Prostate Problems

On this page:

• What are common prostate problems?
• What is the prostate?
• What causes prostate problems?
• Who develops prostate problems and how common are they?
• What are the symptoms of prostate problems?
• See your doctor if you have symptoms
• Do prostate problems cause other problems?
• How does my doctor know if I have a prostate problem?
• How do doctors treat prostate problems?
• What are the side effects of treatments for prostate problems?
• How can I prevent a prostate problem?
• Eating, Diet, and Nutrition
• Points to Remember
• Clinical Trials

What are common prostate problems?

Common prostate problems include

• prostatitis—inflammation, or swelling, of the prostate
• benign prostatic hyperplasia (BPH)—an enlarged prostate due to something other than cancer
• prostate cancer

Read more about prostate cancer at www.cancer.gov.

What is the prostate?

The prostate is a walnut-shaped gland that is part of a man’s sex organs, which also include the penis, scrotum, and testicles. The prostate makes fluid that goes into semen, which is a mix of sperm and prostate fluid. Prostate fluid is important for a man’s ability to father children.

The prostate is in front of the rectum and just below the bladder. The gland surrounds the urethra at the neck of the bladder. The bladder neck is the area where the urethra joins the bladder. The urethra is the tube that carries urine from the bladder to the outside of the body. In men, the urethra also carries semen out through the penis during sexual climax, or ejaculation. The bladder and urethra are parts of the lower urinary tract.

Urine and semen flowing through the urethra pass through the prostate.

What causes prostate problems?

The cause of prostate problems may be

• prostatitis
• BPH

Your doctor may not always know the exact cause of your prostate problem.

Prostatitis

The cause of prostatitis depends on whether you have chronic prostatitis or bacterial prostatitis.

Chronic prostatitis. Doctors do not know the exact cause of chronic prostatitis. Researchers think that an infection of tiny organisms, though not bacteria, can cause chronic prostatitis. Other causes may include chemicals in your urine, your body’s response to a previous urinary tract infection (UTI), or nerve damage in your pelvic area. Most of the time doctors don’t find any infection in men with chronic prostatitis.

Bacterial prostatitis. Bacteria, tiny organisms that can lead to infection, cause some kinds of prostatitis.

Benign Prostatic Hyperplasia

Doctors do not know the exact cause of BPH. Changes in male-hormone levels in older men, aging, inflammation, and fibrosis may play a role in causing BPH. Fibrosis is when extra tissue forms around your organs and becomes thick and stiff.

Who develops prostate problems and how common are they?

Any man can develop a prostate problem. Prostatitis can affect men of all ages. However, it is the most common prostate problem in men younger than age 50. BPH is the most common prostate problem in men older than age 50.

Prostatitis

If you have a UTI, you may be more likely to get bacterial prostatitis. If you have nerve damage in your lower urinary tract or have emotional stress, you may be more likely to get chronic prostatitis.

Benign Prostatic Hyperplasia

Men younger than age 40 rarely have BPH symptoms. The number of men with BPH symptoms increases with age.

If you have a family history of BPH, you may be more likely to get BPH. Other factors that increase your chances for BPH may include certain medical conditions and lifestyle choices.

What are the symptoms of prostate problems?

The symptoms of a prostate problem may include problems with urinating and bladder control. Bladder control is how well you can delay, start, or stop urination. These problems can cause you to

• go to the bathroom frequently
• feel as if you need to rush to the bathroom, only to find you can’t urinate or you urinate only a little
• leak or dribble urine
• have a weak urine stream

Depending on the cause of your prostate problems, you may have other symptoms.

Prostatitis

If you have chronic prostatitis, your symptoms may cause long-lasting pain and discomfort in

• your penis or scrotum
• the area between your scrotum and anus
• your belly
• your lower back

If you have bacterial prostatitis, your symptoms may come on quickly, or they may come on slowly and last a long time. You may not be able to empty your bladder completely. You may have a fever, chills, or body aches.

Benign Prostatic Hyperplasia

If you have BPH, you may need to wake up often to urinate when you sleep. Your urine may have an unusual color or smell. You may also have pain while urinating or after ejaculation.

Do prostate problems cause other problems?

Yes, a prostate problem may cause other problems, such as

• problems having sex
• a UTI
• feeling stressed due to chronic pain
• inflammation in areas near your prostate
• bladder stones
• kidney failure

Which problem you may get depends on the type of prostate problem you have. Other problems may vary from man to man for each type of prostate problem.

How does my doctor know if I have a prostate problem?

