What Are The Symptoms Of Prostate Problems
The symptoms of prostate problems may include
- urinary retentionthe inability to empty the bladder completely
- urinary frequencyurination eight or more times a day
- urinary urgencythe inability to delay urination
- urinary incontinencethe accidental loss of urine
- nocturiafrequent urination at night
- urine that has an unusual color or odor
- pain after ejaculation or during urination
Different prostate problems may have similar symptoms. For example, one man with prostatitis and another with BPH may both experience urinary urgency. Sometimes symptoms for the same prostate problem differ among individuals. For example, one man with BPH may have trouble beginning a urine stream, while another may experience nocturia. A man in the early stages of prostate cancer may have no symptoms at all. Because of this confusing array of symptoms, a thorough medical exam and testing are vital.
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Information Needed To Diagnose An Enlarged Prostate
When you go to your appointment, bring information on your current symptoms, as well as a written record of your past medical problems.
Your doctor will ask if you are having difficulty urinating, a weak stream, or nighttime urinating. They will aslo want to know if you’ve noticed blood in your urine or if there is burning .
You should also bring a complete list of all prescription and over-the-counter medicines that you are taking to see whether they are related to your symptoms. Certain drugs may interfere with urination. Over-the-counter medications, such as allergy and decongestant medicines, may prevent you from urinating. Other drugs that can make your symptoms more severe are opioids and anticholinergics.
Finally, tell your doctor if you have a history of alcohol use. Alcohol can also interfere with urination.
Referral To A Urologist
The GP may refer you to a;urologist or other appropriate specialist;if:
- previous treatments;have not helped your urinary problems
- a urinary infection;does not go away or comes back regularly
- you cannot;fully empty your bladder
- you have kidney problems
- you have stress incontinence, which is when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh
You should also see a specialist if the GP is concerned that your symptoms could be caused by cancer, although for most men this is not the cause.
To help find out what might be causing your symptoms and decide how to manage them, you should be offered extra tests to measure:
- how fast your urine flows
- how much urine is left in your bladder after you have peed
You may also be offered other tests, depending on your symptoms or the treatment you and your doctor are considering.
Page last reviewed: 10 February 2020 Next review due: 10 February 2023
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If You Are Diagnosed With Bph
Taken together, these tests will help your doctor determine whether you have BPH;and if you do, how severe it is. If you have BPH, your doctor should provide you with information on whether simply monitoring your symptoms is a reasonable option, or whether treatment is a better option.
BPH can be treated medically or surgically in some cases.
What Are The Symptoms Of Benign Prostatic Hyperplasia
Since the prostate gland surrounds the urethra , it is easy to understand that enlargement of the prostate can lead to blockage of the tube. Therefore, you may develop:
- Slowness or dribbling of your urinary stream.
- Hesitancy or difficulty starting to urinate.
- Frequent urination.
- Feeling of urgency .
- Need to get up at night to urinate.
- Pain after ejaculation or while urinating.
- Urine that looks or smells “funny” .
The enlargement of the prostate can lead to blockage of the urethra.
As symptoms get worse, you may develop:
- Damage to your kidneys from back pressure caused by retaining large amounts of extra urine in the bladder.
If you have any of these symptoms, see your doctor right away:
- Pain in the area of the lower abdomen or genitals while urinating.
- Cant urinate at all.
- Pain, fever and/or chills while urinating.
- Blood in the urine.
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Herbal Therapies For An Enlarged Prostate
Several herbal supplements are marketed for enlarged prostates. Saw palmetto, beta-sitosterol, and pygeum are all are widely used in Europe. They are available in the U.S. and don’t require a prescription.
However, researchers and doctors are cautious about advising patients to try herbal supplements. Because they are not FDA-regulated, there are concerns about a product’s quality from batch to batch, according to the NIH’s Office of Dietary Supplements. Also, the safety of an herbal product depends on many things — the chemical makeup, how it works in the body, how it is prepared, and the dosage.
Something else to consider: Like any drug, a herbal remedy can affect how other medications or treatments work, or interact dangerously with your other medications. They can also have side effects. And, the AUA points out, they have not been well-studied for effectiveness or safety.
Before trying any alternative treatment, learn as much as you can about it, the AUA says. Most importantly — talk to your doctor before you try an herbal remedy. Many doctors consider alternative therapies like saw palmetto to “have no effect on symptoms, except as expensive placebos,” Slawin tells WebMD.
Beta-sitosterol: This compound is extracted from pollen of rye grass. There has been some evidence that it provides relief from urinary symptoms. However, in four studies the supplement did not increase urinary flow rates, shrink the prostate, or improve bladder emptying.
Tests To Diagnose And Stage Prostate Cancer
Most prostate cancers are first found as a result of screening. Early prostate cancers usually dont cause symptoms, but more advanced cancers are sometimes first found because of symptoms they cause.
If prostate cancer is suspected based on results of screening tests or symptoms, tests will be needed to be sure. If youre seeing your primary care doctor, you might be referred to a urologist, a doctor who treats cancers of the genital and urinary tract, including the prostate.
