What Is Prostate Disease And How Is It Treated?

What Is Prostate Disease And How Is It Treated?

Prostate Enlargement, Prostatitis, And Prostate Cancer Are Common Prostate Diseases. Join Us To Learn More About These Diseases.

The prostate is a small, round-shaped gland in men that produces the seminal fluid that helps nourish and transport sperm. The prostate has several functions. The most essential part of the prostate is to produce semen, which is one of the components of semen. The prostate also controls hormone production and helps regulate urine flow.

Prostate problems are widespread in older men. The most common prostate problems are prostatitis, prostate enlargement, and prostate cancer. Symptoms of prostate problems often manifest as difficulty urinating, which may include poor bladder control or poor urine flow.

What is the prostate?

The prostate is a small gland located directly below the bladder and plays a role in the production and optimization of semen. A capsule of connective tissue that contains muscle fibers surrounds the prostate. This capsule makes the prostate feel elastic when touched.

On average, the prostate is about the size of a walnut or a ping-pong ball. The weight of the prostate is about 30 grams. The prostate is located deep in the pelvis, between the penis and the bladder. You can feel the prostate gland by inserting your finger in the rectum and pressing it towards the front of the body.

The urethra, the tube that leads urine and semen out of the body, passes through the prostate. Since the prostate surrounds this duct, problems with the prostate can affect urine flow. This organ is one of the parts of male reproductive or sexual anatomy. Other parts include the penis, scrotum, and testicles.

What are the functions of the prostate?

A person does not need an active prostate to live, But the prostate is essential for fertility. The functions of the prostate include:

Helping to produce semen: The prostate’s main functionate is to add prostatic fluid to the semen. 20 to 30% of semen volume is related to prostate fluid, and the rest comes from a seminal vesicle or seminal sac (50 to 65%) and testicles (5%).

Prostate fluid contains components such as enzymes, zinc and citric acid that make semen an ideal environment for sperm cells to live. One important enzyme is prostate-specific antigen (PSA), which helps dilute and liquefy semen.

The fluid in the semen helps the sperm to pass through the urethra and survive during its journey to reach the egg. Prostate fluid is slightly acidic; But other components of semen generally make it alkaline. The reason why semen is alkaline is that it can neutralize the acidic environment of the vagina and protect the sperm from damage.

Closing the urethra during ejaculation: during ejaculation, the prostate contracts and pours prostatic fluid into the urethra. Here, this fluid combines with sperm cells and seminal vesicle fluid to form semen, which is then expelled from the body. When the prostate contracts during ejaculation, it blocks the opening between the bladder and the urethra, forcing the semen out. This is why it is not possible to urinate and ejaculate at the same time in normal anatomical situations.

Hormone metabolism: The prostate needs androgens such as testosterone to function properly. Androgens are male sex hormones.

The prostate contains an enzyme called 5-alpha reductase, which converts testosterone to a biologically active form called dihydrotestosterone (DHT). This hormone is important for the growth and normal functioning of the prostate. In developing males, this hormone is necessary for the development of secondary sexual characteristics such as facial hair growth.

Prostate diseases

Benign prostatic hyperplasia, prostatitis and prostate cancer are among the most common prostate diseases. Although these diseases have different causes, they share similar symptoms. That’s why it’s important to talk to your doctor about prostate cancer screening as part of your annual physical.

Suppose you have the symptoms of the mentioned diseases. In that case, the doctor will often refer you to a urologist (a doctor specializing in diseases of the urinary system and male reproductive system). In the following, we explain the mentioned diseases.

Prostate enlargement or benign prostatic hyperplasia (BPH)

Benign prostatic hyperplasia (BPH), an enlarged prostate gland, is a common problem in older men. Enlargement of the prostate gland can cause annoying urinary symptoms such as blocking the flow of urine from the bladder. This condition can also cause bladder problems, urinary tract problems or kidney problems.

There are several effective treatments for prostate enlargement, including medications, minimally invasive treatments, and surgery. To choose the best option, the patient and the doctor consider the symptoms, the size of the prostate and other health conditions that the person may have, as well as the patient’s preference.

When the prostate becomes enlarged, it may block the flow of urine from the bladder to the urethra.

Signs and symptoms of prostate enlargement

The severity of symptoms varies among people with an enlarged prostate gland, but symptoms usually become more severe over time. The common signs and symptoms of benign prostatic hyperplasia are:

  • Frequent or urgent need to urinate
  • Frequent urination at night
  • Difficulty starting to urinate
  • A weak urine stream or a stream that stops and then starts
  • Urine drips at the end of emptying
  • Inability to empty the bladder completely

The signs and symptoms of prostate gland enlargement, which are less common, include:

  • Urinary tract infection
  • Inability to urinate
  • The presence of blood in the urine

Prostate size does not necessarily determine the severity of symptoms. Some men with mildly enlarged prostates can have significant symptoms, while other men with very enlarged prostates may have minor urinary symptoms. In some men, symptoms eventually stabilize and may even improve over time.

Other possible causes of urinary symptoms

Conditions that can lead to symptoms similar to those caused by an enlarged prostate include:

  • Urinary tract infection
  • inflammation of the prostate (prostatitis)
  • Urethral stricture
  • The presence of a wound in the neck of the bladder as a result of past surgery
  • Bladder or kidney stones
  • Problems with the nerves that control the bladder
  • Prostate cancer or bladder cancer

When should you see a doctor?

If you have urinary problems, you should see a doctor. Even if urinary symptoms do not bother you, it is important to identify their cause. Untreated urinary problems may lead to urethral obstruction. If you are unable to urinate, see a doctor immediately.

Cause of prostate enlargement

The prostate gland is located below the bladder. The tube that carries urine from the bladder to the penis for elimination (urethra) passes through the center of the prostate. When the prostate becomes enlarged, it blocks the flow of urine.