Your doctor will know if you have a prostate problem based on the following:

• your medical and family history
• a physical exam, including a digital rectal exam of your prostate
• tests on your urine, blood, and lower urinary tract
• ultrasound
• prostate biopsy

Medical and Family History

Taking a medical and family history is one of the first things a doctor may do to help diagnose your prostate problem.

Physical Exam

A physical exam may help diagnose the cause of a prostate problem. During a physical exam, a doctor typically

• checks your body.
• looks for fluids leaking from your urethra.
• checks for swollen or tender lymph nodes in your groin. Lymph nodes are glands that help you fight infections.
• checks for a swollen or tender scrotum.
• examines your prostate using a digital rectal exam.

For a digital rectal exam, your doctor slides a gloved, lubricated finger into your rectum and feels your prostate. This exam gives your doctor a general idea of the size and condition of your prostate. A digital rectal exam most often takes place in your doctor’s office. You will not need pain medicine.

Tests

Urine test. A urine test involves collecting a sample of your urine in a special container in your doctor’s office or a medical facility. A health care professional tests your urine sample at your doctor’s office or sends your sample to a lab. Your doctor may want to test your urine sample for signs of infection.

Blood test. A blood test involves drawing a sample of your blood at your doctor’s office or a medical facility. A health care professional sends your blood sample to a lab. Your doctor may want to test your blood sample for prostate-specific antigen (PSA). PSA is a protein that your prostate makes. If your PSA level is high, it may be a sign that you have prostate cancer. However, this test isn’t perfect. Many men with high PSA levels don’t have prostate cancer. Your doctor may also test your blood sample for signs of infection.

Urodynamic tests. Your doctor may perform a urodynamic test to see how well your bladder and urethra hold and release urine. Your doctor most often does a urodynamic test during an office visit. The tests can show signs of blockage in your urethra due to prostate enlargement.

More information is provided in the NIDDK health topic, Urodynamic Testing.

Cystoscopy. For this test, your doctor uses a tubelike instrument called a cystoscope to look inside your urethra and bladder. Your doctor performs a cystoscopy during an office visit or in an outpatient center or a hospital. You will receive pain medicine. In some cases, your doctor will give you medicines to help you relax or fall asleep. With a cystoscopy, your doctor can see blockage in your urethra and problems in your bladder.

More information is provided in the NIDDK health topic, Cystoscopy and Ureteroscopy.

Ultrasound

An ultrasound is when a doctor uses a device called a transducer to bounce safe, painless sound waves off of your organs to make pictures of them. A health care professional does an ultrasound in a doctor’s office, an outpatient center, or a hospital, and a doctor interprets the pictures. You will not need pain medicine. To make pictures of the prostate, a health care professional inserts a small transducer into your rectum. The pictures can show the size and shape of your prostate.

More information is provided in the NIDDK health topic, Imaging of the Urinary Tract.

Prostate Biopsy

Prostate biopsy is a test that involves taking small pieces of tissue from your prostate to look at with a microscope. Your doctor does a prostate biopsy in an outpatient center or a hospital. Your doctor will give you medicines to help you relax and stop you from feeling pain, or your doctor may give you medicine so you are asleep during the biopsy. A specially trained doctor examines the tissue in a lab for signs of disease. A biopsy can show whether you have prostate cancer.

More information is provided in the NIDDK health topic, Medical Tests for Prostate Problems.

How do doctors treat prostate problems?

Treatment depends on the type of prostate problem you have.

Prostatitis

Treatment depends on the type of prostatitis.

Chronic prostatitis. If you have chronic prostatitis, your doctor will try treatments to lessen pain, discomfort, and inflammation. Your doctor may give you a medicine called an alpha-blocker to relax the muscles in your prostate and part of your bladder. Tamsulosin (Flomax) and silodosin (Rapaflo) are two commonly used alpha-blockers. Warm baths, relaxation exercises, and physical therapy may help.

Bacterial prostatitis. If you have bacterial prostatitis, your doctor will give you an antibiotic, a medicine that kills bacteria. Bacterial prostatitis generally clears up quickly after treatment with antibiotics. As part of treatment, your doctor may ask you to change your diet and drink more liquids.

Benign Prostatic Hyperplasia

Treatments for BPH include

• watchful waiting
• lifestyle changes
• medicines
• surgery

Watchful waiting. If your symptoms don’t bother you too much, you may choose to live with them rather than take medicines or have surgery. However, you should have regular checkups to make sure your condition isn’t getting worse. With watchful waiting, you can be ready to choose a treatment as soon as you decide to treat your BPH.

