Search the website

Prostatic diseases

Updated July 2006

• Prostatitis
• Enlarged prostate gland
• Prostate cancer

The prostate gland is a firm, round organ about the size of a chestnut. It surrounds the upper part of the urethra (the tube through which urine is emptied from the bladder) and lies underneath the bladder and directly in front of the rectum. The secretions that are produced are added to semen, the fluid that contains sperm.

Disorders affecting the prostate gland are very common, particularly in men over the age of 30, and include prostatitis, in which the prostate gland is inflamed, enlargement of the prostate gland and prostate cancer.

Prostatitis
Inflammation of the prostate gland, sometimes due to infection.

Inflammation of the prostate gland, known as prostatitis, may be acute or chronic. Acute prostatitis is uncommon and tends to produce sudden, severe symptoms that clear up rapidly with treatment. By contrast, chronic prostatitis usually causes mild but persistent symptoms.

In most cases of acute or chronic prostatitis, an exact cause of the disorder cannot be determined. Both forms of the condition can be the result of bacterial infection that spreads from the urinary tract to the prostate gland or may develop in association with sexually transmitted infections.

The symptoms of acute prostatitis develop suddenly, are usually severe, and may include:

• fever and chills
• pain around the base of the penis
• lower back pain
• pain during bowel movement
• frequent, urgent and painful passing of urine.

It can also sometimes cause urinary retention, painful swelling behind the testes, or the formation of an abscess in the prostate gland.

Chronic prostatitis may not produce symptoms, but if they do occur, they develop gradually and may include:

• pain and tenderness at the base of the penis and in the testes, groin, pelvis, or back
• pain on ejaculation
• blood in the semen
• frequent, painful passing of urine

If either acute or chronic prostatitis is suspected, consult a doctor immediately. Although most affected men recover fully, both types of prostatitis can recur.

Enlarged prostate gland
Non-cancerous enlargement of the prostate gland, causing difficulty in passing urine.

In most men over the age of 50, the prostate gland has become enlarged to some degree. Such prostate enlargement is termed benign prostatic hyperplasia. The condition is non-cancerous and is not associated with prostate cancer. Minor prostate enlargement is considered a natural part of the ageing process. The cause of the condition is unknown.

As the prostate gland grows larger, it constricts and distorts the urethra. At first, this enlargement does not cause any symptoms. If the prostate gland continues to enlarge it may cause difficulty in passing urine, resulting in the following symptoms:

• frequent need to pass urine, especially at night or if the bladder is full
• weak, intermittent flow of urine
• dribbling at the end of the urine flow
• feeling that the bladder has not completely emptied

The choice of treatment depends on factors such as age, general health, the degree of the prostate enlargement, and whether the obstruction of urine flow is having harmful effects on the bladder and kidneys. Mild cases may be improved with drug treatment, but surgery is more effective for severe cases. Treatment may affect sexual function, and available treatments should be discussed with a doctor.

Prostate cancer
A cancerous tumour arising from the glandular tissue of the prostate gland.

Prostate cancer is the most commonly diagnosed male cancer in the UK, affecting about one in 12 men at some time in their lives.[1] The number of cases of prostate cancer identified in the UK has been rising since the 1970s, not only in older men, in whom it is most common, but also in men in their 40s and 50s. This increased identification of the cancer in recent years has largely been due to new screening programmes (see Screening for cancer).

Although prostate cancer is the cause of about 10,000 deaths each year in the UK, many tumours grow slowly, especially in older men, and may never cause symptoms. Treatment is more likely to be necessary in younger men.

Prostate cancer may not produce any symptoms, particularly in older men. If symptoms do occur, they are likely to develop when the tumour starts to constrict the urethra (the tube leading from the bladder to the outside of the body). The symptoms may then include:

• weak urinary stream or inability to pass urine normally
• frequent urge to pass urine, especially during the night
• rarely, blood in the urine

In some men, the initial symptoms of prostate cancer are due to the metastasis (spreading) of the cancer to other parts of the body, most commonly the bones, lymph nodes, and lungs. In these cases, the symptoms may include back pain, enlarged lymph nodes shortness of breath and significant weight loss.

If the symptoms of prostate cancer should develop, or if the disorder runs in the family, a GP should be consulted. A diagnosis of cancer of the prostate gland does not necessarily mean that the cancer will cause symptoms or be life-threatening. Sometimes the best policy, especially in elderly men, is to defer treatment and begin regular check-ups to monitor the disease. For men who have had surgery for a tumour confined to the prostate gland, the outlook is good, with more than nine out of 10 men surviving for five years after diagnosis.[1]

References:
[1] British Medical Association (2000). Complete Family Health Guide. London: Dorling Kindersley.

Further information:
- BBC Health - Cancer
- Cancerbackup, Europe's cancer information charity
- Institute of Cancer Research - Everyman website, male cancer campaign
- MedlinePlus Health Topics - Prostate cancer
- MedlinePlus Health Topics - Prostate diseases
- MedlinePlus Medical Encyclopaedia - Enlarged prostate
- MedlinePlus Medical Encyclopaedia - Prostate cancer
- NHS Direct Online Health Encyclopaedia - Prostate disease
- NHS Direct Online Health Encyclopaedia - Cancer of the prostate
- Prostate Research Campaign UK
- The Prostate Cancer Charity
- The Scottish Association of Prostate Support Groups
- Men's Health Forum