Prostate diseases
What are prostate diseases?
The prostate is an organ of the male reproductive system. It is a chestnut-shaped gland, located below the bladder and in front of the rectum. The urethra (tube through which urine exits) passes through the center of the prostate, so urine leaves the bladder through the prostate. Possible diseases of the prostate compress the urethra and cause discomfort when urinating.
The three diseases that most often develop from the prostate are:
- Benign Prostatic Hyperplasia (benign growth)
- Prostate cancer (malignant growth)
- Prostatitis (infection): is an inflammation of the prostate usually caused by a bacterial infection. It is very common and affects 15% to 20% of men at some point in their lives.
Diagnosis
Various tests help the doctor identify the problem and choose the best treatment.
- Digital rectal exam: This exam is usually the first test done. The doctor inserts a gloved finger into the rectum and feels the prostate, which is just in front of the rectum. This exam gives the doctor a general idea of the size and condition of the prostate.
- Blood test: Your doctor may want to do a blood test for prostate-specific antigen (PSA). A high PSA level can be a sign of prostate cancer. However, this test is not foolproof. Many men with high PSA levels do not have prostate cancer.
- X-ray imaging: Your doctor may recommend an X-ray or ultrasound of the prostate. Intravenous pyelography (IVP) is an x-ray of the urinary tract. For IVP, a contrast dye is injected into a vein. Then, when the dye leaves the blood and enters the urine, it can be seen on the x-ray. In rectal ultrasound, a probe, or catheter, is inserted into the rectum to send sound waves that bounce off the prostate.
- Uroflowmetry: The patient is asked to urinate into a special device that measures how fast the urine flows. A reduced flow can indicate BPH.
- Cystoscopy: Another way to identify a problem from the inside is to use a cystoscope. The cystoscope is a thin tube that has lenses like a microscope. The tube is inserted into the bladder through the urethra while the doctor looks through the cystoscope.
It is important to make a correct differential diagnosis to indicate the appropriate treatment.
How is it treated?
There are a wide variety of treatments available for prostate diseases, including minimally invasive therapies and surgery. The best treatment option will depend on several factors:
- The size of the prostate
- The patient’s age
- Your general health
- The degree of discomfort or disorders you are suffering from
Treatment alternatives include:
- Medications: Medications are the most common treatment for mild to moderate symptoms of an enlarged prostate.
- Minimally invasive or surgical therapy: Minimally invasive or surgical therapy may be recommended if:
- Patient has moderate to severe symptoms
- Medications have not relieved symptoms
- The patient has a blockage of the urinary tract, bladder stones, blood in the urine, or kidney problems
- If the patient seeks definitive treatment
- Laser therapy: A high-energy laser destroys or removes excess prostate tissue. Laser therapy usually relieves symptoms right away and has less risk of side effects than non-laser surgery. Laser therapy can be used in men who should not have other prostate procedures because they take blood-thinning medications.
- Open or robotic-assisted prostatectomy: The surgeon makes an incision in the lower abdomen to reach the prostate and remove tissue.Open prostatectomy is usually done if the patient has a very large prostate, bladder damage, or other complications. Surgery typically requires a short hospital stay and is associated with an increased risk of requiring a blood transfusion.