Prostate problems: Conditions and warning signs - Medical News Today

The prostate is a small gland that plays an important role in male reproductive anatomy. Prostate problems can have a range of causes, including prostatitis, benign prostatic hyperplasia, and prostate cancer.

Due to the location of the prostate in the pelvis, problems typically result in urinary symptoms. If people notice any signs or have concerns, they should consult a doctor.

The prostate is a walnut-sized organ that is part of the male reproductive system. It helps to produce semen and regulate urine flow. It also plays a role in hormone production and semen pH balancing. The prostate gland tends to grow with age, making prostate problems more common in older adults.

Problems with the prostate typically affect its function and can cause various symptoms. The most common problems include an inflamed prostate, an enlarged prostate, and prostate cancer.

In this article, we will discuss prostate problems, their symptoms, and treatments.

The prostate is a small gland that sits in the pelvis, just below the bladder. Men, trans women, and people assigned male at birth may have a prostate. It contains a combination of muscle and glandular tissue. The glandular tissue releases substances such as hormones and enzymes.

The prostate is not essential for life but has various functions, including an important role in reproduction. For example, it supplies fluids that mix with sperm and fluids from other glands to make semen. The prostate muscles force fluid and sperm into the urethra during sex.

The prostate also produces prostate-specific antigen (PSA). PSA is a protein that makes semen more watery. Doctors use PSA tests to diagnose problems with the prostate. A prostate problem could refer to any disease or condition that affects prostate functioning.

Potential prostate problems can include:

Prostatitis

Prostatitis refers to inflammation in the prostate that causes pain and other problems. It is the most common urinary tract problem in men under 50 and the third most common among those older than 50.

The four main types of prostatitis include:

CPPS

CPPS is the most common type of prostatitis and can cause pain or discomfort lasting 3 or more months in one or more of the following areas:

• between the scrotum and anus
• lower stomach
• penis
• scrotum
• lower back

It does not involve bacterial infection and instead can occur due to stress or damage to the urinary tract from surgery or a physical injury. It is an inflammation of the prostate and an irritation of the nerves supplying this area. Symptoms of CPPS can include:

• pain during or after urination
• frequent and urgent need to urinate
• a weak or an interrupted urine stream
• difficulty passing urine
• trouble and pain with ejaculation

A doctor may prescribe medications to help decrease pain, discomfort, and inflammation and suggest home remedies to reduce symptoms.

Acute and chronic bacterial prostatitis

Acute and chronic bacterial prostatitis are the result of bacteria entering the prostate from the urethra.

Acute infections have a shorter onset and duration than chronic infections. The symptoms of acute or chronic prostatitis are mostly the same as CPPS but can also include a burning sensation, urinary tract infections, and the need to urinate during sleep. Acute cases could also cause fever and chills.

Doctors will typically treat acute or chronic bacterial prostatitis with antibiotics for 2–14 weeks. Other medications can help with the pain, such as anti-inflammatory drugs.

Asymptomatic inflammatory prostatitis

Asymptomatic inflammatory prostatitis refers to inflammation of the prostate that does not cause symptoms. A doctor may identify it during a routine check.

Benign prostatic hyperplasia

Benign prostatic hyperplasia is where the prostate grows larger without a cancerous tumor. A 2015 study suggests it is the most common disease in older men, occurring in 15–60% of men over 40.

The likelihood of developing benign prostatic hyperplasia increases with age. An enlarged prostate can press on the urethra and affect bladder functioning, causing symptoms that may include:

• difficulty urinating
• urinary retention, which is a complete inability to urinate
• a weak urination stream
• dribbling after urination
• frequent and urgent need to urinate
• feeling unable to empty the bladder
• needing to urinate during the night
• gross hematuria, or visible blood in the urine

Without treatment, benign prostatic hyperplasia can worsen and cause complications, such as bladder stones. Doctors will typically treat the condition depending on its severity. They might suggest medications or surgery. However, some cases may not currently require treatment as the condition can be unpredictable. Doctors may suggest waiting and checking whether the problem worsens before treating it.

