Prostate Disease: Introduction FeedbackA general introduction to Prostate Disease.Source: NHS Choices, 29 Oct 2013
Prostate disease is a general term used to describe a number of medical conditions that can affect the prostate gland.
The prostate gland
The prostate gland is a small gland only found in men. It opens into the urethra (the tube that carries urine from the bladder to the penis), and sits just below the bladder and vas deferens (a pair of ducts through which sperm passes before ejaculation).
The prostate gland helps with the production of semen (the fluid that transports sperm). It produces a thick, white fluid that's liquefied by a special protein called prostate-specific antigen (PSA). The fluid is mixed with sperm, produced by the testicles, to create semen.
There are a number of conditions that can affect the prostate gland including:
- prostate enlargement
- inflammation of the prostate gland (prostatitis)
- prostate cancer
Below is a summary of these conditions, plus links to more detailed information about each of them.
Prostate enlargement is a common condition associated with ageing. About a third of all men over 50 years of age will have symptoms of prostate enlargement (see below).
The urethra is a tube that runs from the bladder through the prostate to the end of the penis. Urine flows through the urethra and out of the body when a man urinates. If the prostate becomes enlarged it can place pressure on the urethra, making it more difficult for the bladder to empty.
An enlarged prostate can cause symptoms that can affect the normal pattern of urination. For example, it can:
- make it difficult for you to start urinating
- weaken the flow of urine or cause 'stopping and starting'
- cause you to strain to pass urine
- cause you to pee more frequently
- wake you up frequently during the night to pee
A simple treatment for prostate enlargement is to reduce the amount you drink before you go to bed.
Medications, such as alpha blockers, are also available to help relax the prostate gland muscles, or reduce its size, making it easier to urinate.
In severe cases that fail to respond to medication, the inner part of the prostate gland that is blocking the urethra can be surgically removed.
Read more about prostate enlargement.
Prostatitis is a poorly understood condition where the prostate gland becomes inflamed (red and swollen). Inflammation often occurs as a response to infection, but in most cases of prostatitis no evidence of infection can be found.
Symptoms of prostatitis include:
- pelvic pain
- testicular pain
- pain when urinating (this is less common and more likely with a urinary tract infection)
- pain when ejaculating semen
- pain in the perineum (the area between the anus and back of the scrotum), which is often worse when sitting, particularly on hard chairs and bicycle saddles
Prostatitis is thought to affect up to 3 in 20 men (15%) at some point in their lives. Although it can affect men of any age, it is more common in men between 30-50 years of age.
Prostatitis can be treated using a combination of painkillers and a type of medication known as an alpha-blocker, which can help relieve the symptoms.
Read more about prostatitis.
In the UK, prostate cancer is the most common type of cancer in men, with over 40,000 new cases diagnosed every year.
Your chances of developing prostate cancer increase with age. Most cases occur in men who are 50 years of age or older.
The causes of prostate cancer are unknown, but risk factors include age, ethnic origin and family history.
The symptoms of prostate cancer are similar to those of prostate enlargement and include:
- needing to pee more frequently (often during the night)
- needing to rush to the toilet
- difficulty starting to urinate (hesitancy)
- straining or taking a long time while peeing
- weak flow
- feeling that your bladder has not emptied fully
The outlook for prostate cancer is generally good because, unlike many other types of cancer, it usually progresses very slowly. Many men die with prostate cancer, rather than as a result of having it.
If treated early, prostate cancer can often be cured. Treatments include:
- surgery to remove the prostate gland
- radiotherapy - using radiation to kill the cancerous cells
- hormone therapy - using medication to block the effects of testosterone (the hormone that stimulates prostate cancer)
These treatments carry the risk of significant side effects including:
- loss of libido (sexual desire)
- erectile dysfunction (the inability to obtain or maintain an erection)
- urinary incontinence (loss of bladder control)
For this reason, many men choose to delay treatment until there is a significant risk of the cancer spreading.
It's usually not possible to cure the cancer if it spreads from the prostate gland to other parts of the body (a process known as metastasis). In this case, the aim of treatment will be to relieve the symptoms and prolong life.
Read more about prostate cancer.
Prostate Disease: Guidance FeedbackThe most relevant search results for Prostate Disease from producers of guidance information.
- Finnish Medical Society Duodecim, 04 October 2010
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Information for the public
Prostate Disease: Information for the public FeedbackThe most relevant search results for Prostate Disease, from Department of Health accredited producers of patient information.
Prostate Disease: Evidence Uncertainty FeedbackThe most relevant search results for Prostate Disease, highlighting areas where further research is needed.