In most men, prostate growth continues throughout life. In many men, this continued growth enlarges the prostate enough to cause urinary symptoms or significantly block the flow of urine. It is not entirely clear what causes an enlarged prostate. However, prostate enlargement may be caused by changes in the balance of sex hormones as men age.

Risk factors of benign prostate hyperplasia

The risk factors of prostate gland enlargement include:

Older age : Prostate enlargement rarely causes signs and symptoms in men younger than 40 years old. About a third of men experience moderate to severe symptoms by the age of 60, and by the age of 80, about half of them show these signs and symptoms.

Family history : Having a blood relative such as a father or brother who has prostate problems means that you are more likely to have problems in this field.

Diabetes and heart disease : Studies show that diabetes as well as heart disease and the use of beta blockers may increase the risk of developing BPH.

Lifestyle : Obesity increases the risk of developing BPH, while exercise can reduce this risk.

Complications of prostate enlargement

Complications of prostate enlargement can include the following:

Sudden inability to pass urine (urinary retention) : It may be necessary to insert a tube (catheter) into the bladder to drain urine. Some men with enlarged prostates need surgery to relieve urinary retention.

Urinary tract infections (UTIs) : Inability to empty the bladder completely can increase the risk of urinary tract infections. If urinary tract infections occur frequently, surgery may be needed to remove part of the prostate.

Bladder stones : These are usually caused by the inability to empty the bladder completely. Bladder stones can cause infection, irritation of the bladder, blood in the urine, and obstruction of the flow of urine.

Bladder damage : A bladder that does not empty completely may become distended and weakened over time. As a result, the muscular wall of the bladder does not contract properly and it becomes more difficult to completely empty the bladder.

Kidney damage: Pressure in the bladder due to urinary retention can directly damage the kidneys or allow bladder infections to reach the kidneys. Most men with an enlarged prostate do not suffer from these complications. Although acute urinary retention and kidney damage can be a serious health threat. According to experts, having a large prostate does not increase the risk of prostate cancer.

psa test

Diagnosis of prostate enlargement

The doctor begins by asking detailed questions about the patient’s symptoms and performing a physical examination. This initial examination will likely include the following:

Rectal examination : the doctor inserts his finger (with a lubricated glove) into the patient’s rectum to check his prostate for enlargement.

Urinalysis : Analyzing a sample of urine can help rule out infection or other problems that can cause similar symptoms.

Blood test : The results can show kidney problems.

Prostate-specific antigen (PSA) blood test: PSA is a substance produced in the prostate. As the prostate enlarges, the PSA level increases. However, elevated PSA levels can also be caused by recent procedures, infections, surgery, or prostate cancer.

After that, your doctor may recommend additional tests to help confirm an enlarged prostate and rule out other possible problems. These tests include:

Urine flow test: The patient urinates in a tank connected to a device that measures the intensity and amount of urine flow. The results of this test help to determine whether a person’s condition is improving or worsening over time.

Residual urine volume test after emptying : This test determines whether you can empty your bladder completely. This test can be done using ultrasound or by inserting a catheter into the bladder after urination to measure the volume of urine left in the bladder.

If the person’s condition is more complicated, the doctor may recommend the following:

Transrectal ultrasound : The ultrasound probe is placed in the patient’s rectum to measure and evaluate the prostate.

Prostate sampling : Transrectal ultrasound guides the needles used for prostate tissue sampling. Examining the tissue can help the doctor diagnose or rule out prostate cancer.

Urodynamics and pressure flow tests : The catheter is inserted into the bladder through the urethra. Water and sometimes air is slowly injected into the bladder. Then the doctor can measure the pressure of the bladder and determine the function of the bladder muscles. These tests are usually only done in men suspected of having neurological problems and in men who have had a previous prostate-related procedure and still have symptoms.

Cystoscopy : a kind of flexible instrument equipped with light (cystoscope) enters the patient’s urethra and allows the doctor to see the inside of the urethra and bladder. Before performing this test, the person is under local anesthesia.

Prostate enlargement treatment

A wide variety of treatments are available for prostate enlargement, including medications, minimally invasive treatments, and surgery. The best treatment option for each patient depends on various factors, including the following:

  • Prostate size
  • Age
  • general health
  • The amount of discomfort a person experiences

If the patient’s symptoms are tolerable, he may decide to delay treatment and monitor the symptoms. For some men, symptoms go away without treatment.

Medicines used to treat prostate enlargement

Medications are the most common treatment for mild to moderate symptoms of an enlarged prostate. Drug options include:

Alpha blockers : These drugs relax the muscles of the bladder neck and muscle fibers in the prostate and make urination easier. Alpha-blockers, which include drugs such as alfozosin, doxazosin, tamsulosin, and silodosin, usually work quickly in men with relatively small prostates. Side effects may include dizziness and an unsafe condition in which semen flows back into the bladder instead of coming out of the tip of the penis (retroverted ejaculation).

5 alpha reductase enzyme inhibitors : These drugs shrink the prostate by preventing hormonal changes that cause prostate growth. It may take six months to see the effectiveness of these drugs, which include finasteride and dutasteride. Side effects of the mentioned drugs include retrograde ejaculation.

Combined drug treatments : If the drugs alone are not effective, the doctor may recommend the simultaneous use of an alpha-blocker and a 5-alpha-reductase enzyme inhibitor.

Tadalafil : Studies show that this drug, which is often used to treat erectile dysfunction, can also treat prostate enlargement.

