The First Step in Diagnosing Prostate Problems

The prostate is a small walnut sized gland that produces part of the liquid in semen. It has two or more sections and is enclosed in an outer layer. It is located in front of the rectum and just below the bladder. Urethra, which is canal that urine passes through from the bladder, is surrounded by the prostate gland. The most common form of prostate problem found in men under 50 is inflammation or an infection called prostatitis. Prostate enlargement is another problem because the prostate gland continues to grow as man ages and matures. Prostate enlargement or BPH is the most common problem for men over 50. If a man is over 50, he is more at risk of de3veloping prostate cancer. The good news is that prostate cancer is less common then an enlarged prostate.

The important first step is to talk to your doctor about problems or symptoms you may be experiencing. A weak urine stream, starting and stopping, and an increased need to get up in the night to urinate are a few of the most common symptoms. When you talk to your doctor or are questioned by a nurse, you will be asked some screening questions. The answer to these questions will help your doctor decide what diagnostic test is needed. Most of the time it will be a PSA test as well as a rectal exam.

You may have trouble with ejaculation, recurring urinary tract infections or strong urges to go especially at night. Your doctor will want to know if you have any pain during urination or after ejaculation. They will want to know how much fluid you take in during the day, if you use alcohol, drink a large amount of caffeine and if your urine has an unusual color or strong odor. You may also be asