What is the Prostate gland?
This small gland only exists in men. Around the size of a walnut, its sits just below the bladder and surrounds part of the urethra, the tube that carries your urine from your bladder. It helps to make some of the fluid in semen so is part of the reproductive system.
What problems can it cause?
Prostate enlargement:
By far the most common issue. In most men the prostate starts to slowly enlarge from their 40’s but symptoms are rare in those under 50. As the prostate enlarges it can compress the urethra and causes bothersome symptoms in around 30% of men. These include:
- Difficulty initiating urination and reduced flow.
- Needing to pass urine more frequently (most noticeable at night).
- Needing to go more urgently.
- Having to stop and start peeing several times.
- A feeling that the bladder has not been fully emptied.
Treatment for prostate enlargement varies depending on how severe the symptoms are. In many men we can simply do nothing and see how things progress over time. In some men simple lifestyle changes such as changing the timing of fluid intake and adjusting caffeine and alcohol intake can be enough. A number of medications exist which can control the symptoms. The common ones are Tamsulosin (Flomax) and Finsteride (Proscar or Propecia). In extreme cases where nothing else has worked, surgery to remove some of the prostate can be considered.
Prostatitis
Inflammation of the prostate is called prostatitis. This is normally caused by infection but sometimes the cause is unknown. Some men with chronic prostatitis can identify triggers and adjust their lifestyle accordingly. Common symptoms are difficulty passing urine, pelvic pain and fever/chills. Bacterial prostatitis needs prompt management as it can become quite serious if left untreated. Prostatitis can be sexually transmitted but it is often caused by regular bacteria in the urinary tract.
Prostate Cancer
This is one of the commonest types of cancer in men. Risk factors include increasing age, having a relative with prostate cancer, Afro-Caribbean ethnicity and obesity. Symptoms overlap with prostate enlargement and include reduced urine flow, frequent urination as well as blood in the urine, erectile dysfunction, weight loss and back pain. Screening for prostate cancer is controversial but should be discussed with your doctor at around 50 years old, or younger if you have one of the risk factors above.
Prostate testing
There are a number of tests which can be performed to check the prostate. Digital rectal exam is a quick examination done in the doctor’s office which causes minimal discomfort. A blood test can be done to check PSA a blood antigen that is specific to the prostate gland. In cases of suspected cancer, a biopsy or scan of the prostate can be done.
Summary
Prostate issues are very common and many men feel awkward or embarrassed discussing symptoms. All of the conditions discussed here are treatable if caught early and we are very experienced in discussing your symptoms in a sympathetic and understanding way. If you are worried, discuss your concerns with your doctor, who can help you decide on the best course of action.
Dr Neil Forrest is a UK trained doctor based at Star Vista clinic. Call: 6339 2727