Minimally invasive and surgical treatments for prostate enlargement

Minimally invasive treatments or surgery may be recommended if:

  • The patient’s symptoms are moderate to severe
  • Medicines do not relieve symptoms
  • Have urinary tract obstruction, bladder stones, blood in urine or kidney problems
  • Prefer definitive treatment

Minimally invasive treatment or surgery may not be a good option if you have the following conditions:

  • Untreated urinary tract infection
  • Urethral stricture
  • History of prostate radiation therapy or urethral surgery
  • A neurological disorder such as Parkinson’s disease or multiple sclerosis (MS)

Any prostate surgery can cause side effects. Depending on the method chosen, complications may include:

  • Semen returns to the bladder instead of exiting the penis during ejaculation (retroverted ejaculation).
  • Temporary difficulty urinating
  • Urinary tract infection
  • Bleeding
  • erectile dysfunction
  • Rarely, loss of bladder control (incontinence).

Minimally invasive treatments and surgery to treat prostate enlargement

Transurethral resection of the prostate (TURP): A lighted scope is inserted into the urethra and the surgeon removes the outer part of the prostate. The TURP procedure generally relieves symptoms quickly, and most men will have a stronger urine stream after the procedure. After TURP, you may temporarily need a catheter to drain your bladder.

Transurethral Incision of the Prostate (TUIP): A lighted scope is inserted into the urethra and the surgeon makes one or two small incisions in the prostate gland, which makes it easier for urine to pass through the urethra. If the prostate gland is slightly enlarged, this option can be suitable, especially if the patient has health problems that make other surgeries too risky.

Transurethral microwave thermotherapy (TUMT): The doctor inserts a special electrode into the prostate area through the urethra. The microwave energy from the electrode destroys the inside of the enlarged prostate gland, shrinking it and making urine flow easier. TUMT may only partially relieve symptoms and it may take some time to see results. This surgery is usually only used in special circumstances and only in small prostates; Because retreatment may be needed.

Transurethral ablation of the prostate (TUNA): In this procedure, a scope is inserted into the urethra and allows the doctor to insert needles into the patient’s prostate gland. Radio waves pass through the needles, heating and removing excess prostate tissue that blocks the flow of urine. The TUNA method may be an option of choice in some cases; But this procedure is rarely used anymore.

Laser therapy: A high-energy laser destroys the overgrown prostate tissue. Laser therapy generally provides immediate symptom relief and has a lower risk of side effects than non-laser surgeries. Laser therapy may be used in men who should not undergo other prostate procedures due to the use of blood thinners.

Laser treatment options include:

Ablation procedures : These procedures evaporate the obstructing tissue of the prostate in order to increase the flow of urine. Examples of this procedure include photoselective vaporization of the prostate (PVP) and holmium laser ablation of the prostate (HoLAP). Non-surgical procedures can cause symptoms of urinary irritation after surgery, so, in rare circumstances, another shave may be needed at some point.

Surgery to remove tissue : Tissue removal procedures such as HoLEP generally remove all prostate tissue that is blocking the flow of urine and prevent the tissue from growing back. The removed tissue can be checked for prostate cancer or other problems. These procedures are similar to open prostatectomy.

Prostatic Urethral Lift (PUL): A special clip is used to compress both sides of the prostate to increase urine flow. This procedure may be recommended if you have lower urinary tract symptoms. The PUL procedure may also be offered to some men who are concerned about the effect of the treatment on erectile dysfunction and ejaculation problems; Because the effect of PUL on ejaculation and sexual function is much less than TURP.

Embolization: In this experimental procedure, the blood supply to or from the prostate is selectively blocked, which causes the prostate to shrink in size. Long-term data on the effectiveness of this method are not yet available.

Open prostatectomy or robot-assisted prostatectomy: The surgeon makes an incision in your lower abdomen to access the prostate and remove tissue. An open prostatectomy is generally performed if the prostate is very enlarged, the bladder is damaged, or there are other problems. Surgery usually requires a short stay in the hospital and the patient may need a blood transfusion.

Care after treatment of prostate enlargement

Follow-up care depends on the specific procedure used to treat your enlarged prostate. If you have non-surgical laser, TUNA, or TUMT procedures, your doctor may recommend avoiding heavy lifting or excessive exercise for seven days. If you’ve had an open or robotic prostatectomy, you may need to limit your activities for six weeks.

The effect of lifestyle and home remedies on the control of prostate enlargement symptoms

To help control the symptoms of an enlarged prostate, try:

Limit the consumption of drinks at night : Do not drink anything an hour or two before going to bed so that you do not have to go to the toilet in the middle of the night.

Limit caffeine and alcohol : They can increase urine production, irritate the bladder, and worsen symptoms.

Limit the use of decongestants or antihistamines : These drugs tighten the band of muscle around the urethra that controls the flow of urine, making it harder to urinate.

When you first feel the need to urinate, do so : waiting too long may overstretch the bladder muscle and cause injury.

Plan to go to the bathroom : To retrain your bladder, try to urinate at regular times, such as every four to six hours throughout the day. This can be especially helpful if you have a frequent and urgent need to urinate.

Follow a healthy diet:  Obesity is linked to prostate enlargement.

Be physically active : Inactivity plays a role in urinary retention. Even a little exercise can help reduce urinary problems caused by an enlarged prostate.

Try peeing in two steps : pass your urine and then repeat it a few moments later.

Keep yourself warm: Cold temperatures can cause urine retention and increase the need to urinate.

Do herbal remedies cure prostate enlargement?

The US Food and Drug Administration has not approved any herbal medicine for the treatment of enlarged prostate. Studies on herbal remedies as a treatment for prostate enlargement have produced conflicting results. One study found that saw palmetto extract was as effective as finasteride in relieving BPH symptoms; But a placebo-controlled trial did not find evidence that saw palmetto extract was better than a placebo.

Other herbal remedies (including beta-sitosterol, pygeum, and rye extracts) have been suggested to be helpful in reducing the symptoms of an enlarged prostate; But the long-term safety and effectiveness of these treatments have not been proven. Tell your doctor if you are taking herbal medicines. Some herbal products may increase your risk of bleeding or interact with other medications you are taking.

