What is the prostate gland?

The prostate gland sits under the bladder, and is coloured red in this diagram. The tube through which urine passes out is called the urethra, and travels right through the middle of the prostate gland.

The job of the prostate gland is to secrete a fluid, called prostatic fluid. When you ejaculate, the prostatic fluid is released, and mingles with the sperm. This fluid contains nourishment and protection for the sperm.

How common are symptoms?

A quarter of all men, aged 40 - 60, will suffer from some symptoms of BPH.
By the time they are 70, 70% will have symptoms.
By the time they are 80, 80% will have symptoms.

In the UK, 78,000 new cases of BPH are diagnosed every year.

What are the symptoms?

Some sufferers become reluctant to go out of the home, because of needing to go to the toilet so often. They become tired through lack of sleep, and feel in constant discomfort

Very occasionally, they become unable to pass urine at all. The bladder becomes very swollen, full, and uncomfortable.

Do the questionnaire

When you want to pass urine, is there a delay before you start?	ANever BSometimes CUsually
When you pass urine, do you find your flow stops and starts?	ANever BSometimes CUsually
When you think you have finished passing urine, do you find a bit more trickles out, and sometimes stains your underwear?	ANever BSometimes CUsually
Has your stream become weaker or thinner in the past year?	ANot really BYes, a bit CYes, a lot
Do you feel your bladder is not quite empty after you have been to pass urine?	ANever BSometimes CUsually
How many times do you usually get up in the night to pass urine?	ANever B1 - 3 C4 or more
How many times do you go to pass urine in the daytime?	ALess than 4 B5 - 7 CMore than 7
When you want to pass urine, do you feel you have to go straight away?	ANever BSometimes CUsually
Do you ever pass urine when you don't mean to?	ANever BSometimes COften

When should I consult my doctor?

If you scored mainly 'A's	you have no difficulty passing urine, and nothing to worry about.
If you scored mainly 'B's	you have some symptoms of BPH, and may wish to discuss this with your own doctor.
If you scored mainly 'C's	you have severe symptoms and should consult your own doctor.

You may need an examination, and possibly a blood test. Your doctor may consider referring you for an operation to remove the prostate gland, or may consider putting you on a course of tablets.

If you have blood in your urine you should consult your doctor. Benign prostatic hypertrophy does not usually cause blood in your urine, and you may have another medical problem that needs investigating.

If you notice burning or stinging when you pass urine, you may have a urine infection. You should consult your doctor.

What about cancer?

However, cancer of the prostate can spread and cause serious problems, so younger men are advised to have any cancerous nodule removed.

Sometimes it is difficult to tell the difference between benign prostatic hypertrophy (BPH) and prostate cancer. The symptoms are very similar. Here are some ways of deciding whether you have prostate cancer or BPH

1. Your doctor may examine you rectally, by inserting a finger into your anal canal. It is possible to feel the prostate gland in this way. Your doctor will feel for any suspiscious nodules.
2. You may have a biopsy done. Under anaesthetic, the doctor takes a small sample of your prostate gland, and this is examined under a microsocope for signs of cancer cells.
3. A blood test (called a PSA test) may be done. Unfortunately, this test is not very accurate. Men with very low PSA levels in their blood are unlikely to have cancer of the prostate. Men with very high levels are likely to have cancer of the prostate. The problem with the test is that you are unlikely to get a definite answer, and the test may need repeating several times.
4. If you have serious symptoms of BPH, your doctor may advise you to have your prostate gland removed. Any cancer nodule will be removed during the operation. Unfortunately, the operation can cause health problems, and should only be performed if really necessary.