Prostate basics

These days mention the word prostate to a man and he immediately looks somber. For an older man, the mere mention of his prostate brings fear. Let us talk about the prostate!

The prostate is a gland sitting at the base of the bladder. It encircles the upper portion of the urethra - the tube along which the urine flows from the bladder to outside. So, the prostate lies just below the bladder's neck.

What does the prostate do?

It contributes about a third of the secretions in the fluid released during ejaculation. It also produces fibrinogenase which causes semen to be sticky, and so prevents spillage from the vagina. The prostate also secretes an antibiotic which helps to protect the couple from infection. The prostate secretes a protein called prostate specific antigen (PSA) which liquefies semen after ejaculation, allowing the sperm to migrate within the female genital tract.

Enlarged prostate

As a man ages, the prostate enlarges due to the proliferation of prostatic cells; this is called benign prostatic hyperplasia (BPH). It causes passing urine frequently at nights, needing to pass urine urgently, and wetting one's self if urine is not passed immediately. Other symptoms include difficulty in passing urine, poor urine flow and incomplete bladder emptying. These symptoms are bothersome and require medical attention. A doctor can easily confirm the condition by doing a digital rectal examination.

Prostate cancer

This is the most common cancer among men. The cancer first appears within the cell and spreads to lymph nodes and bone. It may be detected by measuring the PSA in serum. A PSA value between four and 10 mg/ml carries a 20 per cent chance of cancer. Values above 10 carry a 60 per cent chance of cancer.

Prostatitis

Inflammation of the prostate is called prostatitis. Men who have indwelling urinary catheters, use external urinary appliances or engage in unprotected anorectal intercourse are more likely to have this kind of infection. An acute bacterial infection of the prostate will cause fever, ague, pain in his lower back and pubic area and pain on passing urine. These men require antibiotics in a hospital setting. Chronic prostatitis manifests as recurrent urinary tract infections, discomfort in the genital area, and difficulties with urination. This condition requires long-term treatment with antibiotics.

Don't fear the prostate

The life expectancy of men is more than 70 years and so most men can expect to encounter problems with their prostates. By age 40, men must screen for BPH and prostate cancer. All men above this age should do a PSA test annually. Men can avoid infections of the prostate by using a condom during sexual intercourse. There is no need to fear the prostate.

Dr Pauline Williams-Green is a family physician and president of the Caribbean College of Family Physicians; email: yourhealth@gleanerjm.com.