Prostate conditions

Prostate conditions

Have you given up activities you enjoy because you're afraid of an accident? ·
Do you get up several times each night to urinate?
Does it sometimes feel like you need to urinate, but can't?
 If you answered "yes" to any of the questions above, you may be suffering from a prostate problem.
There are several types of prostate problems. Your doctor can help you find out if your symptoms are signs of a prostate condition or if they're due to another problem, such as a bladder infection. Symptoms can have a wide range of causes and are not always signs of prostate problems. In many cases, behavioral changes or medications can relieve the symptoms or treat the causes of your discomfort.
If you have symptoms, take the quiz to learn more about potential causes.



What is the prostate, and what does it do? The prostate is a walnut-sized gland located just below the bladder, the organ that collects and empties urine. It surrounds the urethra -- the tube which carries urine from the bladder through the penis.
The primary function of the prostate is to produce fluid which becomes part of the semen. It also helps to control the rate and flow of urination.

What type of prostate problem might your symptoms indicate? The successful treatment of prostate problems begins with an accurate diagnosis. During your appointment at Northwest Urology Center, your doctor will discuss your symptoms and history with you to identify the category of prostate disorder you may have:
• prostatitis (infection of inflammation of the prostate gland),
•benign prostate enlargement (BPH), or
•prostate cancer.

The questions he may ask could include the following. Click on the yes or no circle following each question. When you are finished, click on Submit for a possible diagnosis.
Do you
1. Have a sensation of not emptying your bladder completely after you finish urinating?
 Yes  No
2. Have to urinate again less than two hours after you finish urinating?
 Yes  No
3. Stop and start several times when urinating?
 Yes  No
4. Find it difficult to postpone urination?
 Yes  No
5. Get up frequently during the night to urinate?
 Yes  No
6. Take a long time to urinate and have a weak, dribbling stream with no force?
 Yes  No
7. Have to push or strain to begin urination?
 Yes  No
8. Feel a burning sensation while urinating?
 Yes  No
9. See what looks like pus in your urine?
 Yes  No

WE NEED TO BUILD A SCORING FOR THIS.

 Prostate disorders require careful diagnosis. The symptoms can be caused by many other conditions including bladder or urethral infections, or can be side effects of certain prescription drugs. Prostate cancer often doesn't cause symptoms at all. If you're suffering from any urinary discomfort, we recommend making an appointment with the Northwest Urology Center to pinpoint the cause of your symptoms and to determine appropriate treatment.
Prostate disorders generally fall into three categories:
•Prostatitis - infection or inflammation of the prostate
•BPH - Benign prostatic hyperplasia, or non-cancerous enlargement
•Prostate Cancer
Prostatitis    
•Symptoms: May include urgency, frequency, and/or pain during urination, sometimes accompanied by blood in the urine.
•Often found in younger men.
•The prostate can become infected or inflamed, causing swelling.
•Treatment may include lifestyle or dietary changes, or antibiotic medication.
Benign Prostatic Hyperplasia (BPH)
•Symptoms: Although this condition is not cancerous, urination may become more difficult as the bladder muscle works harder to empty the bladder. Other annoying symptoms such as frequent day and nighttime urination, difficulty in controlling the urine stream, and not being able to completely empty the bladder may occur. ·
•Often begins at about age 40-45, due to hormonal changes that result in enlargement of the prostate.
•As the gland enlarges, it may push against the urethra, the tube which carries urine, squeezing it like a clamp around a garden hose. ·
•Treatment depends on the degree of symptoms, ranging from no action to the removal of part or all of the prostate.
Congestion of the Prostate
When the prostate becomes swollen with excess fluid, it can cause congestion --sometimes referred to as prostatosis. This non-cancerous condition can be alleviated with sitz baths, and more frequent ejaculation.
Prostate Cancer
In 1996, over 317,000 American men over age forty were diagnosed with prostate cancer. Fewer men will actually die of prostate cancer, though, than from other types of cancers, such as lung cancer. But detecting and treating prostate cancer can be difficult.
Prostate cancer produces virtually no symptoms in its earliest, and most treatable, stages. It is one of the slowest growing types of cancer-the American Cancer Society estimates that it takes at least 400 days for a tumor to double in size.
The good news is that this type of early stage tumor may be detected during a physical exam.
Symptoms may occur as the tumor grows:
•Frequent urination, especially at night
•Difficulty in controlling the flow of urine
•Inability to urinate
•Urgency to urinate
•Frequent pain or stiffness in the lower back, hips or upper thighs
These symptoms may not necessarily indicate prostate cancer-they are also common indicators of other prostate problems. If you are experiencing any of these symptoms, Northwest Urology Center recommends scheduling an appointment as soon as possible.
Are You at Risk for Prostate Cancer?
There are no clear answers to why men develop prostate cancer. Researchers, however, have found some important factors that may increase the risk.
Over 40 Years Old
Before the age of forty, prostate cancer is very rare; the average age of diagnosis in American men is sixty years old. The chances of developing prostate cancer have been estimated to be about 1 in 10 during a lifetime. In light of these facts, Northwest Urology Center recommends that men over the age of forty have an annual physical exam to check for any abnormal growth of the prostate.
Family History of Cancer
Men who have close male relatives (brother, father, uncle) who had prostate cancer, or close female relatives (mother, sister, aunt) who had breast cancer, are at an increased risk for developing prostate cancer. Although a family history of cancer does not automatically mean that cancer will develop, it does mean that getting regular physical exams is extremely important.
Race
 Studies have shown that in the United States, African-American men are twice as likely to develop prostate cancer, and three times as likely to die from it. In China and Japan, prostate cancer is relatively rare; however, when men from these countries move to the West, their incidence of prostate cancer increases. Globally, the United States and Scandinavia have the highest rates of prostate cancer, and the lowest rates are in Asia and Central America.
High-fat Diet
Research suggests that a diet that is high in fat, particularly dairy foods and red meat, may stimulate prostate cancer cells to grow.
Sexually Active
Men who have had many sexual partners, have a high sexual drive, and a history of sexually transmitted diseases may be at increased risk for developing prostate cancer.
Alcohol consumption and smoking may also increase your risk of developing prostate cancer.
The most important fact to keep in mind is that prostate cancer can be cured if detected early. If you are over 40, or are experiencing any of the symptoms listed above, contact Northwest Urology Center to schedule an exam.

