded flow of urine. 

The procedure takes about 20 minutes and is done under sedation, with no need of catheterisation post-surgery. The procedure is not considered a keyhole surgery as no incision is made. 

“The whole procedure is done through the urinary tract when the patient is sedated. There are no cuts made in the skin,” says Dr Tan. As such, there is very little down time and patients can resume normal activities within a few days. 

“After Mark had the procedure done, he was discharged on the same day,” adds Dr Tan. “He returned to work three days after that.”

One to two weeks after the treatment, Mark noticed an improvement in his urine flow. During a follow-up consultation eight months later, he continued to report excellent urine flow and minimal urinary symptoms.

So, who is this treatment suitable for? Dr Tan says, “Patients not fit for general anaesthesia, patients with enlarged prostates up to 80g, patients who have side effects from medications or who are not keen on lifelong medication, and lastly patients who do not like the possibility of retrograde ejeculation or incontinence.”

A consultation with a urologist is needed to ascertain suitability for the procedure, but Dr Tan recommends anyone troubled by urinary issues to get checked out as soon as possible. He adds, “There is no reason to delay treatment and prolong suffering when there are so many solutions available today.” 

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