The most common diseases of the prostate, also known as the prostate gland, are
Benign prostatic hyperplasia (BPH)
In almost all men, the prostate enlarges with age. This leads to various symptoms. This is referred to as benign prostatic hyperplasia. Around 50 percent of men over the age of 60 and 90 percent of men over the age of 90 are affected.
This disease is usually benign.
Prostate carcinoma
Prostate carcinoma is a malignant change in the prostate cells.
Compared to other tumor diseases, prostate cancer grows very slowly. The tumor usually develops late in life.
Prostatitis
The prostate is a gland that is well supplied with blood and lies directly adjacent to the urethra. As such, it is often acutely affected by bacterial infections (acute bacterial prostatitis).
In the absence of treatment, this disease can become chronic (chronic bacterial prostatitis).
Prostatitis is often at the center of chronic pelvic pain (abacterial prostatitis or prostate pain syndrome).
The prostate is located directly under the bladder and surrounds the urethra © Henrie | AdobeStock
Benign prostatic hyperplasia (prostate enlargement) typically causes the following symptoms:
- Frequent urination with smaller amounts of urine each time
- Nocturnal urination
- difficulty starting
- weakened or interrupted urine stream
- urine dribbling or a feeling of incomplete emptying of the bladder
Prostatitis, on the other hand, is accompanied by pronounced pain in the anal and perineal area. In addition to urination problems and a frequent urge to urinate, there is also pain during ejaculation.
Prostate cancer usually causes no symptoms in the early stages. In the advanced stage
- Micturition problems,
- urinary retention kidneys and
- skeletal complaints
are typical. Also
- fever,
- night sweats and
- weight loss (B symptoms)
are also characteristic of prostate cancer in its later stages.
With age, the sex hormones circulating in the blood stimulate an increase in prostate tissue. The following factors also promote prostate enlargement:
Prostatitis has various causes. Acute bacterial prostatitis is caused by an infection with bacteria. The inflammation is usually triggered by intestinal bacteria such as Escherichia coli. Risk factors that favor bacterial introduction are
- manipulation of the prostate (sampling, urethral catheter) and
- a weak immune system.
In chronic bacterial prostatitis, the same bacteria often cause the disease. However, atypical bacteria such as chlamydia can also be responsible. An acute inflammation that has not been adequately cured with antibiotics is a particular risk factor.
Prostate pain syndrome is the most common form of prostatitis. This is a chronic inflammation that cannot be traced back to bacterial colonization. Doctors do not know why this inflammation occurs. However, they suspect infectious, genetic, neuromuscular and anatomical factors, among others.
The causes of prostate cancer are also not yet known. However, doctors name certain risk factors that favor prostate cancer:
- Familial clustering (the risk is twice as high if a first-degree relative has the disease).
- Age (90 percent of those affected are older than 60).
- Diet (scientists are discussing the influence of animal fats in particular).
Following the consultation with the doctor (medical history), the doctor examines the anal and perianal area externally for changes. The anal canal is then palpated by means of a digital rectal examination (palpation). The doctor examines the sphincter muscle, the prostate and the rectum.
If there are any suspicious changes, the doctor will carry out additional examinations:
Transrectal ultrasound of the prostate(TRUS): the doctor uses the ultrasound images to determine whether the prostate is enlarged. The doctor can also detect inflammation and cancerous tumors using imaging. An ultrasound also allows conclusions to be drawn about the filling of the bladder and kidneys.
Urine flow measurement(uroflowmetry): A urinary stream measurement provides indications of bladder emptying disorders and problems with bladder storage.
PSA test: PSA (prostate-specific antigen) is a protein that is only found in the prostate and only in small quantities in the blood of healthy men. An elevated PSA value is therefore an indication of a disease. Elevated values are present in cases of enlargement, inflammation and cancer of the prostate.
Doctors associate a very high PSA value with prostate cancer. To confirm the diagnosis, the urologist removes tissue from the prostate and has it tested for cancer cells(prostate biopsy).
The treatment methods used depend on the prostate disease in question.
Treatment of benign prostatic hyperplasia
In the case of minor prostate enlargement with few symptoms, the doctor often recommends a controlled wait-and-see approach. Treatment with
- phytopharmaceuticals (e.g. pumpkin seed extract, sawtooth palm fruit) or
- medication (including alpha-blockers, 5-alpha reductase inhibitors and/or anticholinergics)
is sufficient for minor symptoms.
For more pronounced symptoms that cannot be alleviated by medication, the urologist will remove the constricting tissue. Various procedures are available for this purpose.
The doctor often performs a transurethral electroresection (TUR-P). This involves gently removing the prostate tissue through the urethra. If there is a massive tissue enlargement (over 100 grams), urologists usually recommend open incision surgery (prostate adenomectomy).
Treatment of prostatitis
Antibiotic therapy is indicated in the case of a bacterial infection. This lasts at least three weeks.
The doctor treats non-bacterial prostatitis with anti-inflammatory and pain-relieving medication. To additionally alleviate the symptoms, the doctor prescribes pelvic floor physiotherapy and medication to facilitate urination.
Treatment of prostate cancer
Prostate cancer is treated depending on the stage of the tumor.
The decisive factor here is in particular
- whether the tumor is limited to the prostate (early stage) or
- adjacent tissue is already affected and/or
- has formed metastases in lymph nodes or other organs (advanced stage).
Urologists and oncologists treat early-stage cancers by
In the case of distant metastases, the doctor recommends hormone therapy with or without chemotherapy as well as targeted pain treatment.
The prognosis for benign prostatic hyperplasia is very favorable. The disease progresses very slowly and can be treated very well. However, if you do not undergo treatment, this can lead to various complications such as
- Bladder diverticula,
- a barred bladder (thickening of the bladder wall),
- recurrent cysts,
- inflammation and
- kidney dysfunction
can lead to inflammation.
In the case of acute prostatitis, the symptoms subside after just two days of antibiotic treatment. The situation is different with chronic inflammation. In this case, treatment is lengthy and can take more than six months. Therefore, have an acute inflammation treated by your urologist at an early stage so that it does not become chronic.
Prostate carcinoma also has good chances of recovery in the early stages. Over 90 percent of those affected are still alive after 5 years. In the case of advanced cancer, treatment measures stop the spread of the tumor and help to alleviate symptoms.
Common diseases of the prostate include benign prostate enlargement, prostate inflammation and prostate cancer. Your doctor can treat each of these diseases with a good chance of recovery if treatment is started early.
