Prostate problems

The prostate gland is located just below the bladder and surrounds the urethra, the tube which carries urine from the bladder and out through the penis. In some men, an enlarged prostate gland squeezes the urethra so the stream of urine is slowed down.

The prostate is a small gland found only in men. It surrounds the upper part of the urethra and sits just below the base of the bladder. Its function is to secrete nutrient fluid for the sperm in semen which passes though the prostate in the ejaculatory ducts.

Prostate enlargement is also known as benign prostatic hyperplasia (BPH). This is a relatively common condition that affects older men and is not usually a serious threat to health. However, in some men the symptoms can be very disruptive and adversely affect their quality of life.

The risk of getting such symptoms increases with age, and around 40% of men aged 60-plus will suffer from urinary symptoms to some extent.

There are several treatments available for prostate enlargement, including lifestyle changes (such as avoiding alcohol and caffeine), medication and surgery.

Other conditions that affect the prostate include prostate cancer, which is the most common cancer diagnosed in men. The chances of developing prostate cancer increase as you get older and most cases develop in men aged 70-plus. Prostate cancer normally causes no symptoms until the cancer has grown large enough to put pressure on the urethra resulting in urination problems.

Prostatitis is a general term that refers to inflammation or infection of the prostate gland. The condition can be very painful and it develops in men of all ages, unlike most other types of prostate disease which usually affect older men. Chronic prostatitis is the most common type with symptoms lasting for at least three months but varying in severity. In acute prostatitis, the symptoms are severe and develop rapidly. It’s caused by a bacterial infection of the prostate gland and is a medical emergency. Without prompt treatment with antibiotics, the prostate and the surrounding areas can become damaged.

The exact cause of benign prostate enlargement is not fully understood. However, hormones appear to play an important role in the development of the condition. As some men get older, the levels of a type of hormone called dihydrotestosterone (DHT) increases, which may cause the prostate to become enlarged. It could also relate to the levels of two hormones, testosterone and oestrogen, in the body. As men get older, the balance of oestrogen in their body increases which could stimulate prostate growth.

Prostate problems usually affect your ability to pass urine normally. Some conditions can cause blood in the urine and others can cause pain when urinating or ejaculating semen.

The symptoms of benign prostate enlargement, the most common prostate problem, are caused by the enlarged prostate pressing on the bladder and the urethra (the tube that carries urine from the bladder to the penis) which affects your ability to urinate normally. Symptoms include:

  • difficulty in starting to urinate
  • weak flow of urine
  • stopping and starting of urine flow
  • having to strain to pass urine
  • a need to urinate frequently
  • waking up frequently during the night to urinate
  • sudden urge to urinate (may lead to incontinence)
  • inability to empty your bladder fully
  • blood in the urine (haematuria)

Other symptoms are rarer and usually occur in later stages, including urine retention and other complications (e.g. bladder stones, bladder infections and kidney damage).

Symptoms of prostate cancer include:

  • urinating more frequently, often during the night
  • urgent need to urinate
  • difficulty in starting to urinate
  • having to strain to pass urine
  • weak flow of urine
  • feeling your bladder has not fully emptied

Symptoms of prostatitis include:

  • pain when urinating
  • pain when ejaculating semen
  • problems urinating
  • discomfort around the scrotum and at the tip of the penis

Your doctor will discuss your symptoms with you and may need to perform a rectal examination to check for prostate cancer which would cause the gland to become hard and bumpy. Other blood and urine tests may be carried out to rule out other conditions which may cause similar symptoms. You may need to be referred to a specialist to undergo further tests and scans.

TURPis- method of prostate resection, bipolar technology

TURPis (transurethral resection of prostate in saline) is a relatively new method of prostate resection using bipolar technology that results in faster prostate resection combined with vaporization, with minimal bleeding during the procedure.

Prostate gland - trans-urethral resection of prostate (TURP)

Prostate surgery aims to reduce the size of the prostate gland in order to restore normal urination function in men who suffer from an enlarged prostate.

What next?

If you are suffering with a suspected condition, you should seek the advice of your doctor who will be able to refer you to Benenden Hospital for diagnosis and treatment.

There are four ways to access treatment at Benenden Hospital which include self-funding, using private medical insurance or your Benenden membership, or through the NHS e-Referral scheme.