DIAGNOSING PROSTATITIS

DIAGNOSING PROSTATITIS

DIAGNOSING PROSTATITIS

Diagnosis is usually made during a DRE (digital rectal exam), where the physician
inserts a lubricated, gloved finger into the rectum to feel the prostate, or by
examining fluid from the prostate under a microscope. Some doctors use a symptom
index questionnaire developed by the National Institutes of Health. Still,
diagnosing prostatitis isn’t easy, so the most important diagnostic tool your
doctor has is you and your detailed descriptions of your symptoms.
Prostatitis is not considered a serious disease, and it doesn’t lead to cancer. But
i t ’s painful, extremely inconvenient, and sometimes difficult to cure. There are a
number of treatment options that usually provide relief. These include antibiotics,
anti-inflammatories, and surgery.

BPH (BENIGN PROSTATIC HYPERPLASIA)

BPH, sometimes called “prostate enlargement,” is one of the most common conditions
among aging men. BPH is caused when an age-related gradual enlargement
of the prostate gland squeezes the urethra. Half of men between the ages
of 50 and 60 will develop it, and by the age of 70 or 80, about 90 percent will
have experienced BPH symptoms, which may include:
• Frequent, often-urgent need to urinate, especially at night
• Need to strain or push to get the urine flowing
• Inability to completely empty the bladder
• Dribbling or leaking after urination
• Weak urine stream
Because male urinary symptoms can
also be caused by more serious conditions,
such as prostate cancer, it’s
important to see your doctor to determine
the cause of your symptoms.
BPH symptoms vary with the individual.
Since the prostate gland continues
to grow in most older men, their symptoms
may get worse with time. BPH doesn’t usually interfere with sexual function,
although it can. There is no connection between BPH and cancer.
H o w e v e r, if left untreated, the condition can cause bladder infections and kidney
stones, and in some cases, permanent bladder and/or kidney damage.
There are three factors that increase your risk of developing BPH:
• Age: Starting at age 45, the risk of developing BPH increases.
• Family history: If any immediate blood relative had BPH, you are more
likely to develop the condition.
• Some research indicates that medical conditions such as obesity may
contribute to the development of BPH.
F o r t u n a t e l y, the risk of developing uncomfortable BPH symptoms can almost be
completely eliminated by diagnosing the condition early. To do that, your doctor
may order tests to measure how quickly urine flows from the bladder, and he
may do ultrasound or x-ray examinations of the bladder, kidneys, urethra and
prostate. He will probably also order a PSA (prostate specific antigen) test. This
blood test is often used to diagnose and monitor BPH and to help rule out
prostate cancer. (For more information on the PSA test, see the prostate cancer
s e c t i o n . )
TREATING BPH
If you are diagnosed with BPH, your doctor has a number of options to choose
from.

Watchful Wa i t i n g

Watchful waiting means keeping an eye on the BPH symptoms without receiving
any form of treatment. For men with minimal to mild BPH symptoms that
do not interfere with daily routines, this may be a preferred choice. As part of
watchful waiting, men continue to have annual examinations to determine
whether their symptoms change over time.

M e d i c a t i o n s

Drugs called alpha-blockers are the most common
treatment prescribed to manage BPH
symptoms. By relaxing the muscles around
the prostate so that there is less pressure on the
urethra, alpha-blockers usually work quickly to
improve urinary flow. Common side effects
can include stomach or intestinal problems, a
stuffy nose, headache, dizziness, tiredness, a
drop in blood pressure and ejaculatory problems.
Alpha-blockers include Cardura® ( d o x azosin
mesylate), Flomax® (tamsulosin hydrochloride), Hytrin® ( t e r a z o s i n
hydrochloride) and Uroxatral
® (alfuzosin hydrochloride). *
Another type of drug, known as a 5-alpha-reductase inhibitor, is also sometimes
prescribed. Designed to shrink the prostate gland, it may take three to six months
to effectively relieve symptoms. Side effects may include an inability to achieve an
erection, decreased sexual desire and a reduced amount of semen. Examples of
5-alpha reductase inhibitors are Av o d a r t™ (dutasteride) and Proscar
® (finasteride). **
No matter what kind of drug is prescribed, patients and physicians need to be
aware of potential drug interactions with treatments used to manage other conditions
common among aging men, such as erectile dysfunction and hypertension.

S u rgical Tre a t m e n t s

S u r g e ry is typically used only in those patients with major BPH complications
such as frequent urinary tract infections or bladder stones. There are several
non-surgical approaches that use heat therapy to reduce the size of the prostate,
thereby widening the urethra through which urine flows. These heat treatments
include microwave therapy, radiofrequency therapy, electrovaporization and
laser therapy. In the most extreme cases, open surgery may be required.
S u r g e ry treats BPH symptoms by reducing the size of the prostate, but it does
not prevent the cause of the disorder; surgery might need to be repeated within
a few years. Side effects of surgery may include urgency and frequency of urination
for some period after surgery, difficulty in achieving an erection, blood
in your urine, inability to hold your urine (incontinence) or a narrowing of the
urethra (scarring).