Potential prostate problems men may face

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Potential prostate problems men may face

Every single man at some point in his life is at risk of developing prostate issues.  Because all men have a prostate, all men in your life – grandfather, father, brother, husband, son, or boyfriend – has the chance of having to face a diagnosis of a problem with his prostate. 

The walnut-sized prostate gland is tucked away inside a man’s body where it resides in front of the rectum between the bladder and penis.  Weighing around 1 ounce, the prostate surrounds the urethra, the tube that carries urine from the bladder to the penis.  The prostate’s purpose is to secrete fluid that nourishes and protects sperm, making it a vital part of the proper functioning of the male reproductive system.  It is during ejaculation when the prostate contracts, squirting its fluid into the urethra as the millions of sperm speedily travel down to their destination.

Like any part of the human body, the prostate gland can develop certain problems over the course of a man’s life.  But there are three prostate issues that are more likely to cause problems in which a man will need to seek the advice and expertise of a urologist.  These three issues most likely to affect the prostate gland are the following:

1.  Prostatitis

Affecting men of all ages, prostatitis or inflammation of the prostate, is a painful condition in which more than two million men seek help every year from their doctor.  Symptoms of prostatitis can include the following:

·      Burning or painful urination

·      Urgent need to urinate

·      Trouble voiding

·      Difficult or painful ejaculation

·      Pain in the area between the scrotum and rectum known as the perineum

·      Lower back pain

There are four types of prostatitis:

·      Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

·      Chronic bacterial prostatitis

·      Acute (sudden) bacterial prostatitis

·      Asymptomatic inflammatory prostatitis

Depending on a man’s symptoms, will help a doctor determine which type a man has.  It is not completely understood what causes prostatitis but is usually caused by common strains of bacteria. One way an infection may start is when bacteria gets into the prostate when infected urine flows backwards from the urethra. Antibiotics are used to treat it but if the bacteria are not completely eliminated with antibiotics, then prostatitis may recur or be more difficult to treat. 

Other possible causes of prostatitis include:

·      Placement of a catheter ( a tube to drain fluid from the body) or another instrument recently placed in the urethra

·      An abnormality found in the urinary tract

·      A recent bladder infection 

Treating prostatitis usually involves taking an antibiotic along with anti-inflammatory drugs, pain medications, or muscle relaxants.  Other treatment methods might include hot baths or a heating pad to ease pain or in rare cases, surgery on either the urethra or prostate. 

2.  Benign prostatic hyperplasia (BPH)

One of the most common conditions a man can get affecting his prostate is benign prostatic hyperplasia or BPH.  BPH is an enlargement of the prostate putting pressure on the urethra making it difficult to urinate along with other symptoms associated with it. 

It becomes more prevalent as a man ages with the risk of BPH increasing each year after a man turns 40.  By age 60, more than half of all men will have BPH and by age 85, about 90 percent of men have this condition. 

Most of the signs and symptoms of BPH are urinary related.  As the prostate enlarges, this put pressure on the urethra reducing the flow of urine which can result in various symptoms such as:

  • Urinary urgency

  • Frequent urination

  • Dripping and leaking after urination

  • Straining to urinate

  • Waking up during the night to urinate

  • A weak or slow urinary stream

  • Incomplete emptying of the bladder

  • A urinary stream that starts and stops

 Not every man who has BPH will necessarily know it as only about 30 percent of men with it will have noticeable symptoms. The causes of BPH is not known or understood.  What is known is that it mainly occurs in older men.  There appears to be an association with the hormone testosterone as BPH does not develop in men whose testicles were removed before puberty.  Therefore, researchers believe that factors related to aging and the testicles may cause BPH. 

BPH is generally confirmed through urinalysis, PSA blood testing, and a rectal exam.  There is also a BPH Symptom Score Index developed by the American Urological Association (AUA) that will rate BPH based on urinary symptoms ranking it from mild to severe.

Because BPH progresses rather slowly over a number of years, the decision to treat depends the severity of the symptoms on how much the symptoms. Mild cases of BPH may not need any treatment whatsoever.

The main treatments for BPH include:

·      Watchful Waiting/Active Surveillance

·      Medical Therapies

·      Minimally Invasive Surgeries

·      Transurethral Resection of the Prostate (TURP

3.  Prostate cancer

Prostate cancer is when cells in the prostate gland grow uncontrollably.  According to the National Cancer Institute (NCI) approximately 14 percent of men will be diagnosed with prostate cancer at some point during their lifetime, based on 2010-2012 data.  This cancer is considered a fairly common one for men with estimates in 2017 of 161,360 new cases will be diagnosed and an estimated 26,730 men will die from the disease.

However, if prostate cancer is discovered in its early stages, it has a 98.9 percent survival rate as reported from the NCI.  The best defense is to have a game plan of a good offense when it comes to prostate cancer.  Men need to have yearly exams to assess what is going on with their prostate.  A simple rectal exam which takes less than a minute and a yearly PSA blood test starting at age 40 are good screening tools urologists use to detect any changes in the prostate gland.  Not getting screened is unwise as a man will be missing his opportunity to catch any changes before it’s too late.

Treating prostate cancer depends on the staging and aggressiveness at the time of diagnosis.  If prostate cancer is diagnosed at an early stage, one option a man and his doctor may decide to do is called active surveillance.  This is the decision not to treat prostate cancer at the time of diagnosis based on the man’s age, health condition and the rate of growth of the cancer. 

However, if test results show a man’s prostate cancer to be aggressive, there are several methods of therapy to consider, all depending again on each individual man’s prostate cancer, the expected rate of growth, staging and other factors.  The doctor may decide to choose one type of therapy or a combination to beat back the cancer.  His choices range from the da Vinci prostatectomy, radiation therapy, Cyberknife SBRT procedure, IMRT procedure, seed implant procedure, or hormone therapy