When to get your prostate checked: warning signs and advice - Spire Healthcare

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What are the most common prostate issues?

Enlarged prostate

As previously mentioned, an enlarged prostate is one of the most common prostate issues affecting older men. According to Harvard Medical School, by the age of 60, half of men have an enlarged prostate, rising to 90% by age 85. 

The prostate is a walnut-sized gland that wraps around the tube through which you pass urine. An enlarged prostate can, therefore, interfere with your ability to urinate with common symptoms including: 

  • A more frequent urge to urinate, leaking urine, poor flow of urine, trouble starting to urinate, straining to urinate, and pain or burning while urinating — these symptoms most commonly occur with benign prostate hyperplasia (BPH)
  • Painful ejaculation
  • Frequent pain or stiffness in your lower back, upper thighs, pelvis and/or rectum

These symptoms can significantly interfere with your daily routine. However, there are treatments available, many of which involve simple lifestyle changes, such as drinking fewer alcoholic, fizzy, caffeinated and artificially sweetened drinks, drinking less in the evening and not at all two hours before bedtime, and eating more fruit and fibre. 

There are also techniques to ease your symptoms, such as double voiding, where after urinating you try to urinate again to fully empty your bladder. Bladder training can also help by giving you greater control to go for longer periods without urinating. 

If these lifestyle changes aren't enough to provide relief from your symptoms, there are a range of medicines you can try:

  • Alpha-blockers to relax the muscle at the base of the bladder and in the prostate gland
  • Anti-cholinergics to relax overactive bladder muscles
  • 5-alpha reductase inhibitors to reduce the size of the prostate
  • Diuretics taken during the day to speed up urine production so less urine will be produced at night
  • Desmopressins taken at night to slow down urine production 

If medications are ineffective, there are also surgical procedures, such as transurethral resection of the prostate (TURP). 

Prostatitis

Prostatitis occurs when your prostate becomes swollen and inflamed. There are two types: acute prostatitis which comes on suddenly and is caused by an infection, and chronic prostatitis which comes and goes over several months and is usually not caused by an infection.

Symptoms of acute prostatitis include severe pain when urinating and defecating, as well as constant severe pain in your lower back, lower abdomen, penis, anus and/or testicles. You may also be unable to pass urine, have a fever and generally feel unwell. You should contact your GP immediately and depending on the severity of your symptoms, you may need to go to hospital. Painkillers and antibiotics will usually resolve your symptoms in two to four weeks.

Chronic prostatitis can result in similar symptoms as an enlarged prostate, with additional symptoms including pelvic pain after sex, difficulty getting an erection and pain in the area between your anus and scrotum which gets worse after sitting for a long time. This condition can sometimes resolve on its own but if it persists, painkillers and alpha-blockers can help.

Prostate cancer

Symptoms of prostate cancer overlap with symptoms of an enlarged prostate, namely a more frequent urge to urinate and straining to urinate, as well as feeling that your bladder is never fully empty.  You may also notice blood in your semen or urine.

If you have these symptoms, it is more likely that you have an enlarged prostate. However, it is still possible that you may have prostate cancer, especially if you have a family history of this disease. This is why it is important to have these symptoms investigated by your doctor, starting with a prostate exam. You may then need a blood test and biopsy. Early detection is key to successful treatment. 

Prostate cancer is most common in men in their late 70s and has a high survival rate, according to Cancer Research UK. As prostate cancer is slow to grow, many men do not require treatment and instead have regular check-ups with their doctor to keep a close eye on their cancer. For those men that do require treatment, surgery is carried out to remove the prostate, followed by radiotherapy.

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