Lifestyle changes. Your doctor may suggest changes to your lifestyle if your symptoms are mild and bother you only a little. Your symptoms may get better if you

• drink fewer liquids before going out or before going to sleep
• avoid or drink fewer liquids that have caffeine or alcohol in them
• avoid medicines that may affect your bladder, such as certain cold and allergy medicines
• change the timing of your medicines, such as diuretics, also called water pills, or those that treat high blood pressure.

Medicines. Your doctor may prescribe medicines such as finasteride (Proscar) and dutasteride (Avodart). These medicines can stop prostate growth or actually shrink the prostate in some men. Your doctor also may prescribe an alpha-blocker like doxazosin (Cardura) or tadalafil (Cialis), another medicine that relaxes prostate and bladder muscles.

Surgery. If your prostate keeps growing or your symptoms get worse, your doctor may recommend surgery to shrink your prostate. Most of the surgeries are transurethral, which means your doctor inserts a thin tube into your urethra to reach the prostate. Your doctor performs the transurethral surgery in an outpatient center or a hospital. Your doctor will give you medicines to help you relax and stop you from feeling pain, or your doctor may give you medicine so you are asleep during surgery. Most men can go home the same day as the surgery.

In most cases, surgery to shrink or remove prostate tissue offers long-term relief from problems due to BPH. In a few cases, the prostate may continue to grow and problems may return. Surgery for BPH does not prevent cancer. You should continue to have your prostate checked after surgery to make sure your prostate has not grown larger.

In some cases, your doctor may recommend removing your prostate. Your doctor performs this surgery in a hospital. Your doctor will give you medicine so you are asleep during surgery. You will need a hospital stay after your surgery.

What are the side effects of treatments for prostate problems?

The side effects of treating prostate problems may include the following:

• The medicines you take for prostatitis and BPH may make you feel sick or uncomfortable. Tell your doctor right away if you think the medicine is causing you to feel this way.
• Surgery for BPH may have a temporary effect on your ability to have sex. Most men recover their ability to have sex within a year of surgery. The exact length of time depends on the type of surgery and how long you had symptoms before surgery.
• You also may have bladder control problems after treatment for BPH. In most cases, these problems go away after several months.

If you have any problems after treatment for prostate problems, talk with your doctor. Chances are good that your doctor can help you.

If your doctor removes your prostate, you’re more likely to have long-lasting problems with bladder control and having sex. Your doctor can recommend the best treatment options for these problems.

How can I prevent a prostate problem?

Researchers have not found ways to prevent prostate problems. Men with a greater chance of developing a prostate problem should talk with their doctor about any lower urinary tract symptoms and the need for regular prostate exams. Recognizing lower urinary tract symptoms and knowing whether you have a prostate problem can help you get early treatment and reduce the effects of prostate problems.

Eating, Diet, and Nutrition

Researchers have not found that eating, diet, and nutrition play a role in causing or preventing prostate problems.

Points to Remember

• Common prostate problems include
  • prostatitis—inflammation, or swelling, of the prostate
  • benign prostatic hyperplasia (BPH)—an enlarged prostate due to something other than cancer
  • prostate cancer
• Prostatitis is the most common prostate problem in men younger than age 50.
• BPH is the most common prostate problem in men older than age 50.
• The symptoms of a prostate problem may include problems with urinating and bladder control.
• If you have chronic prostatitis, your symptoms may cause long-lasting pain and discomfort in
  • your penis or scrotum
  • the area between your scrotum and anus
  • your belly
  • your lower back
• If you have bacterial prostatitis, your symptoms may come on quickly, or they may come on slowly and last a long time.
• If you have BPH, you may need to wake up often to urinate when you sleep.
• If you can’t urinate at all, you should get medical help right away.
• Your doctor will know if you have a prostate problem based on the following:
  • your medical and family history
  • a physical exam, including a digital rectal exam of your prostate
  • tests on your urine, blood, and lower urinary tract
  • ultrasound
  • prostate biopsy
• Treatment depends on the type of prostate problem you have.
• If you have chronic prostatitis, your doctor will try treatments to lessen pain, discomfort, and inflammation.
• If you have bacterial prostatitis, your doctor will give you an antibiotic, a medicine that kills bacteria.
• Treatments for BPH include
  • watchful waiting
  • lifestyle changes
  • medicines
  • surgery

Clinical Trials

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.

What are clinical trials, and are they right for you?

Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.

What clinical trials are open?

Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov.