The way your prostate gland works and grows is dependent on the male sex hormone, testosterone. Your prostate gland plays an important role in reproduction. Its main job is to produce the fluid part of semen which nourishes the sperm. It also produces a protein called prostate specific antigen (PSA), that’s involved in turning your semen into liquid.
Because your prostate surrounds your urethra, if you have a problem with your prostate it’s likely to affect the way you pass urine. You may hear doctors refer to these problems as ‘lower urinary tract symptoms (LUTS)’ or ‘bladder outflow obstruction’.
Symptoms of bladder problems vary, but you may:
- find it difficult to pass urine, for example straining or taking a long time
- notice a weak flow of urine
- feel that your bladder has not emptied fully
- keep dribbling urine after you’ve finished
- have a sudden urge or frequent need to pass urine
- have to keep getting up at night to pass urine
In men, the most common cause of these symptoms is an enlarged prostate, which can obstruct the flow of urine. Other causes of prostate problems include prostatitis and prostate cancer.
If you have these symptoms and you’re concerned about them, discuss them with your GP.
See below for information about some of the most common problems that can affect your prostate.
An enlarged prostate, also known as benign prostatic hyperplasia (BPH) is caused by an increase in the number of cells in your prostate gland. ‘Benign’ means non-cancerous. So having an enlarged prostate doesn’t mean you’ve got prostate cancer, nor does it mean you’re at greater risk of getting it.
An enlarged prostate doesn’t always cause symptoms. But see our symptoms section above for more information about the kind of problems you may have.
For some men, an enlarged prostate may only cause mild symptoms and won't affect your quality of life. However, some men may need to take medicines to help control their symptoms. If your symptoms are very severe, don’t get better with medication or there are complications from prostate enlargement your doctor may recommend an operation. The most common operation is called a transurethral resection of the prostate (TURP). This will remove the inner core of your prostate gland.
Prostatitis is a general term to explain an inflammation of your prostate gland, which may be caused by a bacterial infection. There are different types of prostatitis that can cause a variety of different symptoms, including:
- pain and discomfort in the area between the scrotum and back passage. It may also be in your lower abdomen or your back
- an urgent or frequent need to pass urine, discomfort on passing urine
- a fever that has suddenly developed, perhaps with aching muscles and/or joints
- pain on ejaculation
If you have these symptoms, discuss them with your GP.
Prostatitis can be treated in different ways depending on the type you have. Your doctor may offer you some antibiotics to help clear up any bacterial infection that might be causing your prostatitis. If these don’t help, they may offer you other medicines, such as alpha-blockers, to help relax the muscle fibres around your prostate gland. For some men the symptoms of prostatitis can last for months and be difficult to treat. If so, your GP may refer you to a urologist, a doctor who specialises in treating conditions affecting the urinary system.
Prostate cancer is the most common type of cancer in men in the UK. It is often slow growing so may not cause problems for many years, if ever. However, in some people it grows quickly and may spread to other parts of your body.
Prostate cancer mainly affects men over 65, although one in four men who get it will be under that age. You’re more likely to get it if your father or brother has had it, or if you’re black African-Caribbean. Symptoms may include difficulties with urinating – see our symptoms section above. If the cancer spreads you may get other symptoms such as lower back pain and blood in your urine. Some prostate cancers grow slowly, and might not need treatment. Others grow more quickly, and may need treatment. Your treatments will depend on whether your cancer has spread, the risk of side-effects and your own personal views. Treatment may include close monitoring, hormonal therapy, surgery, radiotherapy or chemotherapy.
You can find out much more about this condition and how it’s treated from our page on prostate cancer.
If you have any symptoms of prostate problems, you should contact your GP – no matter how old you are. Your GP will ask you about your symptoms. To find out more about how these affect your life your GP might ask you to score them using a specially designed assessment form.
Your GP will examine you. This usually involves a rectal examination to check the size and feel of your prostate. See our FAQ below for more information about this test.
Your GP may also ask you for a urine sample. They may do some tests on your urine in the surgery. They may also send a sample to the laboratory for further testing to see if you have an infection.
You may be asked to take away a ‘frequency and volume’ chart to fill in at home. Over at least three days you record how much you drink, how much urine you pass and how often. You also record whether you have leaking after urinating. You then bring this back to show your GP. It will help them to understand the problems you’re having.