What tests might Northwest Urology Center suggest to diagnosis a prostate disorder?  
Your doctor will thoroughly evaluate you by taking a medical history and conducting a physical exam that includes a digital rectal exam. For this simple screening procedure, the physician will briefly insert a gloved, lubricated finger into the rectum to feel the prostate for bumps, nodules, or other irregularities. This is the most basic test, but the results are not definitive.
Since no single exam or test can provide a complete picture of your health, your doctor may also order certain preliminary tests to confirm the diagnosis. These tests may include taking a urine sample, measuring your flow, examining the inside of your bladder, or taking x-rays. Certain blood tests may also be prescribed. Tests can help pinpoint the cause so that correct, effective treatment can be discussed.
The Prostate-Specific Antigen (PSA) test is a very sensitive blood test which can potentially identify prostate tumors that are so small they cannot be felt manually. The test measures the level of an enzyme that is normally produced by the prostate. 
Transrectal Ultrasonography (TRUS) is a relatively new test which produces a picture from ultrasound waves. It provides valuable information about the actual size of the prostate and can help check for tumors and kidney disease
An Intravenous Pyelogram (IVP) is an x-ray of your kidneys. This test is often used to check the kidneys and other parts of the urinary tract for abnormalities.
Your doctor may recommend a cystoscopy, which involves insertion of a small tube through the penis opening to look for any obstruction caused by the prostate.
The only test that can clearly identify existence of prostate cancer is a biopsy. A biopsy is a microscopic sample of the prostate tissue removed with a needle through the rectum. A biopsy is thought to have about an 85% accuracy rate in detecting cancer. The tissue is then sent to a laboratory for analysis. If there is a tumor, the biopsy will help to determine whether it is malignant, and how advanced the cancer has become.
A follow-up PSA blood test is recommended to be done about four to six months after a biopsy, even if the initial results were negative (no cancer found.) If the second biopsy is also negative, there is a fairly good chance that there is no cancer, and annual checkups should be adequate.

