The prostate is part of a man’s sex organs. It’s about the size of a walnut and surrounds the tube called the urethra, located just below the bladder.
The urethra has two jobs: to carry urine from the bladder when you urinate and to carry semen during a sexual climax, or ejaculation. Semen is a combination of sperm plus fluid that the prostate adds.
For men under 50, the most common prostate problem is prostatitis.
For men over 50, the most common prostate problem is prostate enlargement. This condition is also called benign prostatic hyperplasia (BPH). Older men are at risk for prostate cancer as well, but this disease is much less common than BPH. More information about prostate cancer is available from the National Cancer Institute.
If you’re a man over 50 and have started having problems urinating, the reason could be an enlarged prostate, or BPH. As men get older, their prostate keeps growing. As it grows, it squeezes the urethra. Since urine travels from the bladder through the urethra, the pressure from the enlarged prostate may affect bladder control.
If you have BPH, you may have one or more of these problems:
No. It’s true that some men with prostate cancer also have BPH, but that doesn’t mean that the two conditions are always linked. Most men with BPH don’t develop prostate cancer. However, because the early symptoms are the same for both conditions, you should see a doctor to evaluate these symptoms.
By itself, BPH is not a serious condition, unless the symptoms are so bothersome that you can’t enjoy life. But BPH can lead to serious problems. One problem is urinary tract infections.
If you can’t urinate at all, you should get medical help right away. Sometimes this happens suddenly to men after they take an over-the-counter cold or allergy medicine.
In rare cases, BPH and its constant urination problems can lead to kidney damage.
Several tests help the doctor identify the problem and decide on the best treatment:
Several treatments are available. Work with your doctor to find the one that’s best for you.
A gel may be applied to the urethra to prevent pain or discomfort. You won’t need drugs that make you go to sleep.
Several Transurethral Procedures are treatments for BPH:
Surgical treatment. Surgery to remove a piece of the prostate can be done through the urethra or in open surgery, which requires cutting through the skin above the base of the penis. Your doctor may recommend open surgery if your prostate is especially large. The most common surgery is called transurethral resection of the prostate (TURP). In TURP, the surgeon inserts a thin tube up the urethra and cuts away pieces of the prostate with a wire loop while looking through a cystoscope. TURP and open surgery both require general anesthesia and a stay in the hospital.
No. TURP and other procedures for BPH remove only enough tissue to relieve urine blockage. In a few cases, the prostate may continue to grow, and urinary problems return. You should continue to have your prostate checked once a year even after surgery to make sure that BPH or prostate cancer has not developed.
A prostate removal, or radical prostatectomy, is usually done only to stop prostate cancer from spreading.
Surgery for BPH may have a temporary effect on sexual function. Most men recover complete sexual function within a year after surgery. The exact length of time depends on how long you had symptoms before surgery was done and on the type of surgery. After TURP, some men find that semen does not go out of the penis during orgasm. Instead, it goes backwards into the bladder. In some cases, this condition can be treated with a drug that helps keep the bladder closed. A doctor who specializes in fertility problems may be able to help if backwards ejaculation causes a problem for a couple trying to get pregnant.
If you have any problems after treatment for a prostate condition, talk with your doctor or nurse. Erection problems and loss of bladder control can be treated, and chances are good that you can be helped.
If your prostate is removed completely to stop cancer, you’re more likely to have long-lasting sexual and bladder control problems, such as leaking or dribbling. Your doctor may be able to use a technique that leaves the nerves around the prostate in place. This procedure makes it easier for you to regain bladder control and sexual function. Not all men can have this technique, but most men can be helped with other medical treatments.