The prostate gland lies underneath the bladder and in front of the rectum deep in the male pelvis. It surrounds the urethra, the tube that transports urine from the bladder. The prostate is normally the size of a walnut and functions to secrete fluid that nourishes sperm. Common benign (noncancerous) conditions that can affect the prostate gland are benign prostatic hyperplasia (BPH) and prostatitis.
BPH is a noncancerous enlargement of the prostate gland that can affect men as they get older. It can manifest with urinary symptoms or be asymptomatic. It is important to seek treatment early for this condition because if left untreated it can lead to urinary retention and poor bladder and kidney function.
Symptoms from BPH can include difficulty starting to urinate, a weak urinary stream, increased frequency of urination, increased night time urination, leakage of urine, incomplete emptying of the bladder, and retention of urine. The diagnosis can usually be made by a physician after taking a history and carefully examining the prostate gland. A urine sample is usually checked to make sure there is no blood or infection. A uroflowmetry test is also done sometimes to check the flow rate and a post-void residual is done to measure how much urine is being retained in the bladder.
First line treatment for BPH is dietary and lifestyle modification. If these fail to improve symptoms then medical therapy can be started. Medications can either help shrink the prostate gland or help relax the prostate and bladder. If medical therapy is ineffective, there are surgical options from which the patient may benefit. The most common procedure is a TURP (transurethral resection of prostate). During this procedure a doctor passes a small camera through the urethra and removes excess prostate tissue with a surgical instrument. A laser can also be used to resect prostate tissue. There are also other minimally invasive therapies that can be used in BPH to help improve urinary symptoms and quality of life. Sometimes when the prostate gland is extremely large, surgical removal of the gland is performed through an incision.
Prostatitis is inflammation or infection of the prostate gland. It can present with pain, urinary symptoms, and sometimes fevers, chills, and blood in the urine if there is an acute bacterial infection. Pain is usually located in the area between the scrotum and rectum, testicles, penis, and lower back. Urinary symptoms can consist of urgency, frequency, weak stream, and pain or burning with urination. There can also be some difficulty obtaining erections or pain with ejaculation.
The diagnosis of prostatitis can be made by a physician based on symptoms and a physical exam. The prostate is sometimes swollen and tender. A urine sample may also be collected to look for infection or inflammation. Sometimes a prostate massage is performed and the fluid expressed from the penis after a prostate massage is examined.
When no infection is found, prostatitis can be difficult to treat. Lifestyle and dietary modifications may help as well as pelvic muscle relaxation techniques. Periodic prostate massage and Sitz baths can also be beneficial. Anti-inflammatory medications help relieve pain and swelling and other medications can sometimes be employed to help the prostate muscles relax. Antioxidant supplements may also help in chronic prostatitis. If an infection is suspected, an antibiotic course of 4-6 weeks may be prescribed by your physician. If a prostate abscess is suspected, surgical drainage may need to be performed.
Doctors at The Men’s Clinic at UCLA will help determine if you are suffering from BPH or prostatitis. Each visit will consist of a history and physical exam to determine if you have risk factors and symptoms of benign prostate disorders. They may recommend further tests to help make the diagnosis. Our experts at UCLA will then tailor a treatment plan designed specifically for you. If your symptoms do not improve with medical therapy, they can offer surgical procedures to improve your quality of life.
Board-certified urologists staff The Men’s Clinic at UCLA and you can be assured you are getting an experienced physician performing your evaluation and treatment in a relaxed and comfortable environment. For more information and to schedule an appointment, please call the UCLA Urology Appointment line at (310) 794-7700.