What Does The Prostate Gland Actually Do
The prostate gland isn’t essential for life, but it is vital for reproduction and is part of the male reproductive system.
The function of the prostate is to produce a slightly alkaline fluid called the prostatic fluid that makes up part of the seminal fluid, or semen.
The rest of semen is composed of sperm cells from the testicles, fluid from the seminal vesicles, and secretions from the pea-sized bulbourethral gland.
The prostatic fluid contains substances that are important to the functioning and survival of sperm cells, such as the enzyme;prostate-specific antigen , which thins or loosens up semen, helping the tadpole-like sperm cells swim freely to reach the egg.
When Should Men Be Tested For Prostate Cancer
The U.S. Preventive Services Task Force recommends that men 55 to 69 may be screened for prostate specific antigens, a simple blood test that can indicate the possible presence of cancer in the prostate. Many doctors will recommend this as part of a regular physical exam for men. A digital rectal exam can be performed as well to feel for any abnormalities in the prostate. The American Cancer Society recommends screening for: men 50 and older who are expected to live 10 or more years; men 45 and older who are at high risk ; and men 40 and older who are at very high risk . It is up to the patient to decide to have the screening. If the PSA exam comes back lower than 2.5 ng/mL, the patient may be fine to wait two years for another check. If it is 2.5 ng/mL or over but there is no sign of cancer, another check should be done the next year. The USPSTF does not recommend screening for men 70 and older.
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Providing Your Medical History
At first, the doctor will probably ask you about your medical history. Do you have any chronic illnesses? What illnesses and operations have you had in the past? What medications are you taking, if any? Your doctor is also likely to ask about your psychological well-being and lifestyle: Do you suffer from depression? Are you under a lot of stress? Do you drink alcohol? Smoke? Use illegal drugs? Have you felt a loss of affection for your partner? Have you recently grown interested in a new partner?
As part of this health history, be prepared to tell your doctor specific details about the symptoms that brought you to the office and when they began. Your doctor might want to know how often you had sex before the problem started and if there have been weeks or months in the past when youve had erectile dysfunction. Your doctor may conduct a written or verbal screening test.
If the cause is clear a recent operation for prostate cancer, for example the conversation may move directly to your treatment options. Otherwise, you may need to answer more questions to help the doctor narrow down the possible causes and avoid unnecessary testing.
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Using Pads Or A Sheath
Absorbent pads and pants can be worn inside your underwear, or may replace your underwear altogether. These will soak up any leaks.
Urinary sheaths can also help with dribbling. They look like condoms with a tube coming out of the end. The tube connects to a bag that you can strap to your leg under your clothing.
Prostate Massage And Cancer
Men suspected of having prostate cancer should not be treated with prostate massage, as this may cause tumor cells to break off and spread to nearby tissues.
There’s some evidence that prostate massage, prior to certain tests for prostate cancer, may increase the sensitivity of the test, making it more likely the cancer will be detected.
However, a prostate-specific antigen blood test should not be conducted immediately after a prostate massage, as this could lead to false-positive results.
Even if cancer is not an issue, it’s important to avoid injuring the prostate. The thin, pliable membrane covering the prostatethe prostatic plexusis full of nerves that serve the sponge-like corpora cavernosa of the penis.
Massaging the prostate too intensely can damage nerves in the corpora cavernosatwo chambers composed of erectile tissue that run the length of the penis. Damage to the corpora cavernosa can result in pain and erectile dysfunction.
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Touching Your Prostate With Your Finger
Psa Levels After Treatment
A continuous rise in your PSA level can be the first sign that your cancer has come back. This should be picked up by your regular PSA tests.
The exact change in PSA level that suggests your cancer has come back will depend on which treatment you had. Speak to your doctor or nurse about your own situation.
Your PSA level should drop so low that its not possible to detect it at six to eight weeks after;surgery. This is because the prostate, which produces PSA, has been removed. A rise in your PSA level may suggest that you still have some prostate cancer cells.
After;radiotherapy;or;brachytherapy, your PSA should drop to its lowest level after 18 months to two years. Your PSA level wont fall to zero as your healthy prostate cells will continue to produce some PSA.
Your PSA level may actually rise after radiotherapy treatment, and then fall again. This is called PSA bounce. It could happen up to three years after treatment. It is normal, and doesnt mean that the cancer has come back.
If your PSA level rises by 2 ng/ml or more above its lowest level, this could be a sign that your cancer has come back. Your doctor will continue to check your PSA level and will talk to you about further tests and treatment options.
