Prostate Problems

Laura Mitchell's picture
By Laura Mitchell on November 16, 2018

Our bones stop growing when we reach maturity, but some of our other tissues continue to grow throughout life.

Cartilage is one, which is why our ears and noses continue to grow.

In men, the prostate gland is another.

The prostate is a reproductive gland that contributes to semen production and propulsion. Because of its function and its location—below the bladder and surrounding the urethra—changes to the prostate can create problems with both sex and urination.

The natural aging process causes the prostate to grow in middle age, squeezing the urethra. Growth can also result from infections or tumors. The three most common prostate problems are:

  • Prostatitis, or inflammation of the prostate gland
  • Benign prostatic hyperplasia (BPH), or a non-cancerous overgrowth of prostate tissue that blocks the flow of urine
  • Prostate cancer

Having prostatitis or BPH does not increase your risk of prostate cancer.

Prostatitis

According to the National Institute on Aging, at least half of all men are affected by prostatitis at some point in their lives. It is typically a bacterial infection, but it can also be diagnosed based on symptoms even when no bacteria are found. Symptoms include: 

  • Trouble passing urine
  • Burning or stinging sensations when urinating
  • Frequent urges to pass urine, even when you pass only a small amount
  • Chills and high fever
  • Low back pain or body aches
  • Abdomen or groin pain, or pain behind the scrotum
  • Rectal pressure or pain
  • Discharge from the urethra accompanying bowel movements
  • Genital and rectal throbbing
  • Sexual problems and decreased libido
  • Painful ejaculation 

Depending on the cause, your provider may prescribe antibiotics, anti-inflammatory medications or alpha-blockers as well as recommending home treatments such as warm baths to minimize discomfort.

BPH

The prostate gland is about the size of a walnut in early adulthood. It continues to grow throughout a man’s life, and by age 60 it can be about the size of a lemon. The enlarged prostate can press against the bladder and the urethra, interfering with the flow of urine.
 
BPH is not linked to cancer and does not increase your risk of getting prostate cancer—yet the symptoms for BPH and prostate cancer can be similar. They include:

  • Trouble starting a urine stream, or having to push or strain to begin
  • Passing urine often, especially at night
  • An inability to pass more than a dribble of urine
  • A lingering feeling of fullness in the bladder after urinating
  • Strong or sudden urges to pass urine
  • Weak or slow urine stream, including multiple starts and stops

These symptoms develop slowly over time and can take years before they are considered a real problem, but the earlier you see your provider, the more effective medical interventions can be.

At its worst, BPH can weaken the bladder, resulting in a backflow of urine causing bladder or kidney infections, complete block in the flow of urine and even kidney failure.
 
BPH cannot be cured, but drugs or surgery can often relieve its symptoms. Medical interventions for BPH include:

  • Alpha-blockers, which relax the muscles around the prostate
  • Enzyme inhibitors, which help shrink the prostate.
  • Surgery, when symptoms are severe or medications do not have their intended effects

Surgery carries risk and the medications have side effects of their own, so it is important to discuss all of your options with your provider.
 
If your symptoms are not debilitating, your provider may recommend active surveillance or “watchful waiting” to monitor your symptoms over time.

To minimize discomfort, the American Cancer Society makes the following recommendations for self-care:

  • Limit drinking in the evening, especially drinks with alcohol or caffeine
  • Empty your bladder all the way when you pass urine
  • Use the restroom often; don’t hold your urine for long periods
  • Talk with your provider about prescription or over-the-counter medications you may be taking that can aggravate BPH symptoms

Prostate Cancer

Symptoms of prostate cancer can be similar to those for BPH or infections, so it is important to consult your primary care provider if you have any of the following symptoms:

  • An urgent need to pass urine
  • Decreased urine flow
  • Burning sensation when urinating
  • Frequent sleep interruptions to urinate 

Keep an eye on Carilion Living for more about prostate cancer, coming soon.
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This article was reviewed by Carilion Clinic urologist Christopher Reynolds, M.D.