What You Need to Know About Prostate Health

While most men approaching 50 are told they need to get their prostate checked, many don’t know what the prostate is or what can happen with it. Below are some facts that will help you better understand what the prostate is and the types of problems that can occur. I offer regular screenings in my concierge service at no extra charge, so call me to schedule an appointment, especially if you are in your late 40’s or early 50’s.

What exactly is the prostate? It’s the small male reproductive gland that sits below the bladder and in front of the rectum. It surrounds a part of the urethra – the tube that carries urine out of the bladder. The prostate helps to make semen, and then carries the sperm out from the testicles upon ejaculation.

In most men over the age of 40, the prostate gland starts to enlarge. It starts off as about the size of a walnut, and after 40 it may increase to the size of an apricot. By the age of 60, the prostate can increase to the size of a lemon. An enlarged prostrate can cause a number of problems with urination because it pushes on the urethra. Generally, this happens more in men over 50, but it can certainly happen sooner.

A more common medical term for an enlarged prostate is BPH, or benign prostate hypertrophy. Age and family history play a role in its development and unfortunately it cannot be prevented. About 8 out of 10 men will have BPH, with 90% getting it after age 85. Only 30%, however, find the symptoms of BPH bothersome.

Symptoms include:

  • Trouble with starting urination or unable to urinate freely
  • Increased urinary frequency, especially at night
  • Feeling like the bladder isn’t empty after urinating
  • Increased urinary urgency
  • Frequent starting and stopping during urination
  • Straining to urinate

Typical treatments include:

  • Watchful waiting, done for men who don’t have bothersome symptoms
  • Lifestyle changes, such as decreased fluid intake, especially at night
  • Drug therapy with alpha-blockers and 5 alpha-reductase inhibitors, which help shrink the prostate, but carry an increased risk of cancer
  • Surgery to remove the prostate.

Prostatitis is a common condition that is characterized by inflammation of the prostate. This can happen in men of any age and have symptoms like difficulty urinating, sexual problems, fever, and chills. Treatment generally includes antibiotics.

Regular screening after the age of 50 is recommended. While every two years is recommended for men with only slightly enlarged prostates, yearly screenings and PSA (cancer cell) screening may be necessary in those with family or personal history of prostate cancer and BPH. This decision is made on an individual basis, which I am glad to discuss with my patients at any time.

Dr. Rob Stoltz

Dr. Rob Stoltz

Dr. Rob Stoltz has been a practicing Board-Certified internist in Baltimore County for over 30 years. He received his undergraduate Bachelor of Science Degree at Union College, Schenectady, NY. He attended St. George’s School of Medicine and received his clinical training at Greater Baltimore Medical Center (GBMC). Read Full Bio