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What Causes An Enlarged Prostate
We still dont really know all the things that cause the prostate to grow. But we do know about two risk factors that can increase your risk of having an enlarged prostate.
Age
Your risk of having an enlarged prostate increases as you get older. Many men aged 50 or over have an enlarged prostate, but they dont all get symptoms. And some men have symptoms that don’t bother them.
Hormone levels
The balance of hormones in your body changes as you get older. This may cause your prostate to grow.
Other factors
Some studies show that obese men and men who have diabetes may be more likely to develop an enlarged prostate. Regular exercise may help to reduce your risk of urinary symptoms. But we still need more studies into the causes of enlarged prostate to know for certain if, and how, we can prevent it.
There is also some research that suggests you may be more at risk of developing an enlarged prostate if your father or brother has one. Again, further studies are needed to confirm this.
Bigger But Not Better
Prostatic enlargement is pretty much inevitable. The urinary symptoms associated with it are treated with pills called alpha-blockers, which essentially enlarge the urethral channel by relaxing the muscle fibers within it. You can start with herbals like that of the woody shrub saw palmetto, pumpkin seeds , stinging nettle extract, pygeum, rye grass or beta-sitosterol extract and cruciferous vegetables but in;randomized trials;herbals take a distant second place to alpha blockers. Other drugs called;5-alpha-reductase inhibitors;actually shrink the gland by 1/3 of its size and can also help urination. If these pills don’t keep you peeing straight and strong, there are also various;indescribable procedures;that can remove the excess prostatic tissue. And yes, some of them involve lasers, which you just gotta love.The prostate can also become inflamed, termed;prostatitis,;which occurs in about;10% of men;at least once during their lives. This diagnosis is not subtle as most men with prostatitis pee firewater several times an hour. ;Ways to avoid this include good hydration, regular, timed voiding and treating BPH when it occurs.
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If Youre The Receiving Partner
Youll want to be as relaxed and aroused as possible, because itll make the experience easier and more enjoyable.
The whole poop-comes-out-of-the-butt thing gives some people a case of the heebie-jeebies even when its their own butt.
Remedy this by taking a shower and paying a little extra attention back there to get it squeaky clean. Some people like to use an enema before engaging in butt play, but it isnt necessary.
Use the bathroom before getting started. Prostate stimulation can make you feel like you need to pee, and anal penetration can cause the sensation of needing to poop.
Even though you wont actually do either, worrying that you might can interfere with your ability to let go and enjoy yourself. Knowing your bladder and bowels are empty can help.
Getting used to the sensation of having your prostate touched can help, too. Practice with an anal sex toy, like a butt plug, or your fingers.
Be sure to set the mood so that youre turned on and primed for action. Light candles, watch porn, or engage in some good old-fashioned masturbation or foreplay to get there.
Finally, be sure to lube up real good. Applying a water-based lubricant will allow for easier penetration and make for some easy gliding if stimulating your prostate externally.
Side Effects And Risks
The tissues lining the prostate and rectum are delicate and vulnerable to cuts, tears, and abrasions. Massaging the prostate too intensely can easily lead to soreness. In the study described above, for example, 8.3% of participants reported discomfort after prostate massage.
Overly aggressive prostate massage can also cause rectal bleeding, creating a risk of bacterial infection or aggravating hemorrhoids.
Furthermore, manual prostate massage is discouraged for men with acute bacterial prostatitis. The massage increases inflammation and may promote the spread of bacteria to the urethra, other parts of the urinary tract, and the bloodstream.
That said, a few small studies of the effects of prostate massage performed by a physician have shown it to be beneficial as a therapy for chronic prostatitis when paired with antibiotics.
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Treatment For Urinary Problems
If your urinary problems are caused by infection or enlargement of the prostate gland, treatment may include:
- a long course of antibacterial medication because infection is difficult to get rid of, the antibacterial medication will need to be taken for many weeks
- medication to improve urine flow and other symptoms
- surgical procedures the type of surgery required depends on the size of the prostate and the condition of the urethra. Types of procedures include:
- transurethral resection of the prostate
- transurethral incision of the prostate
- laser resection of the prostate
- open surgery prostatectomy ;
- removal of prostate tissue using water jets or steam
What Are The Symptoms Of Enlarged Prostate
When the prostate becomes enlarged, it can block the urethra and impair bladder function. Symptoms that may indicate this is happening include:
- Urinating many times a day and being unable to hold off urination
- Problems starting a urine stream or a weak or interrupted stream, followed by dribbling at the end
- Waking at night to urinate and accidental loss of urine
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Prostate Cancer Diagnoses And Treatment
All cancer is complex, but prostate cancer testing and treatment is particularly complicated.
