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Symptoms and diagnosis

Symptoms of Prostate Problems

Many men begin to have problems with their prostate as they get older. Most problems are caused by simple enlargement of the prostate, but a few are caused by cancer. To get checked for Prostate Cancer consult with your GP.

Usually the first sign of trouble is with passing urine. A man may notice one or more of the following symptoms:

  • trouble getting the flow of urine started, especially if in a hurry
  • trouble stopping the flow of urine (“dribbling”)
  • the stream of urine is weak, or it stops and starts
  • needing urgently to pass urine at any time
  • feeling a need to pass urine more often during the day, even though not much comes out
  • getting up at night to pass urine more than once
  • feeling a need to pass more urine, even though none comes out
  • pain and/or burning when passing urine; this may be a sign of infection

Benign Enlargement of the Prostate

In men with prostate problems, nine out of ten will have a prostate which has grown too big. This puts pressure on the urethra and may squeeze it enough to block outflow of urine.

This condition of enlarged prostate is called “Benign Prostatic Hyperplasia” or BPH. Benign means it is not cancer, and hyperplasia means “too much tissue”.

BPH occurs with ageing. It affects more than half of all men older than 50.

Medicines or surgery are used to treat it but only when symptoms become troublesome. Remember, BPH is not prostate cancer even though most of the symptoms are the same when passing urine.

Infection of the Prostate

Infection of the prostate is called Prostatitis. It can cause pain, fever, swelling of the prostate, and blood and pus in the urine.

It may have symptoms similar to BPH. Prostatitis is usually treated with antibiotics. Infection of the bladder usually occurs at the same time as infection of the prostate. If blood appears in the urine (Haematuria), contact your doctor for an appointment.


Diagnosis of Prostate Problems

The doctor will need to determine whether the patient’s problems are due to BPH, prostatitis, prostate cancer or some other cause.

The doctor may do the following tests:

Digital Rectal Examination (DRE)

The doctor wears a rubber glove and inserts a finger into the anus to feel the prostate through the wall of the rectum. This is called a digital rectal examination or DRE. The doctor checks the size, shape and hardness of the prostate.

Prostate Specific Antigen (PSA)

PSA is a small protein released into the blood by the prostate. If the amount of PSA in the blood is above the normal levels, it may be due to an enlarged prostate or prostatitis. If the PSA level is high, it is more likely to be due to prostate cancer. The PSA test does not diagnose prostate cancer, it is an indicator that there may be abnormalities in the prostate gland. The important measure associated with regular PSA testing is the change, or rate (velocity) of change that may indicate a problem. This is why it is important to have at least an annual PSA test so that any changes can be noted and acted upon.

Results from a PSA test alone cannot confirm whether prostate cancer is present. Other tests need to be done. Different laboratories use different tests to measure PSA levels in the blood. This can result in different values of PSA levels for the same man. The doctor will take this into consideration when keeping track of a patient’s PSA levels.

Biopsy

A biopsy is the removal of very small pieces of prostate tissue using a fine needle. A local anesthetic may be given first. Several samples may be taken. Men say the discomfort is mild.

The tissue is then looked at under a microscope to see if cancer cells are present. A biopsy is the only way to show for certain whether or not the man has prostate cancer.

Some doctors like to take a picture of the prostate and nearby organs before they do a biopsy. This is done with an ultrasound probe. By producing a picture of the prostate and nearby organs, ultrasound guides biopsy.

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