Prostate Health: Routine Care Recommended

Health experts do not know all of the functions of the prostate gland, yet they do know that the prostate gland plays an important role in both urinary function and sexual function.

It is common for the prostate gland to become enlarged as a man ages, and he is likely to encounter some type of prostate problem in his lifetime.

What can a man do to protect himself? He can find prostate problems early when there is a better chance of successful treatment. The American Urological Association recommends a yearly prostate gland exam by a physician for every man over age 40.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the most common prostate problem for men under 50 is prostatitis, an inflammation of the prostate gland.

And for men over 50, the NIDDK says that the most common prostate problem is prostate enlargement, or benign prostatic hyperplasia (BPH).

The American Foundation for Urological Disease (AFUD), states that when BPH causes bothersome symptoms or seriously affects urinary function, treatment is available to help.

Prostate problems sometimes cause symptoms such as trouble with urination, but a serious prostate problem may have no symptoms at all, states AFUD.

Older men are at risk for prostate cancer, too, but this disease is much less common than BPH.

Prostate cancer, which occurs in one out of 10 men, is usually curable when caught early. Yet this cancer, which kills 34,000 men in the US each year, produces no symptoms in its early stages. Early prostate cancer can only be detected by a prostate checkup. 

What Is Prostatitis?

Prostatitis is one of several benign (non-cancerous), inflamed conditions of the prostate gland. Acute prostatitis occurs suddenly, with sharp, severe symptoms. Chronic prostatitis develops gradually, recurs often, with the infection lasting for prolonged periods of time. Chronic prostatitis is typically difficult to treat.

According to the NIDDK, prostatitis accounts for nearly 25 percent of physician office visits by young and middle-aged men for complaints involving the genital and urinary systems. Some estimates state that at least half of all men, at some point in their lives, will develop symptoms of prostatitis.

According to AFUD, prostatitis is not contagious and is not considered to be a sexually transmitted disease. Acute and chronic bacterial prostatitis infection may occur when bacteria from the urethra enter the prostate from the backward flow of infected urine into the prostate ducts.

Prostatitis and other prostate problems are generally treated by a urologist, a physician who specializes in the treatment of conditions involving the urinary tract in both genders, and conditions involving the genital tract of the male reproductive system.

The following are the most common, general symptoms of prostatitis:

• urinary frequency and/or urgency
  
  
• burning or stinging sensation during urination
  
  
• painful urination
  
  
• reduced stream volume during urination
  
  
• rectal pain and/or pressure
  
  
• fever and chills (usually present with an acute infection only)
  
  
• lower back and/or pelvic pain
  
  
• discharge through the urethra during bowel movements
  
  
• sexual dysfunction and/or loss of libido (sex drive)
  
  
• throbbing sensations in the rectal and/or genital area
  

The following lists four types of prostatitis described by the NIDDK:

acute bacterial prostatitis
Although the least common of all types of prostatitis, acute bacterial prostatitis occurs in men at any age and often with sudden onset and severe symptoms. It is important to seek treatment promptly as this condition is easy to diagnose. Men may find urination difficult and extremely painful. Other symptoms of acute bacterial prostatitis include fever, chills, lower back pain, pain in the genital (between the legs) area, urinary frequency, burning during urination, and/or urinary urgency at night, coupled with aches and pains throughout the body.

chronic bacterial prostatitis
Although fairly uncommon, chronic bacterial prostatitis is a recurrent infection of the prostate gland that is difficult to treat. Symptoms of the infection are often similar to but less intense than acute bacterial prostatitis. However, symptoms of chronic bacterial prostatitis generally last longer and often fever is absent, unlike during an acute infection.

chronic prostatitis/chronic pelvic pain syndrome
Chronic prostatitis/chronic pelvic pain syndrome is likely the least understood form of prostatitis, but the most common form of the disease. Symptoms may resolve and then reappear without warning. The infection may be considered inflammatory, in which urine, semen, and other secretions are absent of a known infecting organism but do contain infection-fighting cells, or the infection may be considered noninflammatory, in which inflammation and infection-fighting cells are both absent.

asymptomatic inflammatory prostatitis
Asymptomatic inflammatory prostatitis may be diagnosed when infection-fighting cells are present, but common symptoms of prostatitis such as difficulty with urination, fever, and lower back and pelvic pain, are absent. A diagnosis of asymptomatic inflammatory prostatitis is made most often during an examination for other conditions, such as infertility or prostate cancer.

