Guys, You Need to Know About Prostate Health

Prostate

Most people only hear about the prostate in terms of adverse medical conditions such as Prostate Cancer. They have little or no knowledge as to what it does. There’s a lot more to the prostate gland than just disease. Let’s explore prostate health and point out a few things men should know.

What Does the Prostate Gland Do?

The prostate is one of the components of the male reproductive system. It is the size of a walnut, weighs about 30g and is smooth and soft to the touch. The prostate sits in the pelvis between the bladder and penis. You can feel it by pressing your finger into your rectum and pressing toward the front of your body.

The prostate surrounds the urethra – the tube that carries semen and urine out of the body.

Healthy Prostate

Though it is not essential for life, it is very important for proper reproductive function. The following are some of the functions of the prostate:

Semen Production

The most vital function of the prostate is its role in the production of prostatic fluid. This fluid makes up at least 20% of the fluid in your semen. The components of your prostatic fluid are essential for the health of the sperm. They include citric acid, zinc, and enzymes. One of the most important enzymes in the prostatic fluid is the prostate-specific antigen. It increases the fluidity of your semen.

Prostatic fluid is slightly acidic. Other components of the semen neutralize the acidity thus making it more alkaline. The overall alkalinity of the prostatic fluid neutralizes the acid nature of the vagina and protects the sperm.

It Closes the Urethra During Ejaculation

When you ejaculate, your prostate contracts and releases prostatic fluid into your urethra. The prostatic fluid mixes with seminal fluid and sperm cells resulting in the creation of semen, which is then expelled by the body.

During ejaculation, your prostate contracts, closing the opening between your urethra and the bladder, causing the semen to push through at speed. This is why a healthy male cannot ejaculate and urinate at the same time.

Hormone Metabolism

There’s an enzyme in your prostate called 5-alpha-reductase. It converts testosterone into dihydrotestosterone (DHT). This is the biologically active form of testosterone. It plays a very important role in the normal development and functioning of the prostate. In the developing male, DHT contributes to the development of facial hair and other secondary sexual characteristics.

Medical Conditions That Affect the Prostate

Most medical conditions that affect the prostate result in the gland becoming enlarged.

Several conditions can affect the prostate. These include the following:

Prostatitis

Prostatitis means inflammation or swelling of the prostate. It is the most common prostate condition in males under the age of 50. When the prostate is inflamed suddenly, the condition is called acute prostatitis. This may be caused by a bacterial infection. Acute prostatitis has a sudden onset and resolves quickly with the right antibiotic treatment. If the prostate is consistently inflamed for more than three months, then the condition is referred to as chronic prostatitis.

Enlarged Prostate

This condition is also referred to as benign prostatic hypertrophy (BPH). According to the National Institute of Diabetes and Digestive and Kidney Diseases, BPH is the most common prostate condition in males over the age of 50. 

When the prostate gland enlarges, it compresses the urethra and narrows the urethra tube. Most complications of BPH are caused by the narrowing of the urethra and the inability to empty the bladder. Such a condition, if prolonged without proper treatment, could weaken the bladder and make it difficult to urinate properly.

Prostate Cancer

Prostate cancer is the most common form of cancer affecting males. At least 1 in 9 males are affected by this condition during their lifetime. On average, a diagnosis is given at age 66. Prostate cancer, like all cancers, is a progressive disease. Outward manifestations of the disease may not occur until the condition has progressed significantly. There are several factors which increase an individual’s risk of developing prostate cancer. These include age (increases with age) and family history (risk is higher when there’s a family history).

Symptoms of Prostate Conditions

Prostate conditions cause problems with bladder control or urination. They also cause problems with urinary tract infections, sexual function, bladder stones, and kidney failure in extreme cases. Other symptoms of prostate conditions include:

  • Pain after ejaculation or while urinating
  • Blood in the urine
  • Pain in the scrotum, penis, or the area surrounding the anus and the scrotum
  • Body aches, chills, or fever.
  • Abdominal discomfort
  • Your urine has an unusual odor or color
  • A weak stream of urine or dribbling of the urine after urinating
  • Trouble controlling your bladder, like delaying or stopping urination.

You need to consult a doctor immediately if you observe one or more of these symptoms.

Medical Tests for Prostate Conditions

Doctors recommend one or more of the following procedures to test for prostate problems:

  • Digital Rectal Examination: The doctor inserts a finger into your rectum and feels the prostate to detect nodules, lumps, and signs of cancer.
  • Prostate Biopsy: If your doctor suspects that you have cancer, he or she will take a small sample of tissue from your prostate for testing. They do this by inserting a needle into your prostate.
  • Prostate-Specific Antigen Test: This is a blood test to measure levels of the PSA. High levels of PSA may indicate a high risk of prostate cancer. However, the PSA test has relatively high rates of false positives.
  • Prostate Ultrasound: It is also known as transrectal ultrasound. A probe is inserted into your rectum and positioned close to the prostate. Most biopsies are done under ultrasound guidance.
  • Prostate MRI: The MRI shows detailed anatomy of your prostate, including probable cancerous areas. Recent technological advancement has made it possible to target these areas using an MRI-ultrasound fusion biopsy.

Treatments for Prostate Conditions

Upon diagnosis, doctors can address prostate conditions using the following measures:

Prostatitis

Antibiotics, medication and surgery are options to treat chronic or acute prostatitis.

Prostate Cancer

Prostate cancer can be treated with any of the following: 

  • prostatectomy (surgical removal of the prostate) 
  • radiation therapy, cryotherapy (the process of killing cancer cells by freezing them)
  • radioactive seed implants (insertion of radioactive seeds into the prostate to kill the cancer cells)
  • hormone therapy 
  • chemotherapy

While being able to address the condition, depending on the progression of the disease, each course of treatment has an effect on the body. Therefore, the doctor will provide the patient with all available options after which they will both agree on the best option.

Enlarged Prostate

Once diagnosed, the following options are available to treat an enlarged prostate:

  • Surgery
  • 5-alpha-reductase inhibitors: these medications work by reducing the level of dihydrotestosterone (DHT). The reduction of DHT causes the prostate to shrink, thus improving the flow of urine.
  • Alpha-blockers: Alpha-blockers relax the muscles surrounding the urethra. This eases the flow of urine.

Takeaway

The prostate gland is not essential for life, but it plays a vital role in the functioning of the male body. If you suspect that you have a prostate condition, consult a doctor as quickly as you can. Early detection is critical to prevent a potentially life-threatening condition. Also, annual preventive checks will be helpful in early detection of prostate cancer.

References

  1. Swerdloff RS, Dudley RE, Page ST, Wang C, Salameh WA. Dihydrotestosterone: Biochemistry, Physiology, and Clinical Implications of Elevated Blood Levels. Endocr Rev. 2017;38(3):220-254. doi:10.1210/er.2016-1067
  2. NIH. Prostate Problems. Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems
  3. Reddy KS, Yusuf S. Emerging epidemic of cardiovascular disease in developing countries. Circulation. 1998;97(6):596–601.
  4. Ogunbiyi JO, Shittu OB. Increased incidence of prostate cancer in Nigerians. J Natl Med Assoc. 1999;91(3):159–164.
  5. Ukoli F, Osime U, Akereyeni F, Okunzuwa O, Kittles R, Adams-Campbell L. Prevalence of elevated serum prostate-specific antigen in rural Nigeria. Int J Urol. 2003;10(6):315–322.
  6. Ezeanyika LUS, Ejike CECC, Obidoa O, Elom SO. Prostate disorders in an apparently normal Nigerian population 1: Prevalence. Biokemistri. 2006;18(2):127–132
  7. Ejike CE, Ezeanyika LU. Prevalence of chronic prostatitis symptoms in a randomly surveyed adult population of urban-community-dwelling Nigerian males. Int J Urol. 2008;15(4):340–343
  8. World Bank . World development report 1993: Investing in health. New York (NY): Oxford University Press for the World Bank; 1993.
  9. Gwartkin DR, Guillot M, Heuveline P. The burden of diseases among the global poor. Lancet. 1999;354(9178):586–589.
  10. Gwartkin DR, Guillot M. The burden of diseases among the global poor: Current situation, future trends, and implications for strategy. Washington (DC): The World Bank; 1999
  11. PDQ® Cancer Genetics Editorial Board. PDQ Genetics of Prostate Cancer. Bethesda, MD: National Cancer Institute. Available at: https://www.cancer.gov/types/prostate/hp/prostate-genetics-pdq