Is sexual activity related to prostate enlargement?

It is likely that age has a much greater impact on prostate health than sex life. A study on about 2000 men with enlarged prostate showed that ejaculation frequency has no effect on prostate size.

prostatitis

Prostatitis is a disorder of the prostate gland that is usually accompanied by inflammation. Prostatitis often causes painful or difficult urination, as well as pain in the groin, pelvic area, or genitals. Bacterial infections cause some cases of prostatitis.

Types of prostatitis

In general, there are four types of prostatitis:

Acute bacterial prostatitis : a bacterial infection of the prostate that is usually associated with sudden and severe symptoms.

Chronic bacterial prostatitis : a persistent or recurring bacterial infection, the symptoms of which are usually less severe.

Chronic prostatitis/chronic pelvic pain syndrome : Persistent or recurrent pelvic pain and urinary tract symptoms without evidence of infection.

Asymptomatic inflammatory prostatitis : This type of prostatitis has no obvious symptoms and is often diagnosed during testing for other conditions.

Symptoms of prostatitis

Signs and symptoms of prostatitis can vary depending on the type of disorder. They may include:

  • Pain or burning sensation when urinating
  • Difficulty urinating, such as dribbling or delayed urination
  • Frequent urination, especially at night
  • Urgent need to urinate
  • cloudy urine
  • The presence of blood in the urine
  • Pain in the abdomen, groin or back
  • Pain in the area between the scrotum and the rectum (interstitial)
  • Pain or discomfort in the penis or testicles
  • painful ejaculation
  • Fever, chills, muscle aches and other flu-like symptoms (with acute bacterial prostatitis)

When should you see a doctor?

Several conditions can cause signs and symptoms associated with prostatitis. It is important to make an accurate diagnosis and treatment as soon as possible. See a doctor immediately if you have the following symptoms:

  • Inability to urinate
  • Painful or difficult urination with fever
  • The presence of blood in the urine
  • Severe discomfort or pain in the pelvic or genital area

Causes of prostatitis

Causes vary depending on the type of prostatitis. Common strains of bacteria usually cause acute bacterial prostatitis. The infection may spread to the prostate from other parts of the urinary or reproductive tract. Chronic bacterial prostatitis is usually caused by the same factors that cause acute bacterial prostatitis. This condition may occur when treatment for an acute infection is not long enough or fails to kill all the bacteria.

Chronic prostatitis/chronic pelvic pain syndrome is poorly understood. Research shows that several factors may play a role. These factors include past infections, nervous system dysfunction, immune system dysfunction, psychological stress, or irregular hormonal activity. Asymptomatic inflammatory prostatitis, which has no known cause, is generally diagnosed during examination for other medical conditions and does not require treatment.

Prostatitis risk factors

Prostatitis risk factors include:

  • 50-59-year-old men are three times more likely to develop prostatitis than 20-30-year-old men.
  • History of prostatitis
  • Urinary tract or reproductive tract infection
  • HIV infection or AIDS
  • Using a tube that is inserted into the urethra to empty the bladder (urinary catheter)
  • Prostate tissue diagnostic sampling (biopsy)

Additional risk factors for chronic prostatitis/chronic pelvic pain syndrome may include:

  • mental stress
  • Nerve damage in the pelvic area due to surgery or trauma

Complications of prostatitis

Complications of acute or chronic bacterial prostatitis can include the following:

  • Bacterial infection of the blood
  • Inflammation of the convoluted tube attached to the back of the testicle
  • A cavity filled with pus in the prostate (prostate abscess)
  • An infection that spreads to the pelvis or lower spine

Complications of chronic prostatitis/chronic pelvic pain syndrome may include:

  • Anxiety or depression
  • Sexual dysfunction such as erectile dysfunction
  • Changes in sperm and semen that may cause infertility

There is no direct evidence that prostatitis can lead to prostate cancer. Researchers are investigating whether chronic inflammation of the prostate is a risk factor for cancer.

Prostatitis: Does sexual activity make prostatitis worse?

Prostatitis is swelling and inflammation of the prostate gland. If you have prostatitis, you don’t need to avoid sex. Normally, sex does not make prostatitis worse; But some men with prostatitis have pain during ejaculation.

Prostatitis is often caused by a bacterial infection. Prostatitis is not usually caused by something that can be transmitted to a person’s sexual partner during sex; But in some cases, prostatitis may be caused by a sexually transmitted infection. If you have sores in your genital area or unusual discharge from your penis, avoid sex until you see a doctor.

Prostatitis and other diseases with similar symptoms have many possible causes. Some of them can have serious consequences if left untreated. See your doctor if you have pelvic pain, painful or difficult urination, or painful ejaculation.

Rectal examination to diagnose prostate diseases

Diagnosis of prostatitis

Symptoms associated with prostatitis can be caused by a variety of conditions. You may be referred to a specialist in urinary tract and reproductive system disorders. The doctor will perform a physical examination, review your symptoms and medical history, and order tests to determine the cause and rule out certain diseases.

Tests to diagnose bacterial infections

Diagnostic tests to evaluate for infection may include:

Rectal examination : In this method, the doctor inserts his finger into the patient’s rectum to diagnose prostate inflammation.

Urine test: A sample of urine must be tested to check the presence and type of bacterial infection.

Blood tests : Blood samples may be tested for signs of infection and other prostate problems.

Prostate sample testing : In some cases, the doctor may gently massage the prostate during a rectal exam to release prostatic fluid into the urethra. After the massage, he takes a urine sample of the prostate fluid with him, which can be tested for bacterial infection.

Other tests

If initial tests show no signs of infection, you may need to have additional tests, including:

Urodynamic tests : To measure how much the bladder and urethra hold and release urine, various tests can be used. These tests can help identify problems related to urination and identify the source of the problems.

