The Prostate

The prostate is part of the male reproductive system. It is located just below the bladder and in front of the rectum. The prostate is normally small in size, about the size and shape of a chestnut. The prostate wraps around a tube called the urethra. The urethra carries urine from the bladder out through the prostate and then the penis. The prostate is mostly made up of muscular and glandular tissues. Its function is to produce and deposit some of the enzymes, proteins and sugars into the fluid of the ejaculate or semen. These substances help to protect and nourish sperm. During the male orgasm (climax), muscular contractions squeeze the prostate's fluid into the urethra. Sperm, which are produced in the testicles, are also propelled into the urethra during orgasm. The sperm-containing semen leaves the penis during ejaculation.
An exclusively male organ, the development of the prostate is spurred by male hormones (especially testosterone). The rate of prostate growth decreases and may stop around age 20. A second growth period often occurs around age 45, as cells in the middle of the prostate start to reproduce more rapidly than normal. This growth may result in an "enlarged prostate" years later.
The prostate is not really an element of the urinary system, but because it surrounds the urethra and can become enlarged or inflamed, it can cause urinary problems. That's why a urologist is the specialist to see when you may be experiencing prostate problems.

Benign Prostatic Hyperplasia (Enlarged Prostate)

If you're a man over the age of fifty and you wake up several times during the night to urinate, you're not alone. In fact, one in two men over fifty suffer from an enlarged prostate—or benign prostatic hyperplasia (BPH)—resulting in sleepless nights. It is not a life-threatening disease, but it does threaten quality of life. BPH can be embarrassing, uncomfortable, and inconvenient.

Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate that restricts the flow of urine from the bladder. There are two growth periods that cause the prostate to enlarge. The first occurs early in puberty, when the prostate doubles in size. The second begins around age 40 and often results years later in BPH. As the prostate enlarges, it presses against the urethra like a clamp on a garden hose. The bladder wall becomes thicker and irritable and begins to contract even when it contains only small amounts of urine. These contractions cause the bladder to weaken, so it doesn't empty completely.

Symptoms of Benign Prostatic Hyperplasia BPH (Enlarged Prostate)

If you are experiencing any one of the following symptoms, you may be suffering from a common condition called benign prostatic hyperplasia (BPH), or enlarged prostate. Common symptoms associated with BPH include:

• Frequent need to urinate
• Sudden need to urinate
• Interrupted sleep to urinate at night
• Weak, variable, or dribbling stream
• Need to strain or push bladder to urinate
• Difficulty beginning urination
• Pain or burning during urination

If you are experiencing urinary discomfort, it is important to contact your physician to evaluate your symptoms.

 

Prostatitis

"Prostatitis" means inflammation of the prostate. This is a condition quite common in adult men and is associated with urinary symptoms and pain. The following information will answer your questions on prostatitis, as well as about the prostate itself.

There are three types of prostatitis:

• acute (bacterial) prostatitis
• chronic (bacterial) prostatitis
• non-bacterial prostatitis

Acute Bacterial Prostatitis is caused by bacteria and is treated with antibiotics. Acute bacterial prostatitis comes on suddenly, and its symptoms can be severe. Symptoms can include fever and chills. If severe, a visit to the emergency room may be necessary and hospitalization is frequently indicated.

Chronic Bacterial Prostatitis is also caused by bacteria and also requires antibiotics. Unlike an acute prostate infection, the only symptoms of chronic bacterial prostatitis may be recurring bacterial cystitis (bladder infection).

Nonbacterial Prostatitis is the most common type of prostatitis and is not caused by bacteria. Antimicrobial medications are not effective for this type of prostatitis. Treatments, described later, may be helpful in some cases. One sub-category of this syndrome includes "Chronic Pelvic Pain Syndrome". Another sub-category may include a disorder common in women known as "Interstitial Cystitis".

How Does Prostatitis Develop?

Despite their names, acute and chronic bacterial prostatitis are not contagious and are not considered be sexually transmitted diseases. Your sexual partner cannot catch this infection from you. The way in which the prostate becomes infected is not clearly understood. The bacteria that cause prostatitis may get into the prostate from the urethra by backward flow of infected urine into the prostate ducts or from rectal bacteria. Certain conditions or medical procedures increase the risk of contracting prostatitis.

You are at Higher Risk for Getting Prostatitis if You:

• Recently had a medical instrument, such as a urinary catheter (a soft, lubricated tube used to drain urine) inserted into the bladder,
• Have an abnormal urinary tract,
• Have had a recent bladder infection,
• Have an enlarged prostate.

What are the Symptoms of Prostatitis?

The symptoms of prostatitis depend on the type of syndrome you have. You may experience no symptoms or symptoms so sudden and severe that they cause you to seek emergency medical care. Symptoms, when present, can include any of the following: fever, chills, urinary frequency, frequent urination at night, difficulty urinating, burning or painful urination, perineal (referring to the perineum, the area between the scrotum and the anus) and low-back pain, joint or muscle pain, tender or swollen prostate, blood in the urine, or painful ejaculation.

Are the Symptoms of Prostatitis Found in Other Disorders?

The symptoms of prostatitis resemble those of other infections or prostate diseases. Thus, even if the symptoms disappear, you should have your prostate checked. For example, benign enlargement of the prostate (benign prostatic hyperplasia or BPH) may produce urinary tract symptoms similar to those experienced with prostatitis. Similarly, urethritis, an inflammation of the urethra (often caused by an infection), may also give rise to many of the symptoms associated with prostatitis.

Still another condition that overlaps the syndrome of prostatitis is prostatodynia (painful prostate). Patients with prostatodynia have pain in the pelvis or in the perineum. Such pain may result from a prostate problem, but the pain can have a variety of different causes including muscle spasms or other musculoskeletal conditions. This is a component of Chronic Pelvic Pain Syndrome. Yet another term your doctor may mention in discussing your prostate problem is prostatosis, a more vague word, which simply means "a condition of the prostate. Because of the connections between the urethra, the bladder, and the prostate, conditions affecting one or the other often have similar or overlapping symptoms.

Preventive Prostate Health Measures

The best protection against prostate problems is to have regular medical checkups that include a careful prostate exam. Men should see a doctor promptly if symptoms occur such as:

• A need to urinate frequently, especially at night
• Difficulty starting urination or holding back urine
• Dribbling of urine
• Inability to urinate
• Feeling that the bladder is not empty after urination
• Weak or interrupted urine stream
• Pain or burning during urination
• Painful ejaculation
• Blood in urine or semen
• Frequent pain in the lower back, hips, or ribs
• Weight loss