Prostate Diseases

The prostate is a walnut-sized gland that sits just below the bladder in men and wraps around the urethra. Three common conditions affect it: benign enlargement, infection or inflammation, and prostate cancer.

Benign Prostatic Hyperplasia (BPH)

Non-cancerous enlargement of the prostate — very common after 50. The enlarged gland presses on the urethra and interferes with urine flow.

• Symptoms: slow stream, straining, stop-and-start flow, not emptying fully, getting up at night to pass urine, urgency.
• Diagnosis: history, physical examination (DRE), urine test, ultrasound, PSA blood test (partly to rule out cancer).
• Treatment: lifestyle (cut evening fluids, caffeine, alcohol), medicines (alpha-blockers, 5-alpha reductase inhibitors), minimally invasive procedures or surgery (TURP, HoLEP) in severe cases.

Prostatitis

Inflammation or infection of the prostate. Can be acute (sudden, fever, painful urination, pelvic pain — usually bacterial, needs antibiotics) or chronic (longer-running pelvic discomfort, bladder symptoms; treatment varies by cause).

Prostate cancer

• Risk rises with age (usually after 50; earlier with strong family history).
• Early-stage cancer often has no symptoms — it is picked up by PSA screening or DRE.
• Later symptoms overlap with BPH; also bone pain (if spread to bone).
• Diagnosis is confirmed by biopsy, often with MRI guidance.
• Treatment depends on stage, grade and overall health — options range from active surveillance (for some low-risk cancers), to surgery (radical prostatectomy), radiotherapy, hormone therapy, chemotherapy and newer targeted treatments.

Red flags — see a Health Expert urgently

• Inability to pass urine at all — acute retention is an emergency.
• Blood in urine or semen.
• Severe pelvic or bone pain.
• Fever with urinary symptoms.
• Unexplained weight loss.

Screening — an honest discussion

Whether to screen all men for prostate cancer with PSA is a nuanced conversation globally. For Indian men, the practical guide: from age 50 (or 45 if a close relative had prostate cancer), discuss a PSA test with a Health Expert — benefits and limitations both — and decide together. Early detection of aggressive cancers saves lives; over-diagnosis of slow-growing cancers can lead to unnecessary treatment.