The prostate gland (the prostate) is an organ of the male reproductive system. It is about the size of a walnut and is found at the base of the bladder. The thin tube that allows urine and semen to pass out of the penis (the urethra) runs through the prostate gland. Alkaline fluid produced by the prostate gland helps to nourish sperm and leaves the urethra as ejaculate (semen).
The prostate undergoes two main growth spurts. The first is fuelled by the sex hormones made by the testes during puberty. This prompts the prostate to reach an average weight of 20 grams. The second growth spurt happens during the fourth decade of life.
Prostate disease and ageing
Around 25 per cent of men aged 55 years and over have a prostate condition. This increases to 50 per cent by the age of 70 years.
A man in his 50s or 60s should discuss with his doctor whether to have his prostate gland checked and how often. Early stages of prostate disease may have no symptoms. For those men with a family history of prostate disease (or particular concerns), prostate checks might be considered earlier. Please discuss with your doctor when prostate checks might be suitable for you.
Types of prostate disease
The three most common forms of prostate disease are inflammation (prostatitis), non-cancerous enlargement of the prostate (benign prostatic hyperplasia, or BPH) and prostate cancer. A man may experience one or more of these conditions.
Inflammation of the prostate (prostatitis)
The main types of prostatitis are:
- bacterial prostatitis – acute or chronic
- non-bacterial prostatitis – also known as chronic pelvic pain syndrome (CPPS).
In most cases, the cause of the inflammation is unknown. However, prostatitis can be caused by bacteria. Bacterial prostatitis responds well to antibacterial drugs that concentrate in the prostate. CPPS is more difficult to manage. It is a common form of prostatitis and symptoms vary from one man to another. There is no single test to diagnose CPPS, so your doctor will need to rule out other possible causes of your symptoms before making a diagnosis.
Possible causes of CPPS include:
- a past bacterial prostatitis infection
- irritation from some chemicals
- a problem with the nerves connecting the lower urinary tract
- problems with pelvic floor muscles
- sexual abuse
- chronic anxiety problems.
Non-cancerous enlargement of the prostate (BPH)
Non-cancerous enlargement of the prostate, or benign prostatic hyperplasia (BPH), is more common as men get older. An obstruction is caused when the bladder neck and prostatic urethra fail to open properly as the bladder contracts during urination.
Obstructions usually show up as lower urinary tract symptoms that sometimes result in the urine staying in the bladder when it's supposed to be released. When this happens suddenly, it's called acute urinary retention. This is very painful and is usually relieved temporarily by inserting a thin tube (a catheter) to release the urine.
Chronic (ongoing) retention, which is less common, can lead to a dangerous, painless accumulation of urine in the bladder. An uncommon form of chronic urinary retention is associated with high bladder pressures, which can damage kidney function.
Prostate cancer is common in the over-65 age group and affects one in seven Australian men up to the age of 75. Around 4,000 Victorians are diagnosed every year. The cause remains unknown, although advancing age and family history are known to be contributing factors.
In the early stages, the cancer cells are confined to the prostate gland. With the more aggressive types of prostate cancer, cancer cells enter the vascular and lymphatic systems early and spread to other parts of the body where they develop secondary tumours, particularly in the bones.
Symptoms of prostate disease
In its earliest stages, prostate disease may or may not be associated with symptoms. The symptoms of prostate disease depend on the condition, but may include:
- difficulties urinating, such as trouble starting the flow of urine
- the urge to urinate often, particularly at night
- feeling as though the bladder can't be fully emptied
- painful urination
- blood in the urine or blood coming from the urethra independent of urination.
Blood in the urine is often due to causes not related to the prostate. Always see your doctor if you find blood in your urine.
Diagnosis of prostate disease
Prostate disease is diagnosed using a variety of tests, including:
- physical examination, including digital rectal examination (DRE), where the doctor inserts a gloved finger into your rectum to check the size of your prostate
- blood test for prostate specific antigen (PSA test; needs to be discussed with the doctor)
- mid-stream urine (MSU) tests to look for infection or blood in the urine
- ultrasound scans and urinary flow studies
- biopsies of the prostate.
Treatment for prostate disease
Treatment for prostatitis may include antibacterial drugs and supportive treatments, depending on the type of prostatitis.
Treatment for BPH may include medications to relax the smooth muscle of the gland or to shrink the size of the prostate, and surgery to produce a permanently widened channel in the part of the urethra that passes through the prostate.
Treatment for prostate cancer is tailored to suit individual circumstances. The nature of the cancer, other health problems the person may have, and their wishes will all be taken into account.
Management approaches for prostate cancer include:
- active surveillance
- surgery - for example, prostatectomy (removal of the prostate)
- ablative treatments such as high-intensity focused ultrasound (HIFU) and NanoKnife
- hormone treatment (androgen deprivation therapy)
- watchful waiting.
Where to get help
- Your doctor
- The Cancer Council Victoria Helpline Tel. 13 11 20
- Kidney Health Australia Tel. 1800 4 543639 (1800 4 KIDNEY)
- Prostate Cancer Foundation of Australia Tel. 1800 220 099
Things to remember
- The prostate gland is a male reproductive organ that produces fluids that feed and protect sperm cells.
- The three most common forms of prostate disease are inflammation (prostatitis), non-cancerous enlargement (BPH), and prostate cancer.
- A man in his 50s or 60s should discuss having his prostate gland checked with his doctor.
- For those men with a family history of prostate disease (or particular concerns), prostate checks might be considered earlier.
This page has been produced in consultation with and approved by:
Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health & Human Services shall not bear any liability for reliance by any user on the materials contained on this website.