Prostate Disease
What is prostatitis?
Prostatitis is where the prostate gland becomes inflamed. It may be caused by bacterial infection or non bacterial inflammation. Prostatitis can affect men across all age groups especially 3rd to 5th decade.
Fissures of the prepuce (Foreskin): This usually happens in diabetic patients. Because of poorly controlled DM patients develop fissures of the foreskin and itching. They may also have difficulty in retracting the foreskin.
Infections: Bacterial and fungal- This may happen either denovo or after exposure to a source. STDs are also known to present with ulcers and discharge.
Congenital penile curvature: This is usually noted in the young men. They don’t have any associated problems except penile curvature during erection. They may not have any history of injury.
Peyronie’s disease: In this condition hard plaques around the erectile chambers there by causing bending of the penis during erection. This can be associated with sever pain.
Trauma: Accidental or deliberately done injury to the penis will be an emergency.
Penile fracture: Acute bending of the erect penis can often result in breaking of the penis which is an emergency and may need surgical treatment.
Small or micro penis: Penis length is an important aspect of genital growth. If the stretched penile length is less than 7cm then it can be considered as a small or micropenis. Surgical and non surgical treatments are available for the same.
Drooping penis: Sometimes men get good erection but feel that the penis does not angulate upwards thus making them under confident about their ability to achieve erection and sexual satisfaction.Male infertility is usually caused by problems that affect either sperm production or sperm transport. With appropriate medical testing, the doctor may be able to find the cause of the problem.
Symptoms of prostatitis :
- Pelvic pain, and pain in genitals, lower back and buttocks
- Pain when urinating
- Urgency and frequency of urination
- Delayed initiation of urine
- Pain after ejaculating
- Perineal pain (the area between the anus and scrotum), which is often made worse by prolonged sitting
How is it diagnosed?
Usually the urologist takes detailed and then does a digital rectal examination. If this is suspicious or in certain cases on clinical suspicion a blood test is done called prostate specific antigen. If this is elevated may help in the diagnosis. But this is not a fool proof test and hence must be confirmed with a biopsy of the prostate.
Treatment of prostatitis
- AAA
- Antibiotics
- Alfa blockers – help in relaxing bladder outlet
- Anti inflammatory drugs
Prostate cancer
This condition was initially thought to be rare in Indian population but is gradually increasing in incidence. More advanced tests with higher sensitivity and specificity are now available for the diagnosis.
Symptoms of prostate cancer
- Frequency (often during the night)
- Urgency
- Difficulty to initiate urination
- Straining or taking a long time while passing urine
- Weak stream
- Sense of incomplete emptying
- Hematuria
Prostate disorders
The prostate is a gland found in men situated below the bladder and surrounds the urethra (the tube that carries urine out of the body). As the man ages prostate is likely to enlarge and may cause problems like obstruction for passing urine, urinary tract infections and bleeding in the urine etc. the prostate enlargement is usually noted in the following conditionsBenign prostatic enlargement, Prostatitis and Prostate cancer.
The prostate gland also contributes in fertility by secretingcertain enzymes which gets mixed with sperm to liquefy the semen. The prostate grows larger due to an increase in the number of cells (hyperplasia). However, the precise reason for this increase is unknown. Many factors may be involved, including androgens (male hormones), estrogens, and growth factors and other pathways.
As the prostate grows larger and opening of the bladder outlet becomes more difficult, the bladder might not be able to empty easily and fully. Sometimes blockage from prostate enlargement may result in acute inability to pass urine(acute urinary retention) -- a painful medical emergency that requires urgent drainage. This type of obstruction may also cause urinary tract infections, bladder stones, bladder diverticulae (outpouchings or pockets inside the bladder), and gradually result in bladder or kidney damage.
Symptoms of prostate enlargement
- Weak stream of urine
- Difficulty to initiate urination
- Sense of incomplete emptying
- Dribbling of urine, especially after urinating
- Urgency
- Leaking of urine
- More frequent urination and a strong and sudden desire to urinate, especially at night
- Blood in the urine
- Inability to pass urine – Acute retention of urine
Prostate enlargement treatement
- Medicines
- Catheters
- Surgery – Open/ TURP / Laser TURP
For self assessment of prostate problems Prostate Symptom Score
Consultation
Joshi's Centre - Sahakara Nagar
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