Prostate disease is a general term used to describe a number of medical conditions that can affect the prostate gland.
The prostate gland
The prostate gland is a small gland only found in men. It opens into the urethra (the tube that carries urine from the bladder to the penis) and sits just below the bladder and vas deferens (a pair of ducts through which sperm passes before ejaculation).
The prostate gland helps with the production of semen (the fluid that transports sperm). It produces a thick, white fluid that's liquefied by a special protein called prostate-specific antigen (PSA). The fluid is mixed with sperm, produced by the testicles, to create semen.
There are a number of conditions that can affect the prostate gland including:
Below is a short summary of these conditions:
Prostate enlargement is a common condition associated with ageing. About a third of all men over 50 years of age will have symptoms of prostate enlargement (see below).
The urethra is a tube that runs from the bladder through the prostate to the end of the penis. Urine flows through the urethra and out of the body when a man urinates. If the prostate becomes enlarged it can place pressure on the urethra, making it more difficult for the bladder to empty.
An enlarged prostate can cause symptoms that can affect the normal pattern of urination. for example, it can:
Investigations may include:
All of the above will be discussed in more detail with you when you come for your appointment. If you are suffering with urinary symptoms please attend the appointment with a full bladder so that a flow rate can be performed.
Prostatitis is a poorly understood condition where the prostate gland becomes inflamed and causes pain and often urinary symptoms. Inflammation can occur as a result of infection but in most cases no evidence of infection can be found.
Symptoms of prostatitis include:
Prostatitis is thought to affect up to 3 in 20 men (15%) at some point in their lives. Although it can affect men of any age, it is more common in men between 30-50 years of age. The symptoms tend to come and go and can be triggered by stress, certain types of food and trauma.
Prostatitis can be treated using a combination of painkillers and a type of medication known as an alpha-blocker, which can help relieve the symptoms.
It is really a diagnosis of exclusion.
In the UK, prostate cancer is the most common type of cancer in men with over 40,000 new cases diagnosed every year.
Your chances of developing prostate cancer increase with age. Most cases occur in men who are 60 years of age or older.
The causes of prostate cancer are unknown but risk factors include age, ethnic origin and family history.
Prostate cancer is usually asymptomatic and detected following a screening blood test called PSA. Patients often request this test or attend their GP surgery because of urinary symptoms and the cancer is detected. It is very unusual for prostate cancer to cause urinary symptoms, these are usually related to benign enlargement. Very rarely it can present with advanced disease when it has already spread beyond the prostate with back pain and weight loss.
The outlook for prostate cancer is generally good because, unlike many other types of cancer, it usually progresses very slowly. Most men die with prostate cancer, rather than as a result of it.
Prostate cancer treatments depend on how aggressive the disease is and if it has spread outside the prostate. Treatments include:
Prostate cancer diagnosis and treatment remains an extremely complex issue. There is no point in detecting disease that would never have caused problems but it is clearly important to identify those patients whose cancer is aggressive. All of the issues will be discussed with you in clinic and a decision made that takes into account all of the above.