 Once your doctor has made a diagnosis, he will work with you to find the treatment that is best for you.
For Infection and Inflammation
Your doctor may prescribe antibiotics, bed rest, stool softeners, and/or increased fluid intake. Inflammations are often treatable with anti-inflammatories or muscle relaxants. Other recommendations may include taking hot baths, relaxing when urinating, and ejaculating frequently.
For BPH
If other conditions have been ruled out through testing, your doctor may determine that you have BPH. A variety of treatments can help solve BPH symptoms, including medications, behavioral changes, or surgery.
TURP  
Transurethral resection of the prostate is a common surgical procedure for non-cancerous prostate enlargement.
Prostate Cancer Treatment Options
Because there is no actual "cure" for prostate cancer, particularly if it is advanced, treatment options are usually only considered if the cancer has not spread outside the prostate. Depending on how far the cancer has progressed, several treatment options are available. Remember, the earlier the cancer is detected, the higher the potential for arresting the spread.
Northwest Urology Center cautions that no treatment is without risk, and virtually all forms of treatment have drawbacks.
Treatment options can be divided into three basic categories:
•watchful waiting
•surgery
•radiation therapy
 Other therapies, such as hormone therapy and chemotherapy may also be used supplementally, but they do not usually promote a cure by themselves.
Watchful waiting
You and your doctor may decide that the best "treatment" may simply be to not take any action other than closely monitoring the progress of the cancer. This option may be appropriate when:
•the patient is older
•aggressive treatment would be more stressful than beneficial
•the cancer is in the early stages and no symptoms are evident
•other health problems are present that may be compromised by aggressive treatment
Surgery    
Surgery, which involves complete removal of the prostate, has traditionally been recommended for:
•younger, healthier patients
•tumors are in relatively early stages of growth
Radical prostatectomy is a surgical procedure which usually takes about two to four hours, and results in the removal of the entire prostate gland, seminal vesicles, and part of the urethra. A temporary catheter to transport urine will be inserted through the penis into the bladder, and will remain in place for three weeks after the operation. Recuperation may take four to six weeks.
Side effects
The two most common effects of surgery are:
1.Impotence The degree of potency that is regained after surgery depends on factors such as a patient's age, prior sexual functioning, and response to surgery. It has been estimated that 75% of men between the ages of fifty and sixty, and 58% of men between the ages of 60 and 70 do NOT become impotent. However, after age seventy, approximately 75% may become impotent.
2.Incontinence After surgery, most men will experience urinary incontinence for several days, and possibly leakage for a period of a few weeks or months. There are exercises that can be done to help strengthen pelvic muscles, which will improve urination problems.
Radiation Therapy
Radiation is an aggressive treatment option which uses x-rays to shrink or kill cancer cells. It is also used to alleviate painful symptoms when cancer has spread to the bone, or simply to shrink tumors that are more advanced.
There are two basic types of radiation therapy:
1.External beam radiation -- This treatment is done by focusing a beam of radiation on the tumor for daily three-minute intervals over a period of six or seven weeks. It is performed on an outpatient basis, and is painless. Side effects can include diarrhea, which can be treated with medication. Within two years of an external radiation treatment, 30-50 % of men develop some degree of impotence. There may be some incontinence, and possibly temporary inflammation of the rectum or bladder.
2.Brachytherapy -- Also known as internal radiation therapy, this type of radiation uses radioactive pellets, about the size and shape of a grain of rice, implanted directly into the prostate. The seeds emit radiation for several months and do not cause any discomfort. Side effects may include sexual impotence and difficulty or pain when urinating.

•Up to 80% of men develop an enlarged prostate, but not all will develop symptoms. Having a regular checkup is the best way to prevent prostate problems.
•Symptoms caused by the prostate don't usually mean cancer.
•Symptoms are not always signs of prostate problems.
•Prostate problems can often be treated without surgery.
•Prostate surgery for benign disease rarely causes impotence or incontinence.
•Cancer of the prostate is the most common type of cancer in men. It is more common among blacks than whites.
•Prostate cancer virtually never occurs before the age of forty; the average age of diagnosis in American men is sixty years old.
•The chances of developing prostate cancer have been estimated to be about 1 in 10 during a lifetime.
•In 1992, approximately 2.048 million men suffered from diseases of the prostate, according to the National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), and U.S. Dept. of Health and Human Services (HHS).
•More than 50% of men past age 60, and 80% to 90% of men past age 80 are diagnosed with an enlarged prostate (BPH), according to a 1991 study by the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.
•120,000 men develop prostate cancer each year; and 30,000 men die of it-Prostate Health Council, c/o American Foundation for Urologic Disease, Inc.,
•Risk factors for prostate cancer may include: 
◦Family history
◦Exposure to the metal cadmium,
◦Exposure to materials in the rubber industry
◦Smoking
◦Alcohol consumption
◦Diet high in fat
•A low-fat diet with plenty of fruits, vegetables, and grains is recommended to reduce the risk of cancer.
•Long-term use of a moderate-dose vitamin E supplement substantially reduced prostate cancer incidence and deaths in male smokers, according to a large prevention trial conducted by the National Cancer Institute (NCI) and the National Public Health Institute of Finland. The report was published in the March 18, 1998, issue of the Journal of the National Cancer Institute. Prostate Information Line 800-543-9632