Imaging : Imaging tests may be recommended to identify prostate disorders, abnormal growths, or other problems in the pelvic area that may be causing pain.

Treatment of prostatitis

Treatment of prostatitis depends on the specific type diagnosed and the symptoms.

Antibiotics will be prescribed when treating infection: If the patient has acute or chronic bacterial prostatitis. In acute cases, antibiotics may be given intravenously to the patient’s body. The course of antibiotic treatment is usually 4 to 6 weeks and in some cases longer. All prescribed medications should be taken to eliminate infection and reduce the risk of chronic bacterial prostatitis.

Treatment of urinary symptoms: Alpha-blocker drugs help to relax the bladder neck and muscle fibers at the junction of the prostate and the bladder. This treatment may reduce urinary symptoms such as painful or difficult urination. While these drugs are usually prescribed for men who have chronic prostatitis/chronic pelvic pain syndrome, they may also be prescribed to relieve urinary symptoms of bacterial infections.

Pain treatment: The doctor may prescribe pain relievers.

Managing psychological symptoms: A doctor may recommend psychotherapy with a mental health professional to help the patient manage the stress, depression, or anxiety that may accompany chronic pain.

Lifestyle and home remedies

The following may help relieve some of the symptoms of prostatitis:

  • Using a sitting bath (sitting in hot water) or a hot water bag to reduce symptoms
  • Limit alcohol, caffeine, and spicy or acidic foods that can irritate the bladder
  • Drink lots of water. This will make you urinate more and help flush bacteria out of the bladder.

Can prostatitis be prevented?

Prostatitis is a condition that causes the prostate gland to become swollen, tender and inflamed. This condition can be very painful especially during urination or ejaculation (release of semen during orgasm). The most common places of pain are the perineum (the area between the anus and the scrotum), the testicles (58%), the suprapubic area (above the pubic bone) and the penis.

Doctors aren’t always sure what causes prostatitis. Common causes vary depending on whether they are acute or chronic and infectious or inflammatory. Sometimes the cause of this is a urinary tract infection. Other times, it is caused by injury or nerve damage.

In many cases, doctors do not find the cause of prostatitis. Because of this, prostatitis can be difficult to treat. For some men, recovery may take months or even years. There is no sure way to prevent this condition; But many small lifestyle changes can help maintain a healthy prostate gland. They may also reduce the risk of prostatitis.

 If you have prostate problems, try the following to reduce symptoms and prevent the problem from worsening.

Maintain hygiene: Keep the penis and the area around it clean to prevent infection.

Avoid sitting for long periods of time: When you sit for long periods of time, it puts pressure on your prostate gland, causing it to become inflamed over time. Try to avoid prolonged cycling and prolonged sitting.

Be physically active : exercise at least three times a week. Take a brisk walk around the park, stretch, hit the gym for cardio. Just move. Physical activity can reduce feelings of anxiety associated with some types of prostatitis. Men with prostatitis also report that exercise relieves their symptoms.

Stay hydrated : Some types of prostatitis occur when bacteria in your urinary tract find their way into the prostate and cause an infection. Be sure to stay hydrated to dilute your urine and flush your bladder.

Ask your doctor for help : If you have a medical condition such as chronic kidney disease or congestive heart failure, ask your doctor about special precautions you should take.

Eat more fruits and vegetables : They are packed with nutrients and can keep your body healthy and help fight infections and inflammation.

Avoid eating spicy foods : There is no research that shows that eating certain foods can prevent prostatitis; But spicy foods can irritate the bladder and aggravate the symptoms of prostatitis.

Limit caffeine and alcohol : Beverages such as tea, coffee, and soda can irritate the urinary tract and bladder. Alcoholic beverages have the same effect.

Maintain a healthy weight : Being overweight is not good for the prostate. Try to lose unwanted weight by having a healthy diet, physical activity and adequate sleep.

Manage your stress:  Prostatitis is more likely to occur in men who are under a lot of stress at work or at home. Talk to a therapist to help you manage your emotions. You can also learn meditation or a method like whole body relaxation. This technique teaches you how to release physical tension from your body to relax your mind.

Practice safe sex : Sexually transmitted infections (STIs) sometimes cause prostatitis. When you have sex with an infected person and don’t use a condom, bacteria can enter your vagina. These microbes may eventually reach the prostate. If you are not having sex with just one person, use a condom every time you have vaginal, oral or anal sex.

See a doctor if you have a problem : pay attention to whether you go to the toilet more than usual or do you have pain when urinating? These can be signs that your prostate has a problem. Also, if you have to strain to defecate or feel pain while doing it, see a doctor.

Prostate Cancer

Prostate cancer is a cancer that occurs in the prostate. Prostate cancer is one of the most common types of cancer. Many prostate cancers grow slowly and are confined to the prostate gland and may not cause serious damage.

However, while some types of prostate cancer grow slowly and may require little or no treatment, other types are aggressive and can spread quickly. Prostate cancer that is diagnosed in its early stages (when it is still confined to the prostate gland) has the best chance of successful treatment.

Signs and symptoms of prostate cancer

Prostate cancer may not cause any signs or symptoms in its early stages. Prostate cancer that is more advanced may cause signs and symptoms such as:

  • Difficulty urinating
  • Hypotension and decreased urine flow
  • The presence of blood in the urine
  • The presence of blood in semen
  • Skeletal pain
  • Lose weight without effort
  • erectile dysfunction

When should you see a doctor?

See your doctor if you notice any persistent and worrisome signs and symptoms.

Causes of prostate cancer

It is not known what causes prostate cancer. Doctors know that prostate cancer starts when changes occur in the DNA of prostate cells. A cell’s DNA contains instructions that tell the cell what to do. These changes tell the cells to grow and divide faster than normal cells.

