Prostate Problems

It seems that most of the men I know are having problems with their prostate. A few even have cancer and the rest are worried about what’s in store for them. What’s going on?

It’s true that prostate problems are very common after age 50. And the older men get, the more likely they are to have such problems. Most prostate problems are not cancer. Still, prostate cancer does affect a lot of men.

The prostate is a gland. It makes fluid that becomes part of semen, the white fluid that contains sperm. The prostate lies low in the body — in front of the rectum and below the bladder (where urine is stored). It surrounds the tube that carries urine away from the bladder (urethra).

When you’re a young man, your prostate is about the size of a walnut. It slowly grows larger as you get older. If the prostate gets too large, it can cause urinary problems. Infection or cancer in the prostate can also cause urinary and other problems. Often, men notice symptoms themselves, and sometimes their doctor finds something during a routine check-up.

There are several different kinds of prostate problems. Only a doctor can tell one from another. That’s why you need to see your doctor if something doesn’t seem right to you.

Common Problems

These problems are not cancer:

Acute prostatitis is an infection of the prostate caused by bacteria. It usually starts all of a sudden. It can cause fever, chills, or pain in the lower back and between the legs. It can cause pain when you urinate. If you have these symptoms, see your doctor right away. Antibiotic drugs can kill the bacteria and help you feel better.

Chronic prostatitis is an infection of the prostate that keeps coming back time after time. This problem can be hard to treat. Sometimes, taking antibiotics for a long time may work. Talk with your doctor about other things you can do to help you feel better.

Benign prostatic hyperplasia, or BPH, is very common in older men. The prostate is enlarged, but it is not cancerous. Over time, an enlarged prostate may press against the urethra, making it hard to urinate. It may cause dribbling after you urinate or a need to urinate often, especially at night. Your doctor will do a rectal exam to check for BPH. And you may need to have special x-rays or scans to check your urethra, prostate, and bladder.

Treatments for BPH include:

• Watchful waiting. If your symptoms are not too bad, your doctor may suggest that you wait before starting any treatment. You will need regular checkups. Treatment can start later on if your symptoms get worse.
• Alpha-blockers. These medicines can ease your symptoms. Side effects may include headaches, dizziness, or feeling lightheaded or tired.
• Finasteride (Proscar^®). This medicine lowers the amount of the male hormone (testosterone) in the body. The result is that the prostate shrinks and urinary problems get better. Side effects can include less interest in sex and problems with erection or ejaculation.
• Surgery. An operation can improve the flow of urine but it can also cause other problems. Usually, men have surgery only if medicine hasn’t worked. Surgery does not protect against prostate cancer. Regular check-ups are important after BPH surgery. Talk with your doctor about this treatment choice. There are three kinds of surgery. All are done with anesthesia:
  • Transurethral resection of the prostate (TURP) is the most common type of surgery. The doctor takes out part of the prostate through the urethra.
  • Transurethral incision of the prostate (TUIP) may be used when the prostate is not too large. The doctor makes a few small cuts in the prostate near the opening of the bladder.
  • Open surgery is used only when the prostate is very large. The doctor removes the prostate through a cut in the belly or behind the scrotum.
• Other treatments. Other ways to relieve the symptoms of BPH use radiowaves, microwaves, or electrical current.