The prostate gland is found just below the bladder in men, and is closely associated with sexual function since it has an involvement with semen. The prostate surrounds the urethra (the tube through which both semen and urine pass to leave the body) and it is this which can cause a number of problems in later years and can have an indirect effect on sexual activity. Only a few things go wrong with the prostate, but those which do are very common.
Most prostate problems are not noticed until they interfere with the passing of urine, or blood is noted in the urine or semen. This is because the gland swells for a number of reasons and tends to block the urethra. In order to uncover any unusual changes, and possibly catch and treat such conditions earlier on, regular examinations are important. This is especially so if there is a family history of prostate illnesses as it is thought to be hereditary. If this is the case your GP may recommend you attend examinations on an annual basis, starting from as early as age 40. These checks can involve rectal examination of the prostate and blood tests.
Since the causes of most problems with the prostate cannot be identified exactly, it is recommended that leading a healthy lifestyle; eating a healthy diet, not smoking, and taking some regular exercise all help avoid these problems.
Prostate Enlargement
Prostate enlargement is a very common condition in older men. In fact as many as half of men over 60 are affected to some extent, and about 80% of those over 80 are affected. It is believed to be caused by the effect of male hormones and the ageing process, and may be an inherited condition.
The main symptom is usually difficulties with urinating, but it can be associated with urinary tract infections (UTIs), and kidney damage if left untreated.
Mild cases should be monitored for change but treatment may be unnecessary unless quality of life is deteriorating. Where medical procedures do not help ease the problems being encountered then surgery to remove all or part of the prostate might be carried out.
Prostate Cancer
Prostate cancer is the growth of the prostate caused by a tumour. It is rare in men aged under 40 but becomes more common as age increases. It is estimated that as much as 60% of all men over 80 have some cancer in their prostate.
The reason why prostate cancer is not so fatal is that it mostly occurs in the oldest men, whose lives tend to be ended by other illnesses, and not by their prostate cancer.
As with other prostate illness, the main symptoms of difficulty urinating, or blood in the urine or semen, tend to appear once the condition has been established. There are seldom any early warning signs which is why regular examinations should be taken. It is only by a detailed examination that cancer can be diagnosed.
There are three main options for dealing with prostate cancer which has not spread from the prostate.
Radiation therapy is estimated to be as effective as surgery for up to 10 years, but there are many unpleasant and sometimes painful side effects. It also results in erectile dysfunction in 60% of men, which may or may not be treatable. (See the sexual problems section of the website for more information.
Surgery provides the best chance for a long term cure and involves the removal of the entire gland and an examination for further spread of the cancer. Erectile dysfunction is common following such surgery and many men opt to have a prosthesis implanted into the penis at the time of the operation to deal with this. (See the sexual problems section of the website for more information.)
When the disease has been found to have spread to other locations in the body treatment is more complex and may involve a combination of interventions, each of which will have its own impact upon sexual activity.
Prostatitis
Prostatitis is a common condition which is inflammation of the prostate gland caused by bacterial infection, possibly from a urinary tract infection.
Apart from the usual prostate related symptoms described previously, prostatitis may be accompanied by rectal, penile, testicle, and low back pain. A fever or chills may also occur.
Acute (short-term) prostatitis may respond to antibiotics and other medications, but if not and the condition becomes chronic (long-term) then the prostate may eventually need to be removed surgically (prostatectomy). This may result in some erectile dysfunction that may be treatable. See the section on sexual problems for more information on erectile dysfunction.