The actual diagnosis of prostate cancer can only be made with a prostate biopsy .
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Transrectal Ultrasound With Prostate Biopsy
Transrectal ultrasound is most often used to examine the prostate. In a transrectal ultrasound, the health care provider inserts a transducer slightly larger than a pen into the mans rectum next to the prostate. The ultrasound image shows the size of the prostate and any abnormal-looking areas, such as tumors. Transrectal ultrasound cannot definitively identify prostate cancer.
To determine whether a tumor is cancerous, the health care provider uses the transducer and ultrasound images to guide a needle to the tumor. The needle is then used to remove a few pieces of prostate tissue for examination with a microscope. This process, called biopsy, can reveal whether prostate cancer is present. A transrectal ultrasound with prostate biopsy is usually performed by a doctor in a health care providers office, outpatient center, or hospital with light sedation and local anesthesia. The biopsied prostate tissue is examined in a laboratory by a pathologista doctor who specializes in diagnosing diseases.
What Tests Detect Prostate Cancer Early
Because prostate cancer cant necessarily be detected at home, its a good idea to learn about the tests that provide early detection 2 . Keep in mind that these tests cant decipher whether or not you have prostate cancer and, following the test, your doctor will most likely suggest a prostate biopsy. If youre wondering how to check for prostate cancer at home, your best bet is to leave it to your health care professional.;
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Use In Men Who Might Have Prostate Cancer
The PSA blood test is used mainly to screen for prostate cancer in men without symptoms. Its also one of the first tests done in men who have symptoms that might be caused by prostate cancer.
PSA in the blood is measured in units called nanograms per milliliter . The chance of having prostate cancer goes up as the PSA level goes up, but there is no set cutoff point that can tell for sure if a man does or doesnt have prostate cancer. Many doctors use a PSA cutoff point of 4 ng/mL or higher when deciding if a man might need further testing, while others might recommend it starting at a lower level, such as 2.5 or 3.;
- Most men without prostate cancer have PSA levels under 4 ng/mL of blood. Still, a level below 4 is not a guarantee that a man doesnt have cancer.
- Men with a PSA level between 4 and 10 have about a 1 in 4 chance of having prostate cancer.;
- If the PSA is more than 10, the chance of having prostate cancer is over 50%.
If your PSA level is high, you might need further tests to look for prostate cancer.;
To learn more about how the PSA test is used to look for cancer, including factors that can affect PSA levels, special types of PSA tests, and what the next steps might be if you have an abnormal PSA level, see Screening Tests for Prostate Cancer.
Surgery For An Enlarged Prostate
For most men with very enlarged prostates, surgery can relieve symptoms — but there are both risks and benefits with each type of operation. Discuss them with your doctor. After a careful evaluation of your situation and your general medical condition, your doctor will recommend which is best for you.
TURP : This is the most common surgery for an enlarged prostate, and considered to bring the greatest reduction in symptoms. Only the tissue growth that is pressing against the urethra is removed to allow urine to flow easily. The procedure involves an electrical loop that cuts tissue and seals blood vessels. Most doctors suggest using TURP whenever surgery is required, as it is less traumatic than open surgery and requires shorter recovery time.
With the TURP procedure, patients can expect to have retrograde ejaculation afterwards, says Westney. This is a condition in which a man ejaculates backward into the bladder instead of through the urethra. “Retrograde ejaculation generally isn’t painful,” she tells WebMD. “It shouldn’t be an issue unless fertility is a concern.” Other possible side effects include blood loss requiring transfusion , painful urination, recurring urinary tract infections, bladder neck narrowing, and blood in the urine.
After TURP, the odds of erection problems range from 5% to 35%. However, this is often temporary — and the ability to have an erection and an orgasm returns after a few months.
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Risk Factors For Prostate Cancer
Some risk factors have been linked to prostate cancer. A risk factor is something that can raise your chance of developing a disease. Having one or more risk factors doesn’t mean that you will get prostate cancer. It just means that your risk of the disease is greater.
- Age. Men who are 50 or older have a higher risk of prostate cancer.
- Race. African-American men have the highest risk of prostate cancerâthe disease tends to start at younger ages and grows faster than in men of other races. After African-American men, prostate cancer is most common among white men, followed by Hispanic and Native American men. Asian-American men have the lowest rates of prostate cancer.
- Family history. Men whose fathers or brothers have had prostate cancer have a 2 to 3 times higher risk of prostate cancer than men who do not have a family history of the disease. A man who has 3 immediate family members with prostate cancer has about 10 times the risk of a man who does not have a family history of prostate cancer. The younger a man’s relatives are when they have prostate cancer, the greater his risk for developing the disease. Prostate cancer risk also appears to be slightly higher for men from families with a history of breast cancer.
- Diet. The risk of prostate cancer may be higher for men who eat high-fat diets.
