Many patients walk into my office and tell me, “Doctor, I’ve got prostate!” I usually reply that I have a prostate too – and so does a three-year-old boy. The prostate itself is a gland located below the bladder, and it only causes urinary symptoms (trouble passing urine) in certain situations.
First of all, the patient’s age matters. In young men – say, between 20 and 40 – inflammatory or infectious conditions of the prostate (prostatitis) predominate. After the age of 50, urinary problems are most often caused by enlargement of the prostate (the “famous” benign prostatic hyperplasia), which also affects the bladder.
It is important to note that there are many other causes of lower urinary tract symptoms (frequent urination with small volumes, difficulty passing urine, being unable to hold urine), such as urinary tract infections, a narrowing of the urinary channel (urethral stricture), a stone in the lower part of the ureter, or a bladder problem unrelated to the prostate – an overactive or underactive bladder. This is why a visit to a urologist is important for a correct diagnosis. Self-medication should be avoided (“I’ll take medicine X because a friend takes it and feels fine”, or various herbal supplements advertised on TV).
Also after the age of 50 (or after 45 for certain patients, such as those whose father or brother has had prostate cancer), the urologist will assess the possibility of a malignant tumour (prostate cancer) during the consultation. The earlier it is found (early detection), the greater the chances of a complete cure after treatment.
In conclusion, prostate disease can be inflammatory (infectious or not – prostatitis), which occurs mainly in younger patients. In patients over 45–50, urinary symptoms are most often caused by an enlarged prostate (benign prostatic hyperplasia), but the possibility of a malignant tumour (prostate cancer) must also be assessed – and sometimes the two conditions coexist.
