About the prostate and prostate problems

The prostate is a gland in male mammals, including human males, located around the urethra header, which produce a secretion that is part of the semen. The prostate secret is wixed with sperm and fluid from the testicles to produce the full szemen. The fluid contains, among other substances nutrients to the sperm, so they can swim all the way to fertilize egg.  

Acute prostatitis

Acute prostatitis is an inflammation of the prostate tissue. Usually the inflammation is a bacterial infection. Symptoms are chills, fever, pain in the lower back and genital area, urinary frequency and urgency often at night, burning or painful urination, body aches, and a demonstrable infection of the urinary tract, seen by white blood cells and bacteria in the urine.

One can usually cure the condition with antibiotic treatment over a few weeks. Acute prostatitis can occur in all ages and is often a component of a more generalized urinary infection.

Chronic prostatitis

Chronic prostatitis is an inflammation with a usually more slow onset and longer duration. This kincd of prostatitis is usually caused by unknown processes and not bacterial infection. Sometimes it is an infection. The main symptom is chronic pelvic pain.

Alpha-blockers and means to relaxe the pelvic nerves are sometimes used to treat the condition. Herbal treatment can be effective. This condition is usually not treated with antibiotics.

Prevention of prostatitis

An active sex life or masturbation resulting in ejaculation promotes mucus departure from the prostate, and with the mucus the germs are fludhed out. Frequent sexual activities therefore prevent the tendency to prostate inflammation due to an infection

Prostate Hypertrophy or Benign Prostate Hypertrofia

During puberty the prostate of a boy grows as a part of the pubertal maturing. In many man it keeps on growing smoothly during the whole life, in some men more than in others, a condition called Benign Prostate Hyperplasia (BPH).

The gland is enlarging because the number of all type of cells within the prostate is increasing, but the new cells are normal cells. This continued growth is partly caused by a variant of the male sexual hormone, dihydrotestosterone. Inflammatory reactions is often also present as a causal factor or as a consequence of the condition.

In some men the enlarged prostate strangles the urethra and the bladder so that the urination is hindered or the urinary function is altered. This seldom happens before the man is past the middle ages. The specific symptoms of prostate enlargement is as follows:

- By examination one finds the prostate enlarged. Often one can feel smooth soft lumps, which are essentially enlarged normal sections of the prostate. The prostate is usually without altered symmetry and distinct irregularities. At the beginning this is the only symptom.

- The prostate area can feel engorged or tender, the man can feel burning sensation during urination, but other pain is seldom felt.

- It takes longer time for the urine to begin flowing, the flow can stop a while before beginning again, the urine flow will get weaker with less pressure at the outlet, and sometimes the urine is only dripping.

- In severe cases the urethra gets completely blocked so that the urine has to be taken out with a catheter.

- Often the bladder will not get totally empty during urination, and after some time the bladder can get permanently distended.

- The man can get more frequent urge for urination, for example during nights, because of incomplete urination and pressure on the prostate.

- Some men lose control of the urination, resulting in involuntary dripping or sudden urine outlet.

BPH is diagnosed by considering the reported symptoms and by inspection of the prostate gland. This is first done by palpation towards the upper wall of the rectum with an inserted finger. Then one often looks at the prostate by means of an ultrasound sond inserted into the rectum. One will also do urine analysis, blood sample analysis and other examinations to exclude cancer, infections or other ailments that can give the same symptoms as BPH.

During exploring with the finger throgh the rectum, the prostate will be concidered enlarged if the finger does not reach the upper edge of the gland, the middle groove of the gland is not intact or the gland is tender.

Benign prostate growth is usually only treated if it causes symptoms. There are several type of treatment:

- One often treats the condition with medicines like finesteride (Proscar, Propecis) and alpha blockers. Finesteride blocks the production of the hormone dihydrotestosterone, and will after some time make the prostate get smaller. Alpha blockers relax muscle bundles in the prostate and area around so that urine flows more easily. One is however reluctant to begin treating with these pharmaceuticals because of a great risk for side effects.

- Finesteride, but in lower and safer doses, is also used to treat male baldness, and men treated with finesteride for prostate growth will often get better hair growth as a useful additive effect.

- One can treat the condition by microwaves that reduce the prostate size by heating. A similar treatment is inserting a needle into the prostate and apply an alternating current through it, that heats parts of the prostate and evaporates these parts. By these treatments one typically uses a working sond inserted through the urethra and a sond in the rectum to get an overview of the prostate area, or to measure the temperature in this area.

- For severe problems with urination one can cut out the whole prostate or parts of it surgically, so-called prostatectomy. Such surgery can cause erectile problems or retrograde ejaculation, a condition where the semen goes into the bladder instead of out through the urethra.

Previously, surgery for prostate enlargement was done by opening low on the abdominal wall and in front of the bladder and peel out the prostate from the inside. By TUR, transurethral resection, performed with an instrument with an electric metal sling into the urethra, prostate tissue around the urine passage is carved away so that the urine has enough room to pass. It is the power of the sling and is pulled out slightly. When burned it away a bit of tissue around the urethra, and it is considerably more room for the urine through the gland.

- On the market you can also find natural remedies to reduce the prostate size and inflammatory reactions in the prostate. Many of these are based on saw palmetto or the substance cernitine extracted from pollen. By a few scientific studies so far done, they seem to be effective and without great side effects. Products based on these ingredients may therefore be a good first choice for treatment of benign prostate growth. The most important working substance in saw palmetto seems to be beta-sitosterole

Other herbal remedies often recommended for prostate problems are pumpkin seed and the bioflavonide lycopene.

Prostate cancer

Prostate cancer is a very common disease by older men. However, the way the cancer develops vary very much in is usually unpredictable. Often it grows so slowly that it will never cause any problem. Other times it develops and send out methastases to other organs fairly quickly.

Prostate cancer is often discovered by exploration through the rectum.

If the cancer is in its initial stage, the opstion is often to do nothing with it an wait to see if it develops further.

For more developed prostate cancer, the treatment is radiation, radioactive implants, surgical removal of the prostate and cytostatica.

Because of the uncertainties with the development of a prostate cancer and that the consequences of the treatment may be worse that the cancer itself in many instances, the recommandation from doctors vary conciderably.