In some men with prostate cancer, the cancer will grow very slowly, and wont significantly affect them during their lifetime. Other mens prostate cancer can grow and spread very quickly. At the moment, there is no test that can tell what type of prostate cancer a man has when he is diagnosed.
Because some treatments for prostate cancer can cause side effects which might impact on quality of life, its important for men to discuss with their doctor all their options for testing and treatment, and to discuss these with their partners and families. These might include watchful waiting, which means waiting to see what the cancer does over time, radiation, surgery or taking medications.
You can read more about what kinds of questions to ask your doctors about prostate cancer testing and treatment on the Cancer Council website.
What Causes Benign Prostatic Hyperplasia
The cause of benign prostatic hyperplasia is not well understood; however, it occurs mainly in older men. Benign prostatic hyperplasia does not develop in men whose testicles were removed before puberty. For this reason, some researchers believe factors related to aging and the testicles may cause benign prostatic hyperplasia.
Throughout their lives, men produce testosterone, a male hormone, and small amounts of estrogen, a female hormone. As men age, the amount of active testosterone in their blood decreases, which leaves a higher proportion of estrogen. Scientific studies have suggested that benign prostatic hyperplasia may occur because the higher proportion of estrogen within the prostate increases the activity of substances that promote prostate cell growth.
Another theory focuses on dihydrotestosterone , a male hormone that plays a role in prostate development and growth. Some research has indicated that even with a drop in blood testosterone levels, older men continue to produce and accumulate high levels of DHT in the prostate. This accumulation of DHT may encourage prostate cells to continue to grow. Scientists have noted that men who do not produce DHT do not develop benign prostatic hyperplasia.
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What Is Your Prostate And What Does It Do
Your prostate is a small gland that lives inside your body, just below your bladder. It sits around the urethra, which is the tube that carries pee from your bladder through your penis. Only men have a prostate.
Your prostate produces some of the fluids contained in your semen, the liquid that transports sperm. This liquid contains special enzymes and hormones that help your sperm cells function properly, which means the prostate plays a key part in your fertility. The muscles in your prostate also help push semen through your urethra when you ejaculate.
What Are Kegel Exercises
Kegel exercises are designed to strengthen the muscles of your pelvic floor.
Theyre often recommended for women, especially after childbirth. But diabetes, prostate surgery, and OAB can also weaken the muscles in your pelvic floor.
Kegel exercises can be done at almost any time. Plus, they dont require special equipment.
But it may take some practice and concentration to get the exercises just right.
First you must find the muscles of your pelvic floor. To do so, start urinating and after a few seconds, stop mid-stream.
Concentrate on the muscles that you just used. Those are your pelvic floor muscles.
Begin your Kegel exercises with an empty bladder. Lie on the floor with your knees bent and apart.
Tighten your pelvic floor muscles for three seconds and then relax them for three seconds. Repeat a few times.
Be sure to focus only on the pelvic floor muscles. Soon youll be able to do this while sitting or standing.
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How Is Yale Medicines Approach To Treating Enlarged Prostate Unique
“Urologists at Yale Medicine can give you a personalized approach to prostate care for both benign and malignant conditions,” says Dr. Honig.;
Doctors at Yale Medicine work closely with specialists across all disciplines at Yale New Haven Hospital. Our doctors are dedicated to providing the latest;treatmentsall personalized to meet the needs of each patient.;This collaboration between different departments and teams sets Yale Medicine apart in its standard of care.
When To Get A Prostate Cancer Screening
A prostate screening can help your doctor find prostate cancer early, but youll need to decide if the benefits of the exam outweigh the risks. Have a discussion with your doctor about prostate cancer screenings.
The U.S. Preventive Services Task Force now recommends that men ages 55 to 69 decide for themselves whether to undergo a prostate-specific antigen screening test, after talking it over with their doctor.
They recommend against screening for men at or above the age of 70.
The American Cancer Society strongly recommends that no one be screened without discussion of the uncertainties, risks, and potential benefits of prostate cancer screening.
They give these specific recommendations for the date at which these discussions with a healthcare provider should take place:
- Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.
- Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative diagnosed with prostate cancer at an early age .
- Age 40 for men at even higher risk .
You should also speak with your doctor about a prostate exam if youre experiencing symptoms of a prostate problem, such as frequent or painful urination or blood in your urine.
After this discussion, if you decide to get a prostate cancer screening, the ACS and the American Urologic Association recommend getting a prostate-specific antigen blood test.
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