Your GP may suggest that you have a PSA (prostate specific antigen) test. This is a blood test that looks at the level of PSA in your blood. It’s often used to help detect cancer in men who have problems passing urine. Although it’s normal to have small amounts of PSA in your blood, you may have a problem with your prostate if your levels are raised. Having a raised PSA might be a sign of prostate cancer, but this is not always the case. And you can have prostate cancer without having a raised PSA. If you’ve been offered this test, it’s important to talk to your doctor about the pros and cons. They’ll be able to help you make a decision that’s right for you. For more information see our page on PSA testing for prostate cancer.
There is always research going on to look into how prostate problems, like prostate cancer, can be prevented. Most of the factors that increase your risk of getting prostate cancer are things you can’t change. These include your age, your family history and your ethnicity.
However, you can make changes to your lifestyle, and these might be important. It seems that men who are overweight or obese have a greater chance of getting faster growing prostate cancer. And there’s some evidence that being physically active lowers your risk.
It had been thought that eating some specific foods reduces your risk of getting prostate cancer. But experts now think this is less likely.
So think about losing any excess weight, eating a healthy diet and taking regular exercise. Don’t put off seeing your GP if you’re worried about possible problems with your prostate. Getting it checked out can help give you peace of mind. And if any treatments are recommended, your GP will be able to help you make a decision that’s right for you.
If you have symptoms that might be linked to prostate problems your GP will probably recommend that you have a rectal examination. This means they will feel your prostate through the wall of your rectum (back passage) with their finger.
The test is also known as a digital rectal examination or sometimes a ‘prostate exam’. Although it may feel a little strange and uncomfortable, it doesn’t hurt and only takes a minute or two.
Your doctor will make sure that the examination is done privately. Your couch may be behind a curtain or they may lock the door so that no one can enter the room unexpectedly. You can ask for someone to be with you during the examination if you wish.
You’ll be asked to remove your lower clothing and lie on your left side on the couch, with your knees drawn up.
Your GP will put a glove on one hand and lubricate their fingers with a gel. They will gently and slowly slide one finger into your back passage until they can feel your prostate gland. You may feel their finger moving around. They will check whether the prostate is enlarged, and whether it has any hard or lumpy areas. Normally the prostate feels smooth.
Your GP will then remove their finger and let you know that they’ve finished. If you need some tissue to wipe away any excess gel, your GP will give you some. You can then get dressed again and your GP will discuss with you what they found.
It’s important not to put off seeing your GP about your prostate symptoms because you’re worried about having a rectal examination. There’s no need to feel embarrassed – it’s an important medical test that your GP has done many times before. And it’s a really quick and easy test to help your GP diagnose problems with your prostate.
- Prostate Cancer UK
0800 074 8383
- Prostate symptoms (bladder outlet obstruction). British Association of Urological Surgeons. www.baus.org.uk, accessed 13 December 2016
- LUTS in men. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised February 2015
- Benign prostatic hypertrophy. Medscape emedicine.medscape.com, updated 6 November 2016
- Lower urinary tract symptoms in men. PatientPlus. patient.info/patientplus, last checked 21 September 2015
- Benign prostatic hyperplasia. PatientPlus. patient.info/patientplus, last checked 12 October 2015
- Prostatitis. PatientPlus. patient.info/patientplus, last checked 29 June 2015
- Prostate cancer. PatientPlus. patient.info/patientplus, last checked 11 February 2014
- Prostate specific antigen (PSA). PatientPlus. patient.info/patientplus, last checked 23 September 2016
- Prostatitis – acute. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised August 2014
- The prostate gland. Macmillan Cancer Support. www.macmillan.org.uk, reviewed 28 February 2015
- Buckley B, Lapitan M and Simpson C. Risk of prostate cancer associated with benign prostate disease: a primary care case – control study. Br J Gen Pract 2011; 61(592):e684–e691. doi:10.3399/bjgp11X606573
- Prostate cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 30 May 2015
- Lui Y, Hu F, Li D et al. Does physical activity reduce the risk of prostate cancer? A systematic review and meta-analysis. Eur Urol 2011; 60(5):1029-44. doi:10.1016/j.eururo.2011.07.007
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- Rectal examination. PatientPlus. patient.info/patientplus, last checked 24 November 2011
- Prostate Cancer UK
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Reviewed by Dr Kristina Routh, Freelance Health Editor, Bupa Health Content Team, December 2016
Expert reviewer, Dr Adrian Raby, General Practitioner and Clinical Lecturer
Next review due January 2020
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