The
prostate is a small organ about the size of a walnut.
It lies below the bladder and surrounds the urethra, the
tube that carries urine from the bladder. The prostate
makes a fluid that becomes a part of the semen, which
is the white fluid that contains sperm.
Prostate problems are common in men older than 50 years.
Most can be treated successfully without harming a person's
sexual function. A urologist is a doctor most qualified
to diagnose and treat many prostate problems.
Non-cancerous Prostate Problems
Acute prostatitis is a bacterial infection of the
prostate. It can occur in men at any age. Symptoms include
fever, chills and pain in the lower back and between the
legs. This problem also can make it hard or painful to
urinate. Doctors prescribe antibiotics for acute prostatitis
and recommend that the patient drink more liquids.
Chronic prostatitis is a prostate infection that comes
back again and again. The symptoms are similar to those
of acute prostatitis except that there is usually no fever.
Also, the symptoms are usually milder in chronic prostatitis.
However, they can last a long time.
Chronic prostatitis is hard to treat. Antibiotics often
work when the infection is caused by bacteria. But sometimes
no disease causing bacteria can be found. In some cases,
it helps to massage the prostate to release fluids. Warm
baths also may bring relief. Chronic prostatitis clears
up by itself in many cases.
Benign prostatic hypertrophy (BPH) is enlargement
of the prostate. This condition is common in older men.
More than half of men in their 60's have BPH. Among men
in their 70's and 80's, the figure may go as high as 90
percent.
An enlarged prostate may eventually block the urethra
and make it hard to urinate. Other common symptoms are
dribbling after urination and the urge to urinate often,
especially at night. In rare cases, the patient is unable
to urinate.
A doctor usually can detect an enlarged prostate by rectal
exam. The doctor also may examine the urethra, prostate
and bladder using a cytoscope, an instrument that is inserted
through the penis.
Prostate Cancer
Prostate cancer is one of the most common forms of cancer
among American men. About 80 percent of all the cases
occur in men older than 65 years. In the early stages
of prostate cancer, the disease stays in the prostate
and is not life threatening. But without treatment, cancer
can spread to other parts of the body and eventually cause
death. Some 40,000 men die every year from prostate cancer
that has spread to other organs.
Diagnosis--To find the cause of prostate symptoms,
the doctor takes a careful medical history and performs
a physical exam. The physical includes a digital rectal
exam, in which the doctor feels the prostate through the
rectum. Hard or lumpy areas in the prostate may mean that
cancer is present.
Some doctors also recommend a blood test for a substance
called prostate specific antigen (PSA). PSA levels may
be high in men who have prostate cancer or BPH. However,
the test is not always accurate. Researchers are studying
changes in PSA levels over time to learn whether the test
may someday be useful for early diagnosis of prostate
cancer.
If a doctor suspects prostate cancer, he or she may recommend
a biopsy. This is a simple surgical procedure in which
a small piece of prostate tissue is removed with a needle
and examined under a microscope. If the biopsy shows prostate
cancer, other tests are done to determine the type of
treatment needed.
Protecting Yourself
The best protection against prostate problems is to have
regular medical check-ups that include a careful prostate
exam. See a doctor promptly if symptoms occur such as
a frequent urge to urinate, difficulty in urinating or
dribbling of urine.
Regular checkups are important even for men who have had
surgery for BPH. BPH surgery does not protect against
prostate cancer because only part of the prostate is removed.
In all cases, the sooner a doctor finds a problem, the
better the chances that treatment will work.
Be sure to follow up with part
2 of this series to learn about
treatment options.
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