What Happens After The Prostate Tests
Urodynamic tests and cystoscopy may cause mild discomfort for a few hours after the procedures. Drinking an 8-ounce glass of water every half-hour for 2 hours may help reduce discomfort. The health care provider may recommend taking a warm bath or holding a warm, damp washcloth over the urethral opening to relieve discomfort. A prostate biopsy may produce pain in the area of the rectum and the perineum, which is between the rectum and the scrotum. A prostate biopsy may also produce blood in urine and semen.
An antibiotic may be prescribed for 1 or 2 days to prevent infection.
Patients with signs of infectionincluding pain, chills, or fevershould call their health care provider immediately.
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Prostate Specific Antigen Testing
Prostate Specific Antigen is a protein made by the cells in your prostate. Your PSA levels can be measured using a blood test and give an indication of your prostate health.
A PSA test isnt a test for cancer. Higher levels of PSA might indicate prostate cancer, but a high reading could also be caused by other conditions. It is also possible to have low level readings and have prostate cancer. This means that a PSA test isnt enough to definitively diagnose or rule out prostate cancer. Your PSA levels can vary, so your doctor might run this test a few times to compare your results and help determine your risk of prostate cancer.
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At the start, prostate cancer does not cause symptoms. As the cancer grows, you may have trouble urinating. Some men need to urinate often, especially at night. Others have pain or burning during urination, blood in the urine or semen, pain in the back, hips, or pelvis, and painful ejaculation.
To find out if these symptoms are caused by prostate cancer, your doctor will ask about your past medical problems and your family’s medical history. He or she will perform a physical exam. During the exam, your doctor will put a gloved finger into your rectum to feel your prostate for hard or lumpy areas.
Your doctor may also do a blood test to check the prostate-specific antigen level. PSA levels can be high in men with an enlarged prostate gland or with prostate cancer. You may also need an ultrasound exam that takes computer pictures of the prostate.
If tests show that you might have cancer, your doctor will want to confirm this with a biopsy. He or she will take out tiny pieces of the prostate to look for cancer cells. Your doctor may want to do a biopsy again to re-check the results.
Treatment for prostate cancer depends on whether cancer is in part or all of the prostate or if it has spread to other parts of the body. It also depends on your age and overall health. Talk with your doctor about the best treatment choice for you. You may want to ask another doctor for a second opinion.
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Diagnosing An Enlarged Prostate
As with all incontinence conditions, a thorough diagnosis must be developed before action can be taken.; You may have heard of some of these exams. And if you havent, now is a good time to familiarize yourself with them. Not only is knowledge power, but it also eliminates surprises.
Because those with BPH can experience symptoms from mild to severe, the treatment options featured here are organized from least invasive to more intense.
When To Contact A Medical Professional
- Less urine than usual
- Back, side, or abdominal pain
- Blood or pus in your urine
Also call if:
- Your bladder does not feel completely empty after you urinate.
- You take medicines that may cause urinary problems, such as diuretics, antihistamines, antidepressants, or sedatives. DO NOT stop or change your medicines without talking to your provider.
- You have tried self-care steps for 2 months and symptoms have not improved.
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If Screening Test Results Arent Normal
If you are screened for prostate cancer and your initial blood PSA level is higher than normal, it doesnt always mean that you have prostate cancer. Many men with higher than normal PSA levels do not have cancer. Still, further testing will be needed to help find out what is going on. Your doctor may advise one of these options:
- Waiting a while and having a second PSA test
- Getting another type of test to get a better idea of if you might have cancer
- Getting a prostate biopsy to find out if you have cancer
Its important to discuss your options, including their possible pros and cons, with your doctor to help you choose one you are comfortable with. Factors that might affect which option is best for you include:;
- Your age and overall health
- The likelihood that you have prostate cancer
- Your own comfort level with waiting or getting further tests
If your initial PSA test was ordered by your primary care provider, you may be referred to a urologist for this discussion or for further testing.
Getting The Results Of The Biopsy
Your biopsy samples will be sent to a lab, where they will be looked at with a microscope to see if they contain cancer cells. Getting the results usually takes at least 1 to 3 days, but it can sometimes take longer. The results might be reported as:
- Positive for cancer: Cancer cells were seen in the biopsy samples.
- Negative for cancer: No cancer cells were seen in the biopsy samples.
- Suspicious: Something abnormal was seen, but it might not be cancer.
If the biopsy is negative
If the prostate biopsy results are negative , and the chance that you have prostate cancer isnt very high based on your PSA level and other tests, you might not need any more tests, other than repeat PSA tests sometime later.
But even if many samples are taken, biopsies can still sometimes miss a cancer if none of the biopsy needles pass through it. This is known as a false-negative result. If your doctor still strongly suspects you have prostate cancer , your doctor might suggest:
- Getting other lab tests to help get a better idea of whether or not you might have prostate cancer. Examples of such tests include the Prostate Health Index , 4Kscore test, PCA3 tests , and ConfirmMDx. These tests are discussed in Whats New in Prostate Cancer Research?
- Getting a repeat prostate biopsy. This might include getting additional samples of parts of the prostate not biopsied the first time, or using imaging tests such as MRI to look more closely for abnormal areas to target.
Prostate cancer grade
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