Mens Health - Prostate
Prostate is a walnut sized gland which surrounds the urethra just below the urinary bladder in men. It has a role in male sexual function. Prostate secretes an enzyme called 'prostate specific antigen' (PSA). Prostate growth depends on the male hormone testosterone. The prostate may be responsible for various symptoms involving your lower urinary tract.
Prostatitis is inflammation of the prostate gland. There are four different types of prostatitis. If you have acute pain in the perineum with temperature and difficulty in passing urine, you may be suffering from acute prostatitis. You will need to see your GP or attend your local emergency department as you may need intravenous antibiotics. Symptoms of chronic prostatitis can include recurrent attacks of perineal pain, pain on ejaculation and recurrent urinary tract infection. Chronic prostatitis is usually treated with a varying combination of antibiotics, alpha blockers and anti-inflammatory drugs. A cystoscopy may also be necessary in some cases when this can be combined with a prostate massage.
Benign Prostatic Hyperplasia
Benign prostatic hyperplasia or BPH is enlargement of the prostate which occurs as men get older. This is related to the presence of the male hormone testosterone. Not all men with BPH will develop symptoms. However some men will have difficulty in urinating as the prostate gland grows and slows the flow of urine. You can also get urgency (feeling of urgent need to pass urine), frequency and nocturia (getting up at night more than usual). If your symptoms disrupt your life, please see your GP or ask to be referred to a urologist.
At North Devon Urology, you will have a comprehensive assessment which will include
- full history
- examination including a rectal exam to assess your prostate
- IPSS questionnaire
- urine dipstick
- flow rate and bladder scan
- PSA blood test if you have not had this done by your GP already
After the assessment, we will discuss with you and make a treatment plan. This may include lifestyle modifications, medications and or prostate surgery
Prostate cancer is the commonest cancer in men in the UK. 1 in 8 men will get prostate cancer in their lifetime. Prostate cancer especially when it is confined within the prostate, may not cause any symptoms. In some cases you may have difficulties with urination, as with benign prostatic enlargement. Less common symptoms include sexual dysfunction or blood in the semen. If you have any of the above, you can ask your GP for a PSA blood test. This along with a digital rectal exam (to asses your prostate) in most cases will be enough to reassure about prostate cancer.
A raised PSA (when confirmed by a second reading) even if the prostate feels normal on examination, would suggest need for further investigation. The exact nature of the tests will depend on your individual circumstances.
I would be very happy to see you if you have any concerns regarding prostate cancer and formulate a management plan. This may include an MRI scan, a biopsy of the prostate or in some cases simply further monitoring of the PSA.
Links to further information
Mens Health - Testis
The vast majority of testicular lumps are non cancerous caused by fluid around testis (hydrocele), epididymal cysts or varicocoele. Rare causes include testicular tumour. If you notice any lump in the testicle, get it checked out by your GP. In most cases your GP will be able to reassure you.
Sudden severe pain and swelling of the testicle can be due to torsion. You must come to the nearest A&E, as you may need an operation urgently to untwist and fix the testicle.
Epididymoorchitis or infection in the testicle is another common cause of swelling and pain in sexually active men or with a urinary tract infection.
Click on the links below for further information.
Chronic testicular pain
If you have pain in one or both testicles for three months or longer and it interferes with your quality of life, you may want to see your GP for further advice. As with any chronic pain, cure can be difficult but with a step wise approach to diagnosis, treatment and lifestyle advice, symptoms can be managed in most cases.