Prostate cancer

Prostate cancer is where cancerous cells grow in the prostate or surrounding tissues. The American Cancer Society states that prostate cancer is the second most common cancer in American men, causing around 248,530 new cases a year. They estimate that around 1 in 41 men will die from prostate cancer, making it the second leading cause of cancer deaths.

It causes many deaths because of how common the disease is and because prostate cancer is usually asymptomatic for many years, meaning people may receive a diagnosis late.

After diagnosis, prostate cancer is highly treatable. Most people with prostate cancer do not die from it.

If prostate cancer does cause symptoms, these include:

• frequent and urgent need to urinate
• a week urination stream
• pain in the rectum, lower back, or around the pelvis and thighs
• pain or burning during urination or ejaculation
• blood in the urine or semen

Doctors will treat prostate cancer differently depending on factors including its severity and the person's overall health. Some treatments include surgery, radiation therapy, hormone therapy, chemotherapy, or immunotherapy.

Prostate problems can range in severity but are usually treatable. It is important for older people, in particular, to be aware of the signs of a prostate problem to get timely treatment. Many signs and symptoms affect urination.

The National Institute of Aging highlights the following common symptoms that may indicate a prostate problem:

• frequent urges to urinate
• having to get up in the night multiple times to urinate
• blood in the urine or semen
• pain or burning during urination or ejaculation
• pain in the lower back, hips, or rectal area
• a weak urine stream or dribbling after urinating

The causes of prostatitis are usually unclear. It can result from nerves and muscles around the pelvis becoming inflamed and causing pain, or it can occur due to a bacterial infection. The infection could be due to infections in other areas, such as the bladder or urinary tract.

Risk factors for prostatitis include:

• having a catheter or another device in the urethra
• abnormal structures in the urinary tract
• bladder or urinary tract infections
• surgery or trauma to the pelvic area or urinary tract

There is also no clear cause of benign prostatic hyperplasia. Some evidence suggests the cause relates to aging as the condition becomes more likely as people get older.

Prostate cancer is the result of genetic changes that cause cancerous cells to grow uncontrollably in the prostate. However, it is unclear what causes these genetic changes to occur in the first place. Factors that can increase the risk of prostate cancer may include:

A doctor will diagnose prostate problems by asking about symptoms and reviewing medical and family histories. They may also perform a physical exam to check for things like swelling around the prostate. A doctor may require further tests to make a diagnosis, such as:

Prostate problems require different treatment approaches depending on their cause. Treatment for common prostate problems typically include:

• watchful waiting, which involves seeing whether symptoms worsen before recommending a treatment
• medications to relax muscles around the prostate and bladder
• surgery
• radio or microwaves to treat urinary difficulties
• pelvic floor therapy
• therapy to deal with the stress of urinary difficulties

Doctors may prescribe specific treatments for some causes, such as antibiotics for chronic or acute bacterial prostatitis.

In cases of prostate cancer, treatments will include options such as surgery, radiation therapy, and hormone therapy. Clinical trials are also testing newer treatments for prostate cancer, such as cryosurgery or photodynamic surgery.

Many prostate problems may not be serious but still require a trip to the doctor. People with urinary problems or other signs of prostate issues should contact a doctor for a checkup. Older people are more likely to develop prostate problems and should be aware of the signs.

Anyone who notices the following symptoms should contact a doctor immediately:

• a complete inability to urinate
• a painful, urgent, and frequent need to urinate
• blood in the urine
• severe pain in the stomach or urinary tract

Prostate problems refer to conditions that affect the function of the prostate and may cause pain or discomfort. Some causes may be mild, but others can become severe without proper treatment, such as prostate cancer. However, most prostate problems are a result of something other than prostate cancer.

People who experience problems urinating or other signs of prostate problems should contact a doctor, who can advise on whether treatment or further tests are necessary to deal with the problem.