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Prostate problems

Responses to some common questions about prostate problems. It's no substitute for talking to your doctors or nurses but a guide to questions you may want to ask.

How do I know if I've got a prostate problem?

It's common to have some problems with your prostate as you get older (over 50). You'll probably have some problems passing urine. You may have some or all of these changes:

Trouble getting started, especially when in a hurry.
Trouble stopping the flow of urine.
Taking longer, because the urine stream is weak, or it stops and starts.
Dribbling of urine after you've finished.
Going more often throughout the day, even though there's not much urine to pass.
Getting up at night to go to the toilet.
Needing to go urgently at any time.
Feeling you haven't quite finished or that you need to go again, even though nothing comes out.
Pain or burning feeling when you urinate.
Occasionally, blood in the urine. This should always be checked by a doctor.

If you have any of these problems, see your doctor about them. Don't just accept them as part of getting older — the right treatment can help you.

What causes the problems?

In 90% of cases, when prostate problems occur it's because the prostate has become enlarged. This enlargement squeezes the urethra. This problem is called benign prostatic hyperplasia (BPH) and is caused by hormone changes in the prostate. This affects about half of all men over 50 and is not cancer.

Sometimes the swelling of the prostate can be caused by an infection called prostatitis, which has similar symptoms to BPH. This problem tends to affect younger men.

Fewer than one man in 10 with prostate problems will have prostate cancer.

Remember – most prostate problems are not cancer, and can be treated.

What will the doctor do?

First of all, the doctor needs to find out what's causing the problem. This will require some tests, which include:

Digital rectal examination

The doctor inserts a gloved finger into your back passage (rectum) to feel the size, shape and texture of your prostate.

Prostate specific antigen test (PSA)

A blood test to look for PSA, which is produced by the prostate. If there's a high level in your blood, you may have prostate cancer, but the doctor will do more tests to be sure. More on PSA.

Biopsy

If your PSA test or digital rectal examination is abnormal your doctor may refer you to a specialist (urologist). The urologist may recommend a biopsy, which involves an ultrasound probe being placed in the rectum to find abnormal areas of the prostate. More on biopsies.

What are the treatments for prostate problems and prostate cancer?

This depends on what your problem is and how severe it is. Your doctor will advise the best course. If you have an enlarged prostate this doesn't mean you're more likely to get prostate cancer.

Benign prostatic hyperplasia (BPH)

Caused by hormone changes in the prostate, BPH affects about half of all men over the age of 50. It causes the prostate to swell. BPH can be treated by medication or surgery. Laser and microwave treatments may also be used.

Medicines can change the hormone levels, or can relax or shrink the prostate so that it doesn't press on the urethra. You may need to take the medicines for some months before your symptoms improve. You'll need to keep taking them until the symptoms are under control, and have checkups with your doctor.

Surgery may be used to remove part of the prostate, to stop it squeezing the urethra. Laser and microwave treatments may also be used.

BPH is not cancer.

Prostatitis

Mainly affecting younger men, prostatitis causes a swelling of the prostate resulting in similar symptoms to BPH. Prostatitis is caused by an infection.

Prostatitis is usually treated with antibiotics. You may need to take the antibiotics for several months. Some men may also need surgery to stop the swollen prostate from pressing on the urethra.

Prostatitis is not cancer.