PREVENTING P r o s t a t e P r o b l e m s Dr Charles Chabert, Urologist So what is the prostate? Or is it prostrate … A recent report on Twitter suggested that most men are unaware of what or where the prostate is, let alone what the correct spelling is! To set the record straight, it is prostate NOT prostrate! In brief, the prostate is a small gland located deep in the pelvis and is part of the male reproductive system. It is the shape of a doughnut with the outlet pipe of the bladder (the urethra) passing through the middle. There are three main conditions affecting the prostate: prostatitis, benign enlargement or BPH (benign prostatic hyperplasia) and the development of an abnormal growth or prostate cancer. Prostatitis takes on different forms from acute bacterial to a non-infective and longerlasting condition, which can be associated with symptoms or occasionally identified on a prostate MRI. It is more commonly found in younger men and at times can run a protracted course requiring treatment with anti inflammatories or antibiotics. Prostatic enlargement or BPH affects all men to a greater or lesser extent as they increase in age. Many men that I see are concerned about the potential for a cancer diagnosis when they notice a change in urination patterns. These changes can include a weaker stream, increased hesitancy, a feeling of incomplete bladder emptying or that they have a desire to urinate more frequently and urgently in the day. They may also notice the need to get up more times at night to urinate. These symptoms are mostly associated with benign prostatic enlargement, not cancer. After a comprehensive check this can be confirmed in most cases and reassurance given. If symptoms are more bothersome there are several treatment options, which can be tailored to the individual needs of a patient. These include different medications, or for more significant improvements, minimally invasive treatments such as UroLift or laser surgery. There are around 22,000 new diagnoses of prostate cancer annually in Australia with approximately 3,300 deaths per year. Prostate cancer is more common with increasing age, a strong family history of the disease, the western diet and in African American populations. Recommendations from the Urological Society of Australia and New Zealand are that screening should be offered to men of average risk between the age of 50 to 69 years after a discussion regarding the pros and cons of screening. Screening involves a simple blood test, the PSA, which should be offered every two years starting at 50. For those who are at a higher risk of the disease, testing can be started earlier from 40 years. If the initial result is at or below the median (0.6ng/ml) testing can be deferred for five years. If above the median it should be assessed annually. Having a digital prostate examination from your family doctor is not recommended. This can be done later by a urologist if needed. If you or a family member have concerns about urination difficulties or wish to discuss testing for prostate cancer, contact your local doctor or review www.prostates.com.au for more information. MEN'S HEALTH 36 Pindara Magazine 2016
Pindara Private Hospital Magazine - Issue Seven
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