Prostate

Women do not have a prostate. Ok, that’s good news for women, but most men have little regard for this important little gland until they begin having various symptoms. Most symptoms do not occur until after the age of 50.

Men, in general, find the whole issue of prostate dysfunction quietly worrisome. Many men are guilty of avoiding their yearly medical check-up, and a surprising number of men have never had the specific examinations in their lives.

Prostate

First, let define what this little body part is: It's a small gland, about the size of a chestnut. It surrounds the urethra (the tube the goes into the penis that pee passes through) and is located just below the bladder.

It's made up of glands and muscle. With increasing age, these tissues increase in size, resulting in enlargement (BPH). BPH is rare before age 40, but is present in about 80% of men by age 80. About half of these men will have symptoms from the enlargement. We do not know what causes BPH but it appears to be related to subtle changes in hormone production, which occur with aging.

Note that BPH (enlargement) is NOT cancer. Although, it does cause problems as it can squeeze the urethra (the tube that carries pee through the penis) and block the passage of urine. Although uncommon, serious medical issues could include damage to the kidneys or bladder. More commonly, the usual symptoms are annoying symptoms during urination.

SYMPTOMS OF BPH

• Urinating frequently
• Urgency to urinate (unable to postpone)
• Sensation that the bladder cannot be fully emptied (still must pee, but cannot)
• Urinating frequently throughout the night
• Difficulty in starting urinating (long pause before starting to pee)
• Pee stream starts and stops
• Incontinence (loss of control)>br>• Pain when urinating
• Blood found in urine

Although BPH (ie: enlargement) is NOT cancer, it can have symptoms similar to cancer, bladder cancer, prostatitis, and others. So, how can you tell if you have simple enlargement or cancer? To rule out cancer, your doctor will perform various tests.

The first test is the Digital Rectal Exam (When I first heard the term, “Digital”, I though, no problem, it’s probably some type of computerized scope thingamajig. I knew I was wrong when I saw my doctor slipping on his rubber glove. Gulp.)

The doctor slips his lubricated, gloved finger into the rectum, and because the gland is located just in front of the rectum, it’s easy for the doctor to feel the it. He can determine if it is enlarged, or if it has any irregularities in shape or texture.

Ok, that test over, your doctor may also order a PSA test (prostate specific antigen) which is a simple blood test. Prostate cancer usually releases more PSA into the blood than a normal (or enlarged) prostate.

Neither of these two tests above are conclusive, so they are often given together for a stronger indicator. If there is a suspicion of cancer following the digital rectal examination, e.g., a nodule or firm area, and/or an abnormal PSA test, then a biopsy will usually be done. This causes minimal discomfort and is usually performed by inserting a needle into the prostate through the rectum.

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