Urinary Problems After 50: Manipal Urologist Explains What’s Normal and When Men Should Seek Help

Post by : Saif Nasser

Urinary problems are often treated as a normal part of ageing, but many men discover that these issues can seriously disrupt daily life. Poor sleep, constant bathroom visits, weak urine flow, and the feeling of not emptying the bladder completely can affect confidence and overall health. In a recent interview with HT Lifestyle, Dr Ravi Shankar J C, consultant urologist at Manipal Hospital, Bengaluru, explained why these symptoms appear and how a newer treatment option is giving hope to men who cannot undergo major surgery.

Dr Shankar said that as men grow older, the prostate naturally becomes larger. For many, this enlargement slowly begins to press on the urinary passage. This condition, called benign prostatic hyperplasia, is extremely common but often ignored in its early stages. When the prostate presses harder on the urinary tube, men notice signs like frequent urination, especially at night, a weak stream, difficulty starting, and the constant feeling that the bladder is not fully empty. According to Dr Shankar, these early clues are usually subtle, which is why men tend to overlook them. But as the blockage worsens, the symptoms can suddenly become severe. In some cases, men may be unable to pass urine at all, and they need a catheter and urgent medical care.

He explained that while traditional surgeries like TURP or laser procedures work well, they require general or spinal anaesthesia. Many older men have other health problems such as heart disease, use of blood thinners, recent joint replacements, neurological disorders, or limited mobility, making major surgery too risky. Because of this, doctors today look for simpler and safer options that reduce complications while still offering good results.

One such option is Rezum therapy, a minimally invasive treatment that is becoming increasingly popular. Dr Shankar explained that Rezum does not involve cutting or removing prostate tissue. Instead, it uses short bursts of steam to shrink the enlarged parts of the prostate from the inside. The procedure takes about ten minutes, can be done with local anaesthesia or light sedation, and does not require stopping blood thinners. Most patients go home the same day. Over the next few weeks, as the swollen tissue gradually shrinks, urine flow becomes easier and symptoms reduce. Another important benefit is that Rezum usually preserves sexual function, which many men worry about before treatment.

Dr Shankar shared that Rezum has been well studied and offers results similar to standard surgical procedures for selected patients, but with fewer risks. Because recovery is quicker and no hospital stay is required, the treatment is becoming more common in Western countries and is now slowly being adopted in India as well.

He also described a case of an elderly patient who had multiple health complications, including Parkinson’s disease, recent hip surgery, and the need for blood thinners. Traditional prostate surgery was too dangerous for him. He struggled with urinary retention for months and could not pass urine without a catheter. After undergoing the Rezum procedure, he recovered well, and once the catheter was removed, he was able to urinate normally again. Dr Shankar explained that the therapy works by sending controlled steam energy into the enlarged prostate tissue, reducing the blockage without major surgery.

The doctor concluded that urinary problems in older men should never be ignored. While some changes are normal with age, persistent symptoms require medical evaluation. With newer treatments like Rezum now available, men who cannot undergo traditional surgery have safer options that can restore comfort and independence.