While other cells die, these abnormal cells continue to live. As a result, the accumulation of abnormal cells forms a tumor that can grow and invade the adjacent tissue. Over time, some abnormal cells can break away from the tumor and spread to other parts of the body (metastasize).

Prostate cancer risk factors

Factors that can increase the risk of prostate cancer include:

Age : The risk of prostate cancer increases with age. The prevalence of prostate cancer is high after the age of 50.

Race : For reasons that are not yet clear, black men are at a higher risk of prostate cancer than men of other races. In black men, prostate cancer is more likely to be aggressive or advanced.

Family history : If a blood relative such as a parent, brother or child has been diagnosed with prostate cancer, your risk may be high. You may also have a higher risk of developing prostate cancer if you have a family history of genes that increase your risk of breast cancer (BRCA1 or BRCA2) or if you have a very strong family history of breast cancer.

Obesity : People who are obese may be more likely to develop prostate cancer than those who are at a healthy weight, although studies have produced conflicting results. In obese people, cancer is more likely to be aggressive and more likely to return after initial treatment.

Complications of prostate cancer

Complications of prostate cancer and prostate cancer treatments include:

Cancer that spreads (metastasizes) : Prostate cancer can spread to nearby organs, such as the bladder, or reach bones or other organs through the bloodstream or lymphatic system. Prostate cancer that spreads to the bones can cause pain and bone fractures. When the prostate has spread to other areas of the body, it may still respond to treatment and be controlled; But it is unlikely to be completely cured.

Urinary incontinence : Both prostate cancer and its treatment can cause urinary incontinence. Incontinence treatment depends on the type of cancer, its severity and the possibility of its recovery over time. Treatment options can include medications, catheters, and surgery.

Erectile dysfunction : Erectile dysfunction can be the result of prostate cancer or its treatments, including surgery, radiation therapy, or hormone therapy. Erectile dysfunction treatment options include medications, vacuum devices, and surgery.

Prostate cancer screening

Testing asymptomatic healthy men for prostate cancer is controversial. There is disagreement among medical organizations about whether the benefits of the test outweigh its possible risks.

Most medical organizations encourage men 50 and older to discuss the pros and cons of prostate cancer screening with their doctor. This discussion should include consideration of the patient’s risk factors and screening preferences.

Screening tests for prostate disease may include:

Anal examination : During this type of examination, the doctor inserts his finger into the patient’s rectum to examine the prostate, which is located next to the rectum. If your doctor detects any abnormalities in the lump’s texture, shape, or size, more tests may be needed.

Prostate-specific antigen (PSA) test: A blood sample is taken from a vein in your arm and analyzed for PSA, a substance naturally produced by the prostate gland. The presence of small amounts of PSA in the circulation is normal. However, a higher than normal level may indicate a prostate infection, prostatitis, prostate enlargement, or prostate cancer.

Diagnosis of prostate cancer

If an abnormality is found during a prostate cancer screening, your doctor may recommend additional tests to determine if you have prostate cancer. These tests include:

Ultrasound : During transrectal ultrasound, a small probe in the size and shape of a cigarette is inserted into the rectum. This probe uses sound waves to create an image of the prostate gland.

Magnetic Resonance Imaging (MRI) : In some situations, your doctor may recommend an MRI scan of the prostate to create a more detailed picture. MRI images may help the doctor plan a procedure to remove samples of prostate tissue.

Prostate tissue sampling : To determine if there are cancer cells in the prostate, your doctor may recommend a procedure to collect a sample of prostate cells (prostate biopsy). A prostate biopsy is often performed using a thin needle that is inserted into the prostate to collect tissue. The tissue sample is analyzed in a laboratory to determine if cancer cells are present.

Determining whether prostate cancer is aggressive or not

Once the biopsy confirms the presence of cancer, the next step is to determine how aggressive the cancer cells are. A doctor examines a sample of cancer cells in the laboratory to determine how different the cancer cells are from healthy cells. A higher grade indicates a more aggressive cancer that is more likely to spread quickly.

The techniques used to determine the aggressiveness of cancer are:

Gleason score : The most common criterion used to evaluate the grade of prostate cancer cells is the Gleason score. The two numbers are combined to determine the Gleason score and can range from 2 (non-invasive cancer) to 10 (very aggressive cancer), although the lower end of this range is not often used.

Most Gleason scores used to evaluate prostate biopsy samples range from 6 to 10. A score of 6 indicates low-grade prostate cancer. A score of 7 indicates moderate-grade prostate cancer, and scores of 8 to 10 indicate high-grade cancers.

Genomic testing : Genomic testing analyzes prostate cancer cells to determine which gene mutations are present. This type of test can provide more information about the patient’s prognosis.

It is unclear which patients may benefit most from this information, so these tests are not widely used. Genomic tests are not necessary for all men with prostate cancer; But in some situations, they may provide more information to make treatment decisions.

Determine if cancer has spread

When prostate cancer is diagnosed, the doctor tries to determine the stage of the cancer. If your doctor suspects that the cancer may have spread beyond the prostate, he may recommend one or more of the following imaging tests:

  • Bone scan
  • ultrasound
  • Computed tomography or CT scan
  • magnetic resonance imaging (MRI)
  • Positron emission tomography (PET scan)

Not everyone needs to do all of these tests. The doctor helps the patient determine the best method for his condition. The doctor uses the information from these tests to determine the stage of the cancer. Prostate cancer stages are indicated by Roman numerals one (I) to four (IV). The lowest stages indicate that the cancer is limited to the prostate. In stage IV, the cancer has grown beyond the prostate and may have spread to other areas of the body.

Prostate cancer treatment

Prostate cancer treatment options depend on various factors, such as how quickly the cancer has grown, how it has spread, and the individual’s overall health, as well as the potential benefits or side effects of the treatment.