Further research on prostate artery embolisation for benign prostatic hyperplasiain the form of randomised trials or cohort studies (for example,National Institute for Health and Care Excellence, 01 April 2013
- UK Database of Uncertainties about the Effects of Treatments, 24 December 2012
- UK Database of Uncertainties about the Effects of Treatments, 13 September 2012
Phosphodiesterase inhibitors for lower urinary tract symptoms consistent with benign prostatic hyperplasiaUK Database of Uncertainties about the Effects of Treatments, 23 October 2012
- UK Database of Uncertainties about the Effects of Treatments, 04 August 2009
Current evidence on the safety and efficacy of laparoscopic prostatectomy for benign prostatic obstruction (BPO) is inadequate in both quantity and quality.National Institute for Health and Care Excellence, 01 November 2008
Current evidence on the safety and short-term efficacy of potassium-titanyl-phosphate (KTP) laser vaporisation of the prostate for benign prostatic obstruction appears adequate to support the use of this procedure provided that the normal arrangementNational Institute for Health and Care Excellence, 01 May 2005
Can effective treatment of irritable bowel syndrome reduce lower urinary tract symptoms associated with prostate disease?UK Database of Uncertainties about the Effects of Treatments, 11 June 2009
Whether one method of administration of anticholinerigic drugs for Overactive Bladder Syndrome, is better than another, and if so when.UK Database of Uncertainties about the Effects of Treatments, 20 January 2009
- UK Database of Uncertainties about the Effects of Treatments, 23 March 2012
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...life, yet few men know anything about their prostate or what can go wrong with it Prostate disease is a general term used to describe a number of medical conditions that can affect the prostate gland. The prostate gland The prostate...
NHS Choices, 29 October 2013 - Publication type: general
...dose rate) directly into the prostate. Cancer networks A...people. Clinically detected disease Cancer that came to light...blockade (CAB) A type of prostate cancer hormone therapy which... The effect of all other diseases an individual patient might have other than the primary disease of interest. Computed...
National Institute for Health and Care Excellence, 27 February 2008 - Publisher: NICE - Publication type: Full Guidance
Is there a more reliable way of distinguishing benign prostate diseases from prostate cancer to improve outcomes for those diagnosed with prostate cancer?
...health conditions Is there a more reliable way of distinguishing benign prostate diseases from prostate cancer to improve outcomes for those diagnosed with prostate cancer? Record type Uncertainties identified from clinicians' questions...
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TA259 Prostate cancer (metastatic, castration resistant) - abiraterone (following cytoxic therapy): guidance
...resistant metastatic prostate cancer in adults, only if: their disease has progressed on...already with metastatic disease and could die of prostate cancer without any...imaging to monitor disease progression in prostate cancer. However...
National Institute for Health and Care Excellence, 27 June 2012 - Publisher: NICE - Publication type: Full Guidance
National Institute for Health and Care Excellence, 25 October 2011 - Publication type: Pathway, Guidance
...type of clinical population (type of prostate disease, either benign prostatic enlargement or prostate cancer) and according to severity of...differences between different types of prostate disease. The trial report that the complication...
Cochrane Database of Systematic Reviews, 13 April 2011 - Publisher: John Wiley & Sons, Ltd
Does a combination treatment of hormone therapy and chemotherapy for prostate cancer improve the disease outcome?
...child terms Neonatal diseases Show subtopics for Neurological...subtopics for Respiratory diseases Respiratory diseases This node has no child...therapy and chemotherapy for prostate cancer improve the disease outcome? Record type...
UK Database of Uncertainties about the Effects of Treatments, 25 January 2013 - Publication type: Known Uncertainty
...watchful waiting for prostate cancer Josephine...Cochrane Prostatic Diseases and Urologic Cancers...procedure include reduced disease specific mortality...treatment for localized prostate cancer. Prostate Disease Patient Outcome Research...
Cochrane Database of Systematic Reviews, 10 November 2010 - Publisher: John Wiley & Sons, Ltd
...for advanced prostate cancer Brian...Cochrane Prostatic Diseases and Urologic...with advanced disease (cancer that...the VA Cochrane Prostate Disease register were...and prostatic diseases. Prostate Cancer Prostatic...
Cochrane Database of Systematic Reviews, 26 April 1999 - Publisher: John Wiley & Sons, Ltd
Prostate cancer incidence and disease-specific survival of men with initial prostate-specific antigen less than 3.0 ng/ml who are participating in ERSPC Rotterdam.
...John Wiley & Sons, Ltd. Title Prostate cancer incidence and disease-specific survival of men with initial prostate-specific antigen less than 3.0...Randomised Study of Screening for Prostate Cancer (ERSPC) applies a prostate...
Cochrane Central Register of Controlled Trials, John Wiley & Sons Ltd, 01 April 2011 - Publisher: European urology
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