What Is the Prostate?
The prostate is a gland about the size of a chestnut and weighs about 30 grams (about 1 ounce). It is part of the male reproductive system and is located inside the body. The prostate’s most important function is the production of a fluid that, together with sperm cells from the testicles and fluids from other glands, makes up semen. The muscles of the prostate also ensure that the semen is forcefully pressed into the urethra and then expelled outwards during ejaculation.The prostate undergoes two main growth spurts. The first is fuelled by the sex hormones made by the testes during puberty. This prompts the prostate to reach an average weight of 20 grams. The second growth spurt begins when men are in their thirties.
The prostate is located directly below the bladder and above the muscles of the pelvic floor. The rectum is behind the prostate, making it possible to feel the gland from the rectum using the finger. The ducts in the prostate gland flow into the urethra, which passes through the prostate. The word “prostate” is taken from the Greek expression meaning “one who stands before,” which describes the position of the prostate gland. Viewed from below, where the urethra leaves the gland, the prostate “stands before” the bladder.
Types of Prostate Disease:
benign prostatic hyperplasia (bph)
Non-cancerous enlargement of the prostate, or benign prostatic hyperplasia (BPH), is more common as men get older. It is not life threatening, but can significantly affect your quality of life.
The enlargement of the prostate gland (which surrounds the top of the urethra) causes the urethra to narrow, and puts pressure on the base of the bladder. This can lead to obstruction (blockage) in the flow of urine.
Obstructions usually show up as lower urinary tract symptoms that sometimes result in the urine staying in the bladder when it’s supposed to be released. When this happens suddenly, it’s called acute urinary retention. This is very painful and is usually relieved temporarily by inserting a thin tube (a catheter) to release the urine.
Chronic (ongoing) retention, which is less common, can lead to a dangerous, painless accumulation of urine in the bladder. An uncommon form of chronic urinary retention is associated with high bladder pressures, which can damage kidney function.
The severity of symptoms in people who have prostate gland enlargement varies, but symptoms tend to gradually worsen over time. Common signs and symptoms of BPH include:
- Frequent or urgent need to urinate
- Increased frequency of urination at night (nocturia)
- Difficulty starting urination
- Weak urine stream or a stream that stops and starts
- Dribbling at the end of urination
- Inability to completely empty the bladder
Less common signs and symptoms include:
- Urinary tract infection
- Inability to urinate
- Blood in the urine
The size of your prostate doesn’t necessarily determine the severity of your symptoms. Some men with only slightly enlarged prostates can have significant symptoms, while other men with very enlarged prostates can have only minor urinary symptoms.
BPH is considered a normal condition of male aging, and many men older than 80 years have BPH symptoms. Although the exact cause is unknown, changes in male sex hormones that come with aging may be a factor. Any family history of prostate problems or any abnormalities with your testicles may raise your risk of BPH. Men who’ve had their testicles removed at a young age don’t develop BPH.
Prostatitis is inflammation (swelling) of the prostate gland. It can be very painful and distressing, but will often get better eventually.
Prostatitis can come on at any age. But usually between 30 and 50.
There are 2 main types of prostatitis:
acute prostatitis – where the symptoms are severe and come on suddenly; it’s rare, but potentially life-threatening and requires immediate treatment
chronic prostatitis – where the symptoms come and go over several months; it’s the most common type
Acute bacterial prostatitis. Your urinary tract is made up of your kidneys, bladder, and the tubes that pass between them. If bacteria from here finds its way into your prostate, you can get an infection. Acute bacterial prostatitis is a severe condition.
This type of prostatitis comes on quickly. You might suddenly have:
- Urgent need to pee but only a little comes out, or you have to get to the toilet quickly to prevent an accident
- High fever
- Trouble peeing
- Pain around the base of your penis or behind your scrotum
- Cloudy urine
Chronic bacterial prostatitis. This is more common in older men. It’s a milder bacterial infection that can linger for several months. Some men get it after they’ve had a urinary tract infection (UTI) or acute bacterial prostatitis.
The symptoms of chronic bacterial prostatitis often come and go. This makes them easy to miss. With this condition, you might sometimes have:
- An urgent need to pee, often in the middle of the night
- Painful urination
- Pain after you ejaculate (release semen at orgasm)
- Lower back pain
- Rectum pain
- A “heavy” feeling behind your scrotum
- Blood in your semen
- Urinary blockage (dfficulty peeing or a weak urine stream)
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). This is the most common type of prostatitis. It shares many of the same signs as bacterial prostatitis. The difference is that when tests are run, no bacteria are present with this type.
Acute prostatitis is usually caused when bacteria in the urinary tract enter the prostate.
The urinary tract includes the bladder, kidneys, the tubes that connect the kidneys to the bladder (ureters), and the urethra.
In chronic prostatitis, signs of infection in the prostate gland cannot usually be found. In these cases, the cause of symptoms is not clear.
Prostate cancer is one of the most common types of cancer in men. Usually prostate cancer grows slowly and is initially confined to the prostate gland, where it may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly.
In the early stages, the cancer cells are confined to the prostate gland. With the more aggressive types of prostate cancer, cancer cells enter the vascular and lymphatic systems early and spread to other parts of the body where they develop secondary tumours, particularly in the bones.
Prostate cancer may cause no signs or symptoms in its early stages.
Prostate cancer that’s more advanced may cause signs and symptoms such as:
- Trouble urinating
- Decreased force in the stream of urine
- Blood in semen
- Discomfort in the pelvic area
- Bone pain
- Erectile dysfunction
Prostate Cancer Causes
On a basic level, prostate cancer is caused by changes in the DNA of a normal prostate cell. Mutations in the abnormal cells’ DNA cause the cells to grow and divide more rapidly than normal cells do. The abnormal cells continue living, when other cells would die. The accumulating abnormal cells form a tumor that can grow to invade nearby tissue. Some abnormal cells can also break off and spread (metastasize) to other parts of the body.
Cancerous or precancerous cells in the prostate gland are called prostatic intraepithelial neoplasia (PIN).
Nearly 50% of all males over the age of 50 years have PIN.
At first, the changes will be slow, and the cells will not be cancerous. However, they can become cancerous with time. Cancer cells can be high or low grade.
High grade cells are more likely to grow and spread, while low grade cells are not likely to grow and are not a cause for concern.