Prostate Problems  

The prostate gland surrounds the urethra (the tube that carries urine and semen through
the penis).  It's located below the bladder.  This gland is "doughnut-shaped.  
It produces semen, which works to keep sperm lubricated and mobile, 
and aids the bladder in the flow of urine.  

After a man reaches puberty, his prostate gradually grows from roughly the size
of a small marble to about the size of a golf ball.  Around 50 and due to a variety of factors,
his prostate begins to grow again.  This increased growth can cause a variety of problems,
most commonly Benign Prostatic Hypertrophy (BPH) or an enlarged prostate, prostatitis,
and even prostate cancer.

The real cause of most of these problems is unknown. They may be
related to hormonal changes brought on by aging.  As a man ages, an increased
amount of hormones such as estrogen and prolactin decreases the rate of which
testosterone and the dihydrotestosterone (DHT) into which testosterone is converted
by 5-alpha-reductase are eliminated from the prostate.  This excessive accumulation
of DHT is thought to be responsible for the problems of the prostate gland.

B P H

Benign Prostatic Hypertrophy  (BPH)

Benign prostatic hypertrophy (BPH) or an enlarged prostate occurs when, in
response to hormones such as testosterone, the cells in the inner core of the
prostate gland grow and form fibrous nodules.  These nodules put pressure
on the urethrae causing pain and problems urinating.  If left untreated BPH can
lead to prostatitis, and in severe cases the bladder's inability to empty completely
 can cause infection to spread in the bladder and even to the kidneys,
possibly causing kidney damage.

BPH will affect an astonishing 50% of men during their lifetimes.  This means that if
you have any symptoms of BPH you are definitely not alone; you just think 
you are because most men never speak of their discomfort.  

Symptoms of an enlarged prostate include the following:

  A need to pass urine frequently                                          
  Pain, burning, difficulty in stopping and starting urination
  Blood in the urine                                                                
           A weak urine flow                                                                        
  Nighttime wakening to empty the bladder                        
                           A constant feeling that the bladder isn't completely empty                      

               An enlarged prostate is diagnosed through a rectal examination, ultrasound, and a         
blood test.  The prostate will be softer than normal and may be two to three     
times larger than normal.  Unlike prostatitis, it will not  be tender to the touch

A severe case of BPH may require the insertion of a catheter, the short-term use 
of an alpha-1 antagonist, or surgery (prostatectomy or removal of the prostate). 

Prostatitis

Prostatitis is an inflammation on the prostate gland that is usually caused by a
bacterial infection that has spread from another part of the body.  Prostatitis can
develop suddenly  as with acute prostatitis, or  gradually build up over an 
extended pereiod of time as with  chronic prostatitis.

Acute prostatitis develops suddenly and is generally caused by a bacterial infection
of the prostate  brought on by e coli, certain sexually transmitted diseases or sexual
contact with an infected person, a urinary tract infection,  urethritis, epididymitis, 
urethral instrumentation, trauma, bladder outlet obstruction, or an infection
elsewhere in the body.  Acute prostatitis is more common in men aged 20-35, men
with multiple sex partners and men who engage in high-risk sexual behaviors.

Symptoms of acute prostatitis may include:

  Chills                                                                                                           
  Fever  associated with lower abdominal discomfort or perineal pain     
  Pain and / or burning with urination, ejaculation, or a bowel movement 
   Urinary retention                                                                                        
                    Blood in the urine and / or semen                                                                               
                       An increased need to urinate                                                                                         
                Testicle pain                                                                                                             

        Unlike acute prostatitis, chronic prostatitis develops gradually, continues for a 
prolonged period of time, and may have subtler symptoms.  Chronic prostatitis will
develop from an acute prostatitis  bacterial infection that keeps recurring or from a
urinary tract infection, urethritis, or epididymitis.  Chronic prostatitis is more common
in men aged 30 to 50 and is thought to also be associated to hormoral chanes of
aging and also certain lifestyle influences (excessive alcohol drinking, perineal 
injury,  certain sexual practices).   

Symptoms of chronic prostatitis include:

  A history of recurrent urinary tract infections                                                 
  Lower back, perineal, pelvic floor, or testicular pain                                      
  Pain and / or burning with urination, ejaculation, or with a bowel movement 
  Blood in the urine                                                                                              
  Incontinence                                                                                                      
  Abnormal urine color                                                                                          

Like an enlarged prostate, prostatitis is diagnosed through a rectal examination. 
Unlike the enlarged prostate however, the prostate infected with prostatitis is swollen, 
warm and very tender to touch. Prostatistis is typically treated with antibiotics to fight infection. 
If antibiotic treatment is unsuccessful, surgery (transurethral resection) may be done.  
This delicate surgery can cause sterility, impotence, and / or incontinence. 

Prostate Cancer

Prostate Cancer, a malignant growth in the outer zone of the prostate gland, is the
most common form of cancer among men.  This disease is most common in older
men, with 80% of cases of prostate cancer occurring in men over age 65.

African American men, men with a family history of prostate cancer or a history of
venereal disease, men with recurring prostate infections, men who have taken
progesterone, and men with a high-fat diet run the highest risk of developing
prostate cancer.

Symptoms of Prostate Cancer may include:

  Pain and / or burning with urination                                                                    
  Frequent urination                                                                                               
  A decrease in the amount of power of urine flow                                               
  Blood in the urine                                                                                                 
  An inability to urinate which occurs when the urethra becomes completely     
blocked or when the cancer spreads to the bladder and ureters
  Lower back, pelvic, or suprapubic pain caused by affected nerves or by the    
spread of the cancer to the bones

Prostate cancer may also be diagnosed by a rectal exam.  Unlike with an
enlarged prostate or prostatitis, the prostate diseased with cancer feels
hard and knobby.  An ultrasound scan of the prostate can also help with 
diagnosis.

Most men over 40 should have a blood test to detect elevated levels of
prostate-specific antigen (PSA).  A PSA of 0 to 4 is considered normal.  

A PSA of 10 or higher is considered a possible indicator of prostate cancer, but 
the test should always be repeated since the PSA level.  Furthermore, the PSA 
test fails to detect almost one third of all prostate cancers, so other
 investigative tests should be considered.

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