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Prostate disease

Dr. MULAY

SUPERSPECIALITY HOSPITAL

Prostate disease

The prostate gland (the prostate) is an organ of the male reproductive system. It is about the size of a walnut and is found at the base of the bladder. The thin tube that allows urine and semen to pass out of the penis (the urethra) runs through the prostate gland. Alkaline fluid produced by the prostate gland helps to nourish sperm and leaves the urethra as ejaculate (semen). The prostate undergoes two main growth spurts. The first is fuelled by the sex hormones made by the testes during puberty. This prompts the prostate to reach an average weight of 20 grams. The second growth spurt begins when men are in their thirties.

Types of prostate disease

The three most common forms of prostate disease are:
1.inflammation (prostatitis).
2.non-cancerous enlargement of the prostate (benign prostatic hyperplasia, or BPH) and prostate cancer.

Inflammation of the prostate (prostatitis)

While prostatitis can affect men of any age, it is more common in younger men, aged between 30 and 50 years. The main types of prostatitis are:
1) bacterial prostatitis – acute or chronic bacterial infectionnon
2) non-bacterial prostatitis – inflamed prostate, also known as chronic pelvic pain syndrome (CPPS).
In most cases, the cause of prostatitis is unknown. Bacterial prostatitis responds well to antibiotic drugs that can get into the prostate.
Non-bacterial prostatitis, or CPPS, is the most common form of prostatitis and is more difficult to manage. Symptoms vary from one man to another. There is no single test to diagnose CPPS, so your doctor will need to rule out other possible causes of your symptoms before making a diagnosis.

Non-cancerous enlargement of the prostate (BPH)

Non-cancerous enlargement of the prostate, or benign prostatic hyperplasia (BPH), is more common as men get older. It is not life threatening, but can significantly affect your quality of life.

The enlargement of the prostate gland (which surrounds the top of the urethra) causes the urethra to narrow, and puts pressure on the base of the bladder. This can lead to obstruction (blockage) in the flow of urine.

Obstructions usually show up as lower urinary tract symptoms that sometimes result in the urine staying in the bladder when it’s supposed to be released. When this happens suddenly, it’s called acute urinary retention. This is very painful and is usually relieved temporarily by inserting a thin tube (a catheter) to release the urine.

Chronic (ongoing) retention, which is less common, can lead to a dangerous, painless accumulation of urine in the bladder. An uncommon form of chronic urinary retention is associated with high bladder pressures, which can damage kidney function.

Symptoms of prostate disease

Prostate disease is diagnosed using a variety of tests, including:
1.physical examination, including digital rectal examination (DRE), where the doctor inserts a gloved finger into your rectum to check the size of your prostate
2.blood test for prostate specific antigen (PSA test; discuss this with your doctor)
3.mid-stream urine (MSU) tests to look for infection or blood in the urine
ultrasound scans and urinary flow studies
4.biopsies of the prostate.

Treatment for prostate disease

Treatment for prostatitis may include antibacterial drugs and supportive treatments, depending on the type of prostatitis.
Treatment for BPH may include medications to relax the smooth muscle of the gland or to shrink the size of the prostate, and surgery to produce a permanently widened channel in the part of the urethra that passes through the prostate.
Treatment for prostate cancer is tailored to suit individual circumstances. The nature of the cancer, other health problems the person may have, and their wishes will all be taken into account.
Management approaches for prostate cancer include:
1.active surveillance
2.surgery – for example, prostatectomy (removal of the prostate)
3.radiotherapy
4.ablative treatments such as high-intensity focused ultrasound (HIFU) and NanoKnife
5.hormone treatment (androgen deprivation therapy)
6.chemotherapy
7.watchful waiting.