1. What is the prostate, and what does it do?
The prostate is a walnut-sized gland located just below the bladder, the organ that collects and empties urine, and surrounds the urethra-the tube which carries urine from the bladder through the penis. The primary function of the prostate is to produce fluid which becomes part of the semen; it also helps to control the rate and flow of urination.
2. What types of prostate gland problems are there and what causes them?
There are three basic categories of prostate conditions:
1.Prostatitis (infection of inflammation of the prostate gland)
2.Benign Prostate Enlargement (BPH)
3.Prostate Cancer
Prostate disorders require careful diagnosis. The symptoms can be caused by many other conditions including bladder or urethral infections, or can be side effects of certain prescription drugs. Prostate cancer often doesn't cause symptoms at all. Prostate disease can be due to many factors including aging, hormones, genetics, alcohol consumption, smoking, and exposure to certain chemicals.
3. What can I do to prevent prostate problems?
Although there is no guaranteed way to completely eliminate the risk of prostate problems, there are steps you can take to reduce your risk.
1.Regular checkups: After the age of forty, you should have annual physical exams, and testing to monitor for any signs of prostate cancer. This is especially imperative if you or a close relative have a history of breast or prostate cancer.
2.Diet: Eating a high fiber, low fat diet is highly recommended. Fruits and vegetables, which are high in substances called antioxidants, have been shown to have powerful anti-cancer effects. Antioxidants are commonly found in foods such as broccoli, cauliflower, dark green leafy vegetables, and citrus fruits.
3.Alcohol: Reduce alcohol consumption.
4.Smoking: Quit.
4. What behavioral changes could I make to help ease prostate discomfort?
•Try drinking less fluid during the times when you're not near a bathroom. But remember you should drink at least eight glasses of fluid each day.
•Don't drink too much liquid at one time or before going to bed.
•Cut back on coffee, tea, other caffeine, or alcohol. All of these increase urine volume.
•Whenever possible,
 urinate as soon as you feel the urge. Relax and don't force. •Urinate regularly.
•After you urinate, try to urinate again to completely clear out your bladder.
•Avoid riding on soft care seats or bicycle seat that aren't properly adjusted. The pressure can bruise your prostate.
•Try to avoid certain medications (such as antidepressants, diuretics, and cold medications) that can worsen your symptoms.
5. What tests might my doctor suggest to diagnosis an prostate problem?
To thoroughly evaluate your situation, your doctor will take a medical history and conduct a physical screening that includes a pelvic exam and a rectal exam. He may also order certain tests that may include taking a urine sample, measuring your flow, examining the inside of your bladder, or x-rays. Tests can help pinpoint the cause so correct, effective treatment can be prescribed.
6. What is PSA?
 PSA is an abbreviation for Prostate Specific Antigen. It is a protein made by the glandular cells of the prostate. A small amount continuously leaks into the blood. The amount circulating in the blood can be measured. The amount of PSA in the blood can increase due to conditions such as prostate gland infection, benign enlargement of the prostate, and cancer of the prostate.
7. Should I have my PSA checked?
The American Urologic Association recommends that all men 50 years and older get a yearly PSA blood test. If you have a family history of prostate cancer, or if you are African-American, the test needs to be performed every year after the age of 40.
8. Is a rectal exam necessary if a PSA test is done?
Yes. Sometimes the PSA is not elevated when there is prostate disease. Therefore, the combination of a PSA blood test with a rectal examination will be more likely to detect a problem with the prostate.
9. What types of medications might my doctor prescribe for prostate disorders?
•Prostate muscle relaxants can help relax prostatic muscles and strengthen bladder muscles, helping you urinate better.
•Hormone suppressers can block the hormonal enzyme that causes prostate growth, which helps to bring the prostate back to normal size. These medications may relieve BPH symptoms and increase urinary flow rate.
•Bladder relaxants may relax the bladder's squeezing muscles, while strengthening the sphincter muscle.
•Antibiotics may help control infection.