Only men have a prostate gland. It is located just below the bladder, and is closely associated with sexual function since it produces a component of semen. It encircles the urethra, the tube through which both semen and urine pass to leave the body and it is this which can give rise to a number of problems in later years. Few things go wrong with the prostate, but those which do are very common.
Most difficulties associated with the Prostate are not detected until they interfere with the passing of urine or blood is noted in the urine or Semen. This is because the gland swells for a number of reasons and tends to choke off the Urethra. In order to detect any abnormal changes, and possibly treat such conditions earlier, regular examinations are important. This is especially so if there is a family history of Prostate Illnesses. Examinations may be on an annual basis, starting from as early as age 40 and can involve Rectal examination of the Prostate and blood tests.
The causes of most problems with the Prostate cannot be identified exactly so recommended preventative measures to help avoid them consists of the usual advice you would expect for leading a healthy lifestyle; a healthy diet, no smoking, and regular exercise.
What is Prostate Enlargement?
Prostate enlargement (Benign prostatic hyperplasia – BPH):
This is very common in older men. As many as half of men over 60 are affected to some extent, and as many as 80% of those over 80. It is believed to be caused by the effect of male hormones and the ageing process and may be an inherited condition. Difficulties with Urinating are the main Symptom, but it can be associated with Urinary tract Infections (UTIs) and kidney damage if left untreated. Accurate diagnosis can only be made by medical examination so go to your GP if you notice any problems Urinating.
Mild cases should be monitored for change but treatment may be unnecessary unless quality of life is seriously affected. Medical or surgical intervention may be required at that point. Some medications work by relaxing the Prostate muscle cells to allow easier Urination. A side effect of these for some men is Retrograde ejaculation, also known as internal Ejaculation which is described in the Ejaculation section of this site.
Other medications limit Testosterone production to shrink the Prostate. Side effects here can include a decrease in Sex drive (Libido), difficulties with Ejaculation or with gaining erections (ErectileDysfunction). Where medical procedures do not help alleviate the problems being encountered then surgery to remove all or part of the Prostate might be carried out (prostatectomy). Again, side effects can include Erectile Dysfunction, Retrograde ejaculation in almost 90% of cases, and urinary Incontinence. Other methods used can include TURP (Transuretheral resection of the Prostate) which is less traumatic, laser and high-intensity sound therapies.
What is Prostatitis?
Prostatitis is a common condition which is Inflammation of the gland caused by bacterial infection, possibly from a Urinary tract infection. Apart from the usual Prostate related symptoms described previously, prostatitis may be accompanied by Rectal, Penile, testicular and low back pain. A fever or chill may also occur.
Acute prostatitis may respond to antibiotics and other medication. If this is not the case and the condition becomes Chronic then the Prostate may eventually be removed surgically (prostatectomy). The results for sexual activity are the same as with any prostatectomy – Erectile Dysfunction that may be treatable as described elsewhere.
What is Prostate Cancer?
Prostate cancer is the growth of the Prostate caused by a Tumour. It is rare in men aged under 40 but becomes more common as age increases. It is estimated that as many as 60% of all men over 80 have some cancer in their Prostate. The younger the person, the more aggressive and serious the cancer tends to be. The older the person, the more slowly developing it usually is – taking perhaps 10 years to become significant.
Although it is the most common cancer in men it accounts for only 3% of annual deaths. Lung cancer is responsible for 8% and heart disease for 30%. A reason for this may be that it mostly occurs in the oldest men.
For these men, it can be the case that their lives are ended by other Illnesses rather than their Prostate cancer. Nevertheless, any diagnosis of cancer will be very frightening. As with other Prostate illness, the main symptoms of difficult Urination or blood in the urine or Semen tend to appear once the condition has been established. There are seldom any early warning signs which is why regular examinations should be considered. It is only by a detailed examination that cancer can be diagnosed.
There are three main options for dealing with Prostate cancer which has not spread from the Prostate:
For men aged 70 and over with other serious Illnesses the doctor may simply wait and see what happens since 90% of cancers will not progress significantly in the patient’s lifetime. Intervention may be worse than leaving the illness alone.
Radiation therapy is estimated to be as effective as surgery for up to 10 years, but there are many unpleasant and painful side effects. It also results in Erectile Dysfunction in 60% of men, which may or may not be treatable as outlined elsewhere on this site.
Surgery provides the best chance for a long term cure and involves the removal of the entire gland (radical prostatectomy) and an examination for further spread of the cancer. Erectile Dysfunction is common following such surgery and many men opt to have a Prosthesis implanted into the Penis at the time of the operation to deal with this. When the disease has been found to have spread to other locations in the body, treatment is more complex and may involve a combination of Interventions, each of which will have its own impact upon sexual activity similar to what has been described previously.