Sometimes prostate obstruction does not cause the bladder to not empty enough, but does cause thickening and strengthening of the bladder muscles but also quite a bit of irritability of the bladder. This is a situation where prostate obstruction AND overactive bladder coexist. Sometimes patients will benefit from a combination of prostate medication AND bladder medicine. The prostate medicine is given first because medicines that relax the bladder muscle in the face of prostate obstruction can lead to lack of emptying and slower stream. In some cases the prostate medicine is not effective enough and some patients need prostate surgery first and then bladder medicine to calm the bladder after the obstruction is relieved with surgery.
In the most severe cases of prostate blockage that are not treated, the incomplete emptying and/or high pressure in the bladder can be transmitted back up to the kidneys. Urine is made in the kidneys, and then is dripped down through a tube from the kidneys to the bladder called the ureter. Back pressure transmitted to the kidneys can damage the kidney cells, cause swelling of the inside of the kidneys where the urine is temporarily stored and kidney damage in these cases can be severe and even in some cases irreversible. However, in many cases the kidney failure due to prostate blockage is reversible with proper treatment. There are many causes of kidney failure and a less common cause is BPH. Urologists such as Dr. Newman have several choices for prostate blockage surgery but a common approach is laser ablation.