Always consult your physician for more information.

Online Resources

American Cancer Society

American Prostate Society

American Urological Society

Centers for Disease Control and Prevention (CDC)

Healthfinder, US Department of Health and Human Services (HHS)

National Cancer Institute Prostate Cancer Information

National Institutes of Health (NIH)

NIH 4Women.Gov on Men's Health

National Library of Medicine

National Prostate Cancer Coalition

October 2004

Prostate Health: Routine Care Recommended

What Is Prostatitis?

What Is Benign Prostatic Hyperplasia (BPH)?

Online Resources

Other Resources:

Find a St. John's Mercy Physician

Sports & Therapy Services at St. John's Mercy

Men's Health Information

St. John's Mercy Classes and Programs

What Is Benign Prostatic Hyperplasia (BPH)?

Benign prostatic hypertrophy, or BPH, is a condition in which the prostate gland becomes very enlarged and may cause problems associated with urination.

BPH can raise PSA (prostate-specific antigen - a blood test used to help detect prostate cancer by measuring a substance produced by the prostate) levels two to three times higher than the normal level.

An increased PSA level does not indicate cancer, but the higher the PSA level, the higher the chance of having cancer.

Some of the signs of BPH and prostate cancer are the same. However, having BPH does not seem to increase the chances of developing prostate cancer.

A man who has BPH may also have undetected prostate cancer at the same time or may develop prostate cancer in the future.

Therefore, the National Cancer Institute and the American Cancer Society recommend that all men over 50 consult their physicians about having a digital rectal exam (DRE) and PSA test once a year to screen for prostate cancer.

The American Foundation for Urological Disease recommends that African-American men and men with a family history of prostate problems have a DRE and PSA test at beginning at age 45.

As the prostate enlarges, it presses against the urethra and interferes with urination. At the same time, the bladder wall becomes thicker and irritated, and begins to contract - even when it contains small amounts of urine - which causes more frequent urination. And, as the bladder continues to weaken, it may not empty completely and leave some urine behind.

Blocking or narrowing of the urethra by the prostate, and partial emptying of the bladder, cause many of the problems associated with BPH.

Common symptoms of BPH include:

• leaking or dribbling of urine
  
  
• more frequent urination, especially at night
  
  
• urgency to urinate
  
  
• urine retention - inability to urinate
  
  
• a hesitant, interrupted, weak stream of urine
  

These problems may lead to one/more of the following:

• incontinence
  
  
• kidney damage
  
  
• bladder damage
  
  
• urinary tract infections
  
  
• bladder stones
  

Diagnosis of BPH in its earlier stages can lower the risk of developing such complications. Delay can cause permanent bladder damage for which BPH treatment may be ineffective.

In addition to a complete medical history and physical examination, diagnostic procedures for BPH may include the following:

• digital rectal examination (DRE) - a procedure in which the physician inserts a gloved finger into the rectum to examine the rectum and the prostate gland for signs of cancer.
  
  
• renal ultrasound - a non-invasive test in which a transducer is passed over the kidney producing sound waves which bounce off of the kidney, transmitting a picture of the organ on a video screen. The test is used to determine the size and shape of the kidney, and to detect a mass, kidney stone, cyst, or other obstruction or abnormalities.
  
  
• intravenous pyelogram - a series of x-rays of the kidney, ureters, and bladder with the injection of a contrast dye into the vein - to detect tumors, abnormalities, kidney stones, or any obstructions, and to assess renal blood flow.
  
  
• cystoscopy - an examination in which a scope, a flexible tube and viewing device, is inserted through the urethra to examine the bladder and urinary tract for structural abnormalities or obstructions, such as tumors or stones.
  
  
• urine flow study - a test in which the patient urinates into a special device that measures how quickly the urine is flowing. A reduced flow may suggest benign prostatic hyperplasia (BPH).
  

Always consult your physician for more information.