By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine
The prostate is a small gland found only in men. It surrounds the tube that carries urine out of the body called the urethra. This gland produces a thick, white fluid that gets mixed with sperm to create semen. It is about the size and shape of a walnut, but tends to get bigger as you get older. Sometimes, the prostate can become swollen or enlarged by the following conditions:
• prostate enlargement
• prostatitis (inflammation of the prostate)
• prostate cancer
Today I will discuss these conditions which account for the most common and main problems of the prostate gland.
Prostate enlargement is a very common condition associated with aging. More than 1 in 3 of all men over 50 will have some symptoms of prostate enlargement. It’s not known why the prostate gets bigger as you get older, but it is not caused by cancer and does not increase your risk of developing prostate cancer. An enlarged prostate can put pressure on the urethra, which can affect how you urinate. Signs of an enlarged prostate can include:
• difficulty starting or stopping urinating
• a weak flow of urine
• straining when urinating
• feeling like you’re not able to fully empty your bladder
• prolonged dribbling after you’ve finished urinating
• needing to urinate more frequently or more suddenly
• waking up frequently during the night to urinate
Simple measures such as reducing the amount you drink (especially tea, coffee and alcohol) before bed can sometimes help control the symptoms. Medication can help reduce the size of your prostate and relax the muscles of your bladder. In severe cases that do not get better with medication, the inner part of the prostate can be surgically removed.
Prostatitis is where the prostate gland becomes swollen or inflamed. It’s sometimes caused by a bacterial infection, although more often that not, no infection can be found, and it’s not clear why it happened. Unlike prostate enlargement or prostate cancer – which usually affects older men – prostatitis can develop in men of all ages. However, it’s generally more common in men aged between 30 and 50.
Symptoms of prostatitis can include:
• pain in the pelvis, genitals, lower back and buttocks
• pain when urinating
• a frequent need to urinate
• difficulty urinating, such as problems when starting to urinate
• pain when ejaculating
• pain in the area between the anus and scrotum, which is often made worse by prolonged sitting
Prostatitis can be treated using a combination of painkillers and a type of medication called an alpha-blocker, which can help to relax the muscles of the prostate and bladder neck. Medication that shrinks the prostate gland may also be helpful. Most men will recover within a few weeks or months, although some will continue to have symptoms for longer.
Prostate cancer is ranked as among the most common type of cancer in men, with more than a million new cases every year globally. It’s not clear why it occurs, but your chances of developing prostate cancer increase as you get older. The condition mainly affects men over 65, although men over 50 are also at risk.
The risk of developing prostate cancer is also increased depending on your family history and race. It is more common among men of African-Caribbean and African descent than in Asian men. Having a brother or father who developed prostate cancer under the age of 60 seems to increase your risk of developing it, and having a close female relative who developed breast cancer may also increase your risk of prostate cancer
The symptoms of prostate cancer can be difficult to distinguish from those of prostate enlargement. They may include:
• needing to urinate more frequently, often during the night
• needing to rush to the toilet
• difficulty in starting to urinate
• straining or taking a long time while urinating
• weak flow
• feeling that your bladder has not fully emptied
• blood in urine or blood in semen.
The outlook for prostate cancer is generally good because, unlike many other types of cancer, it usually progresses very slowly. Many men die with prostate cancer rather than as a result of having it. Prostate cancer therefore does not always need to be treated immediately. Sometimes, it may initially just be monitored and only treated if it gets worse.
Now that you are more aware of the common prostate problems, do not hesitate to visit your doctor if you are experiencing symptoms associated with these conditions.
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