Prostate Problems

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What is the prostate?

The prostate gland is part of a man's reproductive system. It is usually a little bigger than a walnut. It is located between the base of the bladder and the beginning of the penis. It surrounds the upper part of the urethra. (The urethra carries urine from the bladder out through the penis.) The prostate gland produces a fluid that is ejaculated with sperm.

Prostate problems are common in men over the age of 50. If the prostate becomes enlarged or inflamed, it can put pressure on the urethra and cause problems with urination.

Prostatitis

Prostatitis is swelling and tenderness (inflammation) of the prostate. It can be caused by bacteria that enter the urethra, but more often the cause is not known. Prostatitis is sometimes sexually transmitted. It may cause pain when you urinate. You may feel the urge to urinate more than usual. You may have fever and pain in the lower back or groin. When prostatitis is caused by an infection, it is treated with antibiotics. It can take a while for prostatitis to go away, and it may come back.

Benign prostatic hypertrophy or hyperplasia (BPH)

BPH is an enlarged prostate. It is a common health problem for men over age 60. The cause is not known.

As the prostate gets bigger, the passageway through the urethra gets smaller. The bladder muscle forces urine through the narrowed urethra by squeezing more strongly. This can make the bladder muscle thicker and more sensitive. You may feel the need to urinate more strongly and more often. You may start to get up several times a night to urinate. You may have trouble starting and stopping the flow of urine, and you may have a weak stream when you urinate.

As the prostate grows even bigger, the urethra may be squeezed more tightly. This may make it hard for the bladder to empty completely.

Rarely, BPH may cause urinary tract infections. It may even damage the bladder or kidneys over time. It may also cause a sudden inability to urinate (acute urinary retention), a medical emergency.

Many men with enlarged prostates have no symptoms. Fewer than half of the men diagnosed with BPH develop symptoms severe enough to need treatment. However, symptoms of BPH should always be checked by your healthcare provider because prostate cancer causes similar symptoms.

If you have BPH but your symptoms are mild, you may not need treatment other than one or more exams a year. This helps make sure that you do not develop more serious problems. This program of care is called watchful waiting. Sometimes symptoms get better without treatment.

There are many treatments for relieving the symptoms of BPH. Medicine may be taken to stop the prostate from getting bigger. It may even cause the prostate to get smaller. Another type of medicine relaxes the muscles in the prostate and lessens the symptoms. Various procedures, such as microwaves, radio waves, or a laser, may be used to destroy excess prostate tissue.

If you have complications or your symptoms are severe, your provider may recommend surgery. The common surgery for BPH is transurethral resection of the prostate (TURP). In this procedure, the surgeon scrapes away growths inside the prostate through a small scope put into the urethra. The surgery reduces pressure on the urethra and generally gives relief from symptoms.

Prostate cancer

Prostate cancer is the most commonly diagnosed cancer in American men. Prostate cancer often has no symptoms, especially in the early stages. When it causes symptoms, at first they are very similar to the symptoms of BPH. Both BPH and prostate cancer cause enlargement of the prostate and squeezing of the urethra. Some possible symptoms are:

• weak flow of urine
• urine flow that starts and then stops too soon
• trouble starting or stopping the flow of urine
• frequent and urgent need to urinate, especially at night
• pain or burning during urination
• trouble having an erection, or pain when semen comes out of the penis (ejaculation)
• frequent pain in the lower back, hips, or upper thighs (usually because of a spread of the cancer beyond the prostate gland).

Prostate cancer screening includes a blood test (prostate specific antibody or PSA test) and a rectal exam. Prostate cancer may be treated with surgery, radiation therapy, or hormone therapy.

Because prostate cancer tends to be very slow growing, it may not be treated at all if you are over 75 years old unless the enlarged prostate is causing urinary problems.

How can I take care of myself?

• Have regular medical checkups, including rectal exams.
• Talk with your healthcare provider about the PSA test.
• See your provider if you start having urinary symptoms, such as trouble starting to urinate or a weak flow of urine.
• Have a healthy lifestyle. Eat a healthy diet and get enough rest and regular exercise.

Developed by Ann Carter, MD, for RelayHealth.
Published by RelayHealth.
© 2009 RelayHealth and/or its affiliates. All Rights Reserved.