Immediate treatment may not be necessary

Low-grade prostate cancer may not require immediate treatment. For some cases, treatment may never be needed. Instead, doctors sometimes recommend active surveillance. In active surveillance, regular blood tests, rectal exams, and prostate biopsy may be done to monitor cancer progression. If the tests show that the cancer is progressing, you may choose a treatment such as surgery or radiation therapy.

Active surveillance may be an option for cancer that does not cause symptoms, is expected to grow slowly, and is confined to a small area of ​​the prostate. Active surveillance may also be considered for someone with another serious illness or advanced age, making cancer treatment more difficult.

Surgery to remove the prostate

Surgery for prostate cancer involves removing the prostate gland (radical prostatectomy), some nearby tissue, and some lymph nodes. Surgery is an option for treating cancer that is limited to the prostate. This method is sometimes used to treat advanced prostate cancer in combination with other treatments. To access the prostate, surgeons may use the following methods:

Making several small incisions in the abdomen: during robot-assisted laparoscopic prostatectomy, surgical instruments are connected to a mechanical device (robot) and enter the desired area through several small incisions made on the abdomen. The surgeon sits behind a console and uses hand controls to direct the robot to move the instruments. Most prostate cancer operations are performed using this technique.

Making a long incision in the abdomen: During retropubic surgery, the surgeon makes a long incision in the lower abdomen to access the prostate gland and remove it. This approach is much less popular; But it may be necessary in some situations.

Radiotherapy

Radiation therapy uses high-intensity energy to destroy cancer cells. Radiation therapy for prostate cancer may include:

External radiation therapy (radiation that comes from outside the body) : During external radiation therapy, the patient lies on a table while a machine moves around the body and directs high-energy beams such as X-rays or protons to the patient’s prostate cancer. The patient usually undergoes external beam radiation therapy five days a week for several weeks. Some medical centers offer shorter courses of radiation therapy that use higher doses of radiation over fewer days.

External beam radiation therapy is an option for treating cancer that is limited to the prostate. This procedure can also be used after surgery to remove any remaining cancer cells if there is a risk of the cancer spreading or returning. For prostate cancer that has spread to other areas of the body, such as the bones, radiation therapy can help slow the growth of cancer and relieve symptoms such as pain.

Brachytherapy or internal radiation therapy (radiation is placed inside the patient’s body) : Brachytherapy involves placing radioactive sources inside the prostate tissue. This radiation often contains rice-sized radioactive grains that enter the prostate tissue. These seeds emit low amounts of radiation over a long period of time. Brachytherapy is an option for treating cancer that has not spread beyond the prostate. In some situations, doctors may recommend both types of radiation therapy.

Freezing or heating prostate tissue

Abrasion treatments : Prostate tissue is destroyed using cold or heat. Options may include:

Freezing prostate tissue : Cryoablation or cryotherapy for prostate cancer involves using very cold gas to freeze prostate tissue. The tissue is allowed to thaw and this procedure is repeated. Freezing and thawing cycles destroy cancer cells and some of the surrounding healthy tissue.

Heating the prostate tissue : High Intensity Focused Ultrasound (HIFU) treatment uses focused ultrasound energy to heat the prostate tissue and destroy it.

These treatments may be used to treat very small prostate cancers when surgery is not possible. They may also be used to treat advanced prostate cancers if other treatments, such as radiation therapy, have not helped.

Researchers are investigating whether cryotherapy or HIFU to treat parts of the prostate may be an option for cancer that is confined to the prostate. This strategy, called focal therapy, identifies the area of ​​the prostate that contains the most aggressive cancer cells and treats only that area. Studies have shown that focal therapy reduces the risk of side effects; But it is not clear whether this method has the same survival advantages as treatment for the entire prostate.

Hormone Therapy

Hormone therapy is a treatment to prevent the production of testosterone hormone in the body. Prostate cancer cells rely on testosterone to help them grow. Stopping the flow of testosterone may cause cancer cells to die or slow down their growth.

Hormone therapy options include:

Drugs that block the body’s production of testosterone : Certain drugs, known as luteinizing hormone-releasing hormone (LHRH) or gonadotropin-releasing hormone (GnRH) agonists and antagonists, prevent the body’s cells from receiving messages to make testosterone. As a result, the testicles stop producing testosterone.

Drugs that block testosterone from reaching cancer cells : These drugs, known as antiandrogens, are usually prescribed along with LHRH agonists. This is because LHRH agonists can cause a temporary increase in testosterone before decreasing testosterone levels.

Orchidectomy or testicle removal: removing the testicles reduces the body’s testosterone level quickly and significantly; But unlike drug options, surgery to remove the testicles is permanent and irreversible.

Hormone therapy is often used to treat advanced prostate cancer in order to shrink the cancer and slow its growth. Hormone therapy is sometimes used before radiation therapy to treat cancer that has not spread beyond the prostate. This treatment helps shrink the cancer and increases the effectiveness of radiation therapy.

Chemotherapy

In chemotherapy, drugs are used to quickly kill growing cells, including cancer cells. Chemotherapy can be given by injection, pill, or both. Chemotherapy may be a treatment option for prostate cancer that has spread to other parts of the body. Chemotherapy may also be an option for cancers that do not respond to hormone therapy.

Immunotherapy

Immunotherapy uses the body’s immune system to fight cancer. The body’s immune system, which fights diseases, may not attack cancer; Because cancer cells produce proteins that help them hide from immune system cells. Immunotherapy works by disrupting this process.

Prostate cancer immunotherapy can include the following:

Engineering the patient’s cells to fight cancer : In Ciplocell-T treatment, some immune cells are taken, genetically engineered in the laboratory to fight prostate cancer, and then returned to the patient’s body through a vein. This method is an option for the treatment of advanced prostate cancer that does not respond to hormone therapy.

