Prostate Diseases

Introduction

Male patients may suffer from lower urinary tract symptoms atributed to the prostate gland. Symptoms can include difficulty urinating, incomplete bladder emptying, and urinary frequency. A urologist will often be asked to evaluate men with these symtoms.

Patient Evaluation

Urologic evaluation will include a complete history and physical examination. The prostate will be checked for enlargement and nodularity, and a serum prostate specific antigen (PSA) level will often be measured. The serum PSA is a component of prostate cancer screening. In benign prostate enlargement, the serum PSA blood test may help the urologist estimate prostate size.

Prostate Cancer Screening

If the prostate examination reveals a nodule, or if the serum prostate specific antigen (PSA) level is abnormally elevated, the patient will be advised of the potential benefit of prostate biopsy to rule out the presence of a prostate cancer. In those men with prostaate cancer, early detection will allow for local definitive therapy with curative intent. Therapuetic options include radical prostatectomy, robotic radical prostatectomy, prostate brachytherapy (seed therapy) and external beam radiation therapy. No one therapy is right for all men. The most appropriate treatment will depend upon cancer grade and stage, serum PSA level, and the patient's cancer treatment goals.

Benign Prostatic Hyperplasia (BPH)

When a benign prostate enlargement is found to be the cause of symptoms, the patient will be told that he has benign prostatic hyperplasia, or BPH. The degree of symptoms and bother will be quantified utilizing the American Urologic Association Symptom Index, and objective measurement of urinary flow rate and bladder emptying obtained electronically. This information will help guide a patient in deciding between watchful waiting and other treatment options. The patient with mild urinary symptoms of BPH may decide to monitor his symptoms and follow up periodically for a urologic examination. For more significant urinary symptoms, a full discussion of available therapies is indicated. Treatment options for men with symptoms of BPH include several oral medications, minimally invasive procedures, and traditional prostate surgery.