Prostate Diseases

Prostate diseases are common, especially in men over the age of 50.

Prostate problems can range from simple inflammation to cancer. As you get older, your prostate gets larger, and problems are more likely to develop.

The three most common types of prostate disease are:

• Benign Prostate Enlargement
• Prostate inflammation (prostatitis)
Prostate cancer 

Although these diseases have different causes, they have similar symptoms. For this reason, it is important that you do not skip prostate cancer screening as part of your annual physical examination and that you see your doctor if you have any of the symptoms listed below.


Prostate Symptoms

Symptoms vary according to the shape of the problem in the prostate gland, but because it is an organ that surrounds the urinary canal, the symptoms usually show themselves with changes in urination habits.

Frequent urination, inability to urinate as easily as before, slowing of the forward flow of urine, feeling that there is still urine after urination, blood in the urine that cannot be described, pain in the genital area, and a decreased amount of semen come to mind as some of the symptoms of prostate diseases.

Prostate enlargement is not always a problem. Although there is a perception that the larger the prostate, the more diseases it causes, this is not true. However, his complaints about prostate size are not directly proportional.

Prostate Enlargement Symptoms

The severity of symptoms varies in people with enlarged prostates. Common signs and symptoms of prostate enlargement include:

  • Frequent or urgent need to urinate
  • Increased frequency of urination at night
  • Difficulty starting to urinate
  • Weak urine stream or a stream that stops and starts
  • Inability to completely empty the bladder

Less common signs and symptoms include:

  • Urinary tract infection
  • Inability to urinate
  • Blood in the urine

The size of your prostate does not always determine the severity of your symptoms. Some men with a small prostate size may have significant symptoms, while other men with a very enlarged prostate may have only minor symptoms.

Why does the prostate grow?

In men, the prostate enlarges in early puberty and can double in size. After the age of 25, the prostate enlarges in all men in different ways. The causes of prostate enlargement are still not fully known today, and it is thought that testosterone and estrogen play a serious role in this growth. The prostate gland begins to grow in men in their 30s and lasts until the end of life. While prostate enlargement is seen in half of men over the age of 50, this rate increases to 65% after the age of 60. At the age of 80, the growth rate exceeds 90%. A significant portion of these patients are followed up with medication or surgery.


How is prostate enlargement diagnosed?

The urologist will determine whether the prostate is enlarged or not through a manual and ultrasound examination. But more important than how many grams or milliliters the prostate is is how much it blocks the urinary tract and whether this growth is benign or malignant. A urine flow measurement (uroflowmetry) test is performed to understand whether the urinary tract is blocked. Manual prostate examination and a blood test called PSA are helpful in distinguishing benign prostate enlargement from prostate cancer.

How is prostate enlargement treated?

After it is understood that the person's urinary complaints are due to benign prostate enlargement, if the symptoms are at a level that requires treatment, first of all, various drugs are used to loosen and sometimes reduce the prostate. In this way, the urinary canal relaxes, making it possible for the patient to urinate comfortably.

The treatment not only allows the patient to urinate comfortably, but also relieves the bladder, which has begun to strain due to the obstruction in the prostate. Thus, permanent damage to the bladder and subsequent kidneys is prevented.

In some patients, prostate enlargement may continue, and symptoms may worsen despite drug therapy. In this case, the patient should be operated on to remove the obstruction caused by the prostate. In this surgery, it is aimed at cleaning the part of the prostate that enlarges and presses on the urinary canal and opening the urinary tract. This surgery is mostly performed as an endoscopic (closed) method.

This surgery for benign prostate enlargement should not be confused with a radical prostatectomy for prostate cancer. In surgeries performed for benign enlargement, only the part of the prostate obstructing the urinary tract is cleaned, while in prostate cancer, it is aimed to remove all tissues of the prostate organ from the body.

Does standing to urinate affect the prostate?

This question is frequently asked because it is thought that standing urination causes prostate enlargement. However, enlargement of the prostate is a process completely independent of standing or sitting.

We cannot say that standing urination enlarges the prostate, but in people who have started to have urinary complaints due to prostate enlargement, standing or sitting urination may affect that person's full and effective bladder emptying. For most people, sitting down to pee can allow for better bladder emptying, with the bladder being compressed by pressure and the more prominent contribution of the abdominal muscles. As a result, standing or sitting to pee does not affect the course of prostate enlargement, but it can positively or negatively change urinary complaints due to prostate enlargement.


Prostate and Sexuality

The effect of prostate diseases on sexual functions is one of the most frequently asked, curious, and complained-about problems. Changes in the habit of urination, the inability to urinate comfortably, and staying inside affect their social life and comfort, as well as their sexual functions.

Significant relief can be achieved with drug treatment for prostate diseases. These treatments are not treatments that completely remove the prostate. The aim is to urinate more easily and eliminate urinary complaints. Since the prostate is still in place and continues to grow, drug therapy may become insufficient to eliminate the complaints in the future. After this stage, surgery will be required.


Can a patient with prostate surgery have a child naturally?

In men who have undergone surgery due to prostate enlargement, there is a decrease in the amount of semen as some of the semen will escape into the bladder during ejaculation. The probability of the patient having children in a normal way is reduced. However, even if the patient cannot have children in the normal way, this problem can be eliminated with an easy technique such as vaccination. In surgeries for prostate cancer, since the semen ducts and the glands that make up the semen are removed, the patient can have a child only with the in vitro fertilization method.