Prostate Issues and Procedures
Prostate gland problems are a common cause of urinary issues in men, and the risk of developing a prostate condition increases with age. A variety of prostate procedures are available to relieve symptoms.
The prostate gland is part of the male reproductive system. It is located inside the groin, just underneath the bladder and in front of the rectum. The prostate secretes a fluid that mixes with sperm and fluids from other glands to form semen. Prostatic fluid contains substances that promote the proper functioning of sperm.
Normally, the adult prostate is the size and shape of a walnut, but it tends to grow larger with age. If it grows too large, it can cause problems with urination and sexual function. Sometimes, changes in the prostate can lead to cancer.
Types of Prostate Issues
Common prostate problems include:
- benign prostatic hyperplasia (BPH) — also called enlarged prostate, a common issue in older men that can cause urinary incontinence, also known as urine leakage, or frequent urination during the night
- prostate cancer — a common malignancy that does not always cause symptoms and is most treatable when detected early
- prostatitis — or inflammation of the prostate, which can cause pelvic pain and urinary issues
Causes of Prostate Issues
Prostatitis is usually due to bacterial infection. The causes of BPH are not clear, but changes in male hormones, inflammation and scar tissue formation, called fibrosis, may contribute. Prostate cancer is caused by changes in the genes of prostate cells. According to the American Cancer Society, it is not known exactly why these changes occur, but age, race, family history, inherited genetic mutations, exposure to toxins and other environmental factors may play a role.
Signs and Symptoms of Prostate Issues
Urinary signs of prostate problems may include:
- blood in urine
- frequent urination
- inability to empty bladder completely
- leaking or dribbling urine
- weak urine stream
Depending on the underlying cause, other symptoms of prostate problems may include:
- bladder stones
- fever and chills
- kidney problems
- pain in the abdomen, pelvis, hips or lower back
- painful ejaculation
- urinary tract infection
- sexual dysfunction
How Are Prostate Issues Diagnosed?
In addition to physical examination and review of health history, diagnostic tests may include:
- blood and urine tests
- digital rectal examination of the prostate
- imaging studies such as transrectal ultrasound and transrectal magnetic resonance imaging, or MRI
- prostate-specific antigen test to help detect prostate cancer and other abnormalities
- transrectal biopsy to check for prostate cancer
A variety of minimally invasive procedures are available to treat BPH and prostatitis including:
- laser prostatectomy — which uses a laser to remove prostate tissue blocking the urethra
- transurethral electrovaporization — which a strong electric current to destroy prostate tissue
- transurethral incision — to enlarge the urethra
- transurethral microwave thermotherapy — which uses heat generated by microwave pulses to destroy prostate tissue
- transurethral needle ablation — which uses high-frequency sound waves to shrink the prostate
- transurethral resection of the prostate — which uses a special cutting tool called a resectoscope to remove part of the prostate blocking the urethra
Prostate cancer treatment plans may include options such as chemotherapy, radiation, immunotherapy, bisphosphonate therapy, targeted therapy, hormone therapy and surgery.
The main type of surgery for prostate cancer is radical prostatectomy (total prostate removal). Techniques include:
- laparoscopic radical prostatectomy — a minimally invasive procedure performed through the smallest possible incision
- open prostatectomy — including radical retropubic prostatectomy (large incision in the abdomen) and radical perineal prostatectomy (incision in the area between the anus and scrotum)
- robot-assisted radical prostatectomy — another type of laparoscopic surgery performed using a robotic surgical system equipped special surgical instruments