The prostate can be quite a troublesome little organ. Though it may be small, prostate problems are very common, and all men are at risk of developing a condition or disease at any point of their life.
The prostate gland is a part of reproductive system, found only in men. Its main role is to produce the fluid that carries and protects sperm. It is located in the lower abdomen in men only.
The prostate surrounds the upper part of the urethra, the thin tube that carries urine from the bladder to the penis. It also carries semen from the prostate and sperm from the testicles to penis during ejaculation.
Problems with the prostate can range from enlargement to infection to cancer, and are common in men over 50, though they can affect men at any age. Let’s take a look at some common prostate conditions.
Cancer of the prostate is the second most common in men after skin cancer, affecting roughly 1 in 6 at some point in their life. However, it is also highly treatable because it grows relatively slowly and because screening processes are efficient.
There are two main types of prostate cancer. If the cancerous cells are contained within the prostate, this is known as localised prostate cancer. Success rates for treatment are quite high in these cases.
If the cancer has grown and spread outside the prostate into the neighbouring organs such as the seminal vesicle or bladder, this is known as locally advanced prostate cancer. If the cancer cells have spread to the bones, lymph nodes, or lungs, this is known as metastatic prostate cancer. Both of these are much harder to treat.
Diagnosing prostate cancer involves a digital rectal exam and a PSA blood tests. If these initial tests reveal you may be at risk of cancer, a biopsy may be required.
Treating prostate cancer is complex, with disease factors and patient factors being considered. Broadly speaking, patients need to pick between robotic surgery, radiotherapy and radioactive seeds (seed brachytherapy).
Benign prostatic hyperplasia – also known as benign prostatic hypertrophy or abbreviated as BPH – is the gradual enlargement of the prostate. This is very common in men as they get older, affecting more than 4 in 5 men over the age of 80.
Due to the location of the prostate, enlargement results in compression of the urethra and an obstruction to the flow of urine, causing all sorts of issues with urination due to compression of the urethra and obstruction to the flow of urine. Symptoms do not affect all men, and can range from mild to severe.
Treatment of BPH will involve removing the obstructing tissue. This can either be done using transurethral techniques (where an instrument called a resectoscope is inserted into the penis), minimally invasive techniques (laparoscopic or robotic surgery), or laser treatment. All of these can be very effective at reducing symptoms, and have great long term outcomes.
Prostatitis is the swelling and inflammation of the prostate gland, an unlike the above it can affect men of all ages. It is caused by either a bacterial or non-bacterial infection of the prostate and can cause pain, discomfort and difficulty with urination.
There are four types of prostatitis: acute bacterial prostatitis, where bacteria makes its way to the prostate via the urinary tract; chronic bacterial prostatitis, where a milder infection lingers for several months with symptoms that come and go; chronic prostatitis, where an infection is caused by physical injury, stress, nerve damage or past infections; and asymptomatic prostatitis, where the prostate is inflamed but no symptoms present themselves.
Treatment of prostatitis will depend on the type and the underlying cause. Antibiotics and symptom management are common treatments. For serious urinary obstructions or chronic pelvic pain syndrome, surgery may be required.
Dr Arianayagam is an experienced urologist and specialist urological surgeon based in Sydney. He works from his urology clinic in Bella Vista, and at both public and private hospitals across Sydney, and treats all kinds of prostate conditions.
If you have any further questions about urology or would like to book an appointment, please feel free to call today.
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