The information you will read here about prostate diseases has been updated with the latest updates made in 2022 by the American Urological Association (AUA) and the European Association of Urology (EAU) on the diagnosis of all urological diseases and prostate treatment.

With the development of medicine today, the awareness of people, and the significant advancements in antibiotics, we rarely encounter acute infections of the prostate.

In our current urological practice, we deal with three main prostate diseases:

1. CHRONIC PROSTATITIS

2. BENIGN PROSTATIC HYPERPLASIA

3. PROSTATE CANCER

In this section, I will provide you with clear but detailed information about these three diseases.

  1. Chronic Prostatitis

– Also referred to as chronic pelvic pain.

– It is the male counterpart of the disease known as painful bladder syndrome in women.

– It is not a life-threatening disease but significantly reduces the quality of life.

– Many patients experience accompanying depression, anxiety, hopelessness, and mood disorders.

– The disease typically starts with “burning and discomfort” in the groin, lower abdomen, testicles, and the area known as the perineum. “Burning” is the best description of the disease.

– Many patients with chronic prostatitis have other complaints unrelated to urology, primarily constipation and bowel problems.

– Symptoms such as decreased erection quality, constant cold sensation in the penis, and premature ejaculation often accompany the burning sensation in chronic prostatitis patients.

In addition, patients with chronic prostatitis often have significant lower urinary tract symptoms:

– Frequent urination

– Weak urine flow

– Waking up at night to urinate

– Small amounts of urine each time, with burning sensation

– Increased pain and discomfort as the bladder fills, with some relief after urination

Diagnosis

– Multiparametric prostate MRI is used to diagnose inflammation within the prostate.

– Prostate examination performed by an experienced surgeon.

Treatment

– Chronic prostatitis is not an infectious disease, but some antibiotics (not all) can benefit patients when used for six weeks.

– Medications used for benign prostatic hyperplasia can provide some relief by slightly enhancing urine flow for a short period.

– Some herbal pills can be beneficial when used for 12 weeks.

– Periodic massages performed by an experienced urologist can help patients.

2. Benign Prostatic Hyperplasia (BPH)

The prostate is an organ like our eyes and ears; it is not a disease. Every male child is born with a prostate. However, in colloquial language, we often hear questions like “Do I have prostate?” or “I have become a prostate.” In everyday language, these expressions refer to the enlargement of the prostate.

The condition that makes people ill is the enlargement of the prostate with age. The prostate begins to enlarge due to hormonal changes after the age of 40. This enlargement is not cancer; it is benign and is known in urology as “BPH” or benign prostatic hyperplasia.

How Does Prostate Enlargement Cause Illness?

As shown below, in men, urine is expelled from the bladder through the urethra, which passes through the prostate. As the tissues around the urinary canal grow, they compress the urethra passing through the prostate, making it difficult for urine to be expelled. Sometimes the enlargement can block the bladder outlet, similarly hindering the expulsion of urine.

Symptoms of This Obstruction

– Decreased strength of urine flow, with urine falling closer than before

– Burning sensation when starting to urinate

– Difficulty starting urination

– Intermittent urination (urinating in stops and starts)

– Prolonged time in the restroom (taking a long time to empty the bladder)

– Feeling of incomplete emptying after urination

– Frequent urination at night

– Frequent urination during the day

– Sudden urge to urinate, sometimes leading to incontinence

Patients come to us with one or more of these symptoms.

3. Prostate Cancer

In this section, you will read about the diagnosis, follow-up, and treatment of prostate cancer based on the latest scientific guidelines and information from the EAU (European Association of Urology) and AUA (American Urological Association) as of 2022.

Urology specialists around the world base their diagnoses and treatments on the guideline information obtained from the research conducted on tens of thousands of patients by these associations. This information is periodically updated, and we follow these updates to apply advancements in diagnosis and treatment.

– It typically occurs after the age of 50.

– The incidence is higher in developed countries, occurring in 1 out of 8 men.

– Known causes: obesity, vitamin D deficiency, genetics (the incidence increases 2.5 times if present in family members).

Is There a Relationship Between Prostate Size and Urination Complaints?

This is a very common and logical question. Is there a connection between prostate size and urination complaints? Generally, I can say there is a connection between the way the prostate grows and urination difficulties. The prostate can grow towards both sides of the bladder neck. As people age, everyone’s prostate will inevitably grow. If it grows to both sides, it does not cause much urination trouble. But a patient can live their entire life with a small prostate of 150 grams without needing surgery. However, if part of that prostate or a 30, 35, 40-gram prostate grows towards the bladder neck and blocks the bladder outlet, that will definitely require surgery.