Helping immune cells recognize cancer cells : Immunotherapy drugs that help immune system cells recognize and attack cancer cells are an option for treating advanced prostate cancers that do not respond to hormone therapy.

Targeted drug therapy

Targeted drug therapies focus on specific abnormalities in cancer cells. By inhibiting these abnormalities, targeted drugs can cause cancer cells to die. If hormone therapy is not effective, targeted therapy drugs may be recommended to treat advanced or recurrent prostate cancer.

Some targeted therapies are only effective in people whose cancer cells have certain genetic mutations. A patient’s cancer cells may be examined in a laboratory to determine whether the drugs can be effective.

Diet containing vegetables / healthy diet

Prostate Cancer Prevention: Ways to reduce your risk of prostate cancer

There is no surefire way to prevent prostate cancer. Study results are often conflicting, and most studies aren’t designed to prove whether something prevents prostate cancer definitively. As a result, there is no obvious way to prevent prostate cancer.

In general, doctors recommend that men with an average risk of prostate cancer make choices that benefit their overall health if they are interested in prostate cancer prevention.

Eat a healthy diet : There is some evidence to suggest that eating a healthy diet that is low in fat and high in fruits and vegetables may help reduce the risk of prostate cancer, although research results have been conflicting and this issue is strongly debated. Not proven. If you want to reduce your risk of prostate cancer, try the following:

Choose a low-fat diet . Foods containing fat include meat, plant nuts, oils and dairy products such as milk and cheese.

In some studies, the risk of prostate cancer was higher in men who consumed the highest amount of fat per day. This does not prove that excess fat causes prostate cancer. Other studies have not shown this connection, But reducing the amount of fat you eat each day has other proven benefits, such as helping with weight control and heart health.

To reduce the amount of fat consumed daily, limit fatty foods or choose low-fat varieties. For example, reduce the amount of fat you add to foods when cooking, choose lean cuts of meat, or choose low-fat dairy products.

Have a diet rich in fruits and vegetables : Whether you can prevent prostate cancer through diet has not yet been conclusively proven; But having a healthy diet that includes a variety of fruits and vegetables can improve your overall health. Fruits and vegetables contain many vitamins and nutrients that can contribute to your health.

Choose healthy foods instead of supplements : Studies have not shown that supplements play a role in reducing prostate cancer. Choose foods that are rich in vitamins and minerals so you can maintain healthy levels of vitamins in your body.

Cut down on dairy : In studies, men who consumed the most dairy each day (such as milk, cheese, and yogurt) had the highest risk of prostate cancer; But study results have been inconsistent, and the risk associated with dairy is thought to be small.

Maintain a healthy weight : The risk of prostate cancer may be higher in obese men (body mass index of 30 or higher). If you are overweight or obese, work on losing weight. You can do this by reducing your calorie intake and increasing your exercise. If you are at a healthy weight, try to maintain it by exercising most days of the week and choosing a healthy diet rich in fruits, vegetables, and whole grains.

Exercise most days of the week : Studies on exercise and prostate cancer risk have shown that men who exercise may have a lower risk of prostate cancer.

Exercise improves your overall health, helps maintain weight, and improves your mood. Try to exercise most days of the week. If you are new to exercise, start slowly and build up more time each day. Exercise has many health benefits and may reduce the risk of heart disease and other cancers. Exercise can help you maintain or lose weight. If you are not used to exercise, start slowly. Try to exercise for 30 minutes most days of the week.

Talk to your doctor about your risk of prostate cancer: Some men have a higher risk of developing prostate cancer. For those at high risk of developing this cancer, options, such as medications, may be available to reduce the risk. If you think you are at high risk for prostate cancer, talk to your doctor. If you are at high risk of developing prostate cancer, you and your doctor may consider other medications or treatments to reduce your risk.

Some studies show that the use of 5-alpha reductase inhibitors such as finasteride and dutasteride may reduce the overall risk of prostate cancer. These drugs are used to control the enlargement of the prostate gland and treat hair loss. Although some evidence suggests that people who use these drugs may be at increased risk of developing a more serious form of prostate cancer (high-grade prostate cancer). If you are concerned about your risk of breast cancer, talk to your doctor.

Prostate cancer and its relationship with sexual activity: Does frequent ejaculation reduce the risk of prostate cancer?

Currently, there is no conclusive evidence that frequent ejaculation reduces the risk of prostate cancer. Some studies have shown that the risk of prostate cancer may be slightly lower in men who have higher ejaculation frequency. Although this difference seems to be very small. Other studies have not confirmed this result.

Conclusion

The prostate gland, which is about the size of a walnut, is located below the bladder. This gland surrounds the upper part of the tube that carries urine out of the bladder. The prostate and other gonads produce a fluid that transports sperm during ejaculation. Prostate enlargement, prostatitis and prostate cancer are among the most common prostate diseases.

Benign prostatic hyperplasia is a non-cancerous enlargement of the prostate gland. This situation is very common; But it rarely causes symptoms before the age of 40. Some of the symptoms of prostate enlargement include difficulty urinating, feeling the need to urinate even when the bladder is empty, frequent urination, especially at night, intermittent and weak urine flow, and the feeling of incomplete emptying of urine.

Prostatitis is an inflammation of the prostate that a bacterial infection can cause. Men of any age can develop prostatitis, and this condition can occur in prostates of any size (enlarged or not). Symptoms of prostatitis include things like difficulty urinating, frequent urination, especially at night, pain or burning during urination, chills and fever with urinary problems.

Prostate cancer in its early stages may not cause any symptoms; But as it progresses, symptoms often appear. Symptoms of prostate cancer include the need to urinate frequently, especially at night, difficulty starting to urinate, inability to urinate, weak or interrupted flow of urine, urination accompanied by pain and burning, painful ejaculation, presence of blood in the urine or semen, frequent pain or Stiffness in the back, hips, or thighs.