Men’s Health's Articles Archives
What is Prostate Cancer?
Prostate cancer is a malignant tumor of the prostate gland, the small walnut-sized gland that lies below the bladder in men. It is one of the most cancers in men in the United States and almost 10% of the adult male population will develop prostate cancer.
The increase in prostate cancer diagnosis over recent years can be attributed to prostate specific antigen (PSA) testing which allows for widespread screening. This coupled with repeated prostate biopsy in the event of elevated PSA levels has allowed for early diagnosis and rapid commencement of treatment thereby reducing the mortality rates. Nevertheless, prostate cancer claims the lives of over 30,000 men in the United States every year.
Weak bladder is a common term to denote two urinary disorders, either urinary incontinence or frequent urination. Despite the use of the term ‘weak’, there is often no functional disorder of the bladder and successful treatment will lead to normal urinary habits and bladder control. Often the same causative condition can lead to both frequent urination and urinary incontinence and the various causes may differ among males and females. A weak bladder should not be confused with a cystocele where the bladder protrudes into the vagina, commonly known as a droopy or fallen bladder.
There are three main conditions that frequently affect the prostate gland :
- Prostatitis which is inflammation or infection of the prostate gland.
- Benign prostatic hyperplasia (BPH) which is the nodular enlargement of the prostate gland due to an increase in the number of cells (not malignant).
- Prostate cancer which is a malignant tumor of the prostate gland.
The prostate gland is an accessory gland in males sitting beneath the bladder and encircling the urethra. It produces and secretes prostatic fluid into the urethra which makes up about 20% of the semen. This fluid is essential to activate the sperm cells and maintaining normal motility and functioning.
The different prostate problems often present in a similar manner, especially in the early stages, with varying degrees of urinary problems and urinary pain commonly reported. Further investigation like cytology and culture of urine or expressed prostatic secretions, measuring and monitoring the PSA levels or a prostate biopsy may be necessary to conclusively identify the type of prostate problem.
Prostate pain (prostatodynia) or discomfort may be seen in all three of the main conditions affecting the prostate gland – prostatitis, benign prostatic hyperplasia (BPH) and prostate cancer. The pain may vary in severity and nature radiating to surrounding structures and extending to the lower back or even the tip of the penis.
At times, prostate pain may involve a large area of the lower abdomen or the entire pelvis. It is not uncommon for no pain to be present, especially in mild BPH and chronic prostatitis, with discomfort or pain only being reported during acute exacerbations and a secondary prostate gland infection.
What is prostatitis?
Inflammation of the prostate gland is known as prostatitis. It may be caused by an infection but there are other non-infectious causes that may also be responsible. Infectious causes of prostatitis are less frequently seen. The non-infectious causes of prostatitis are often chronic and more complex than infectious prostatitis.
Types of Prostatitis
Prostatitis can be categorized as acute or chronic bacterial prostatitis (infectious) or chronic abacterial prostatitis and granulomatous prostatitis. The more widely used classification for prostatitis these days is as follows :
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Chronic prostatitis and chronic pelvic pain syndrome (CPPS), which may be inflammatory or non-inflammatory
- Asymptomatic inflammatory prostatitis
Simply, prostatitis can be divided into infectious and non-infectious.
The prostate gland is major component of male reproductive system. It is an accessory gland that is about the size of a walnut and plays a crucial role in fertilization as its secretions assist with sperm motility and function. The prostate is made up largely of glandular tissue and smaller quantities of fibromuscular tissue.
What does the prostate gland do?
The prostate gland produces a slightly alkaline fluid which adds to the bulk of the ejaculated sperm. The prostatic fluid is a thin, milky fluid containing calcium, citrate, phosphate and enzymes. By neutralizing the acidic environment in the female reproductive tract, prostatic fluid allows sperm to become more motile and fertilize an ovum, if present. Without this contribution, sperm would not function optimally.
There are a number of sexually transmitted diseases but in men, the most commonly seen infections include chlamydia, gonorrhea, genital herpes, HPV (human papilloma virus), syphilis and HIV (human immunodeficiency virus).
Men who are at a greater risk are those who :
- Have multiple sexual partners
- Practice unprotected sex (whether oral, anal or vaginal)
- Have a previous history of sexually transmitted infections
These infections may present with various signs and symptoms in the groin area that may be indistinguishable from other medical conditions. To the untrained eye, it is often difficult to identify the causative organism simply by the physical signs and symptoms. However, the following clinical features should raise the concern about a sexually transmitted disease (STD).
HIV infection rarely presents with the signs and symptoms discussed below, except for short term lymph node swelling. Refer to Early Signs of HIV Infection.
Prostate Biopsy Sampling
How many samples are taken in a prostate biopsy?
A sextant or 6-core biopsy scheme used to be the standard approach where 6 samples are taken systematically from the prostate. The 6 core samples included one each from the base, mid-gland, and apex on either side.
The currently recommended scheme for biopsy is the extended-pattern biopsy which involves taking 12 core samples systematically. In addition, further samples are taken from any lesion that is detected upon a digital rectal examination or ultrasound.
A saturation biopsy scheme (only when indicated) involves taking 30-50 core specimens. Seminal vesicles also may be included in the biopsy in some high risk patients.
BernieK Asked :
I am a 52 year old male and have been have had 3 urinary tract infections in the last 8 months. The first two times I was just given antibiotics by my doctor. No tests apart from an examination. I developed severe diarrhea that lasted for like 2 months. When I got my third infection I insisted that tests be done because I was tired of this repeated antibiotic prescription. The doctor took blood and urine for testing and now wants to send me to a specialist for a further check up. I know this is necessary especially as I am getting older.
My doctor says that the specialist will have do a rectal exam and other tests to strike off certain possibilities. He did not specify anything and I am now a bit worried. I was wondering if there are tests and so on that my doctor could do ahead of time so that we don’t waste the specialist’s time. I want to get all this over and done with instead of going back and forth between doctors. What are the alternatives and what should my doctor be looking for? Like most men, I am really not looking forward to my first and hopefully last rectal exam.
Hematospermia is the term for blood in the semen and can vary from a light pink discoloration to red streaks in the ejaculate. At times the blood may not be visible and many men would not know that they have passed blood when ejaculating. It is rare for semen to be bloody to the extent that it masks the the natural color of ejaculate.
The prostate gland, which lies below the bladder and surrounds the urethra, is the male organ that produces semen. It is very common for the prostate gland to start enlarging after the age of 40, although it may not always produce symptoms. The first noticeable symptoms appear when the enlarged prostate gland presses upon the urethra, causing problems with urination. The most common problems encountered with the prostate are benign prostatic hyperplasia (BPH), prostate cancer and prostatitis.
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