What is the prostate?

The prostate is a gland in the male reproductive system. It is located below the bladder and in front of the rectum.

It makes fluid that mixes with sperm to create semen. Its muscles help push semen out during ejaculation. The prostate also helps control the flow of urine and semen, and processes male hormones.

As you get older, the prostate can grow bigger or develop cancer.

What medical conditions can affect the prostate?

The prostate can develop several problems, especially as you get older, which may affect urination, sexual health and overall wellbeing.

Common prostate problems include:

• benign prostatic hypertrophy (BPH) and benign prostatic enlargement (BPE)
• prostate cancer
• prostatitis (inflammation of the prostate gland)

Benign prostatic hypertrophy and benign prostatic enlargement

Benign prostatic hypertrophy (or hyperplasia) is the natural growth of extra cells in the prostate. This is a process that happens as you get older. It doesn't directly cause symptoms, but leads to the prostate getting bigger.

Benign prostatic enlargement is the actual enlargement of the prostate caused by BPH. It can press on your bladder and urethra, leading to symptoms.

Prostate cancer

Prostate cancer is the most common cancer in adult males. In the early stages, it doesn't usually cause any symptoms. As it grows, it might lead to symptoms. Regular check-ups can help find it early and be treated more effectively.

Prostatitis

Prostatitis is when your prostate gland becomes inflamed. There are 4 main types:

• acute bacterial prostatitis — a sudden infection in the prostate, often caused by bacteria
• chronic bacterial prostatitis — recurring infections in the prostate, also caused by bacteria and often linked to repeated urinary tract infections (UTIs)
• chronic prostatitis or chronic pelvic pain syndrome — long-term pain in the prostate and urinary area, but not caused by infection
• asymptomatic inflammatory prostatitis — inflammation with no symptoms, often found during tests for other conditions

What are the symptoms of prostate problems?

Trouble passing urine (weeing) is common in older people. It's also one of the most common signs that there may be a problem with your prostate.

Benign prostatic hypertrophy and benign prostatic enlargement

Symptoms may include:

• difficulty starting to wee
• a weak urine stream
• needing to wee frequently or urgently
• incomplete urination (needing to wee even right after weeing)
• wake at night to wee

Prostate cancer

Prostate cancer often grows slowly, with few or no early symptoms. Advanced prostate cancer may lead to:

• urinary issues, such as difficulty weeing
• pain in your back and hips
• blood in your urine
• erectile dysfunction

Prostatitis

Symptoms may include:

• fever
• pain or burning when weeing or ejaculating
• trouble urinating
• pain in your scrotum, penis, testicles, rectum or pelvis
• blood in your urine can sometimes happen

Some people have no symptoms.

What causes prostate problems?

Prostate problems can happen due to several conditions that may affect your prostate gland. Factors that may contribute to these conditions include:

• hormonal changes
• getting older
• infections
• genetic factors

Benign prostatic hypertrophy and benign prostatic enlargement

Hormonal changes and an imbalance between testosterone and oestrogen may contribute to its development.

Prostate cancer

Prostate cancer is often influenced by older age, genetics and hormonal factors.

Prostatitis

Prostatitis can develop when bacteria enter your prostate through the urinary tract, bloodstream or nearby areas. Some types are not caused by infection. The reasons for inflammation are not always understood.

When should I see my doctor?

You should see your doctor if you:

• have symptoms, such as frequent weeing, blood in your urine or persistent discomfort
• are unable to wee or notice significant changes or difficulties when weeing
• have pain in your back, shoulders, groin, belly or genitals
• have a fever, chills or a burning sensation when weeing

Also see your doctor if you have any other symptoms that concern you.

How are prostate problems diagnosed?

Your doctor may ask questions about your symptoms and how they affect your life. They may also ask you about your family health history of prostate problems.

Tests used to diagnose prostate problems include:

• urine tests
• blood tests such as a prostate-specific antigen (PSA) blood test
• physical examination of your prostate — your doctor can examine your prostate by gently inserting a gloved finger into your rectum
• imaging tests including ultrasound or an MRI scan
• prostate biopsy
• uroflowmetry — to test the speed and volume of your urine flow
• cystoscopy — use a thin, flexible camera (endoscope) inserted into the urethra to check for blockages or other structural issues

How are prostate problems treated?

Treatment depends on the condition and the severity of your symptoms. It may include lifestyle changes, medicines or medical procedures. Sometimes, no treatment is required.

Benign prostatic hypertrophy and benign prostatic enlargement

If you have an enlarged prostate that is causing you problems, treatment may include:

• lifestyle changes — such as limiting caffeine and alcohol and following a regular urination schedule
• medicines — to relax your muscles or shrink your prostate
• surgery — prostate surgery may be needed in severe cases

Prostate cancer

If you are diagnosed with prostate cancer, further tests will help your doctor decide on treatment. If the cancer is slow-growing, regular check-ups may be enough to monitor it. Treatments may include:

• surgery
• chemotherapy
• radiotherapy
• hormone therapy

Prostatitis

If you have prostatitis, antibiotics and anti-inflammatory medicines may help. A warm bath can also help relieve symptoms.

Living with prostate problems

If you have prostate problems, small lifestyle changes can help relieve your symptoms. Here are some tips to try:

• Manage fluid intake — drink less before bed or going out to lower nighttime or frequent urination.
• Prevent constipation — eat high-fibre foods to keep your bowel movements regular.
• Practice double voiding — after urinating, wait a moment, relax and try again to fully empty your bladder.
• Set a schedule — urinate regularly during the day, such as every 90 to 120 minutes.
• Strengthen your pelvic floor muscles — with exercises such as squeezing the muscles you use to stop urine flow.

Talk to your doctor about other ways to improve your quality of life while managing prostate issues.

What are the complications of prostate problems?

Prostate problems can lead to difficulties, such as urinary retention, where it's hard or impossible to urinate. It may also lead to recurrent urinary tract infections (UTIs) due to incomplete bladder emptying. Sexual or erectile problems can also occur.

In severe cases, prostate problems may lead to complications such as:

• kidney damage
• kidney stones
• long-term urinary problems

Prostate cancer can spread to other parts of the body. If you have any symptoms of prostate problems, see your doctor.

Can prostate problems be prevented?

While you can't fully prevent prostate problems, certain lifestyle changes may help lower your risk:

• Keep active.
• Maintain a healthy weight.
• Eat a balanced diet rich in fruits and vegetables.
• Limit alcohol and caffeine.

Regular check-ups with your doctor can also help catch any problems early.

Resources and support

Cancer Council provides a booklet for people with prostate cancer, their families and friends.

Healthy Male offers information about topics related to prostate problems, such as:

• when your partner has chronic prostatitis or chronic pelvic pain syndrome
• the difference between prostate enlargement, prostatitis and prostate cancer
• lower urinary tract symptoms, symptoms related to problems with your bladder, prostate and urethra

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Other languages

Multicultural Health Communication Service offers translated information about prostate and bladder problems.

Looking for information for Aboriginal and/or Torres Strait Islander people?

HealthInfoNet offers information about topics related to prostate problems for Aboriginal and/or Torres Strait Islander people:

• Know about your prostate — prevention and living well
• Men's business — prostate problems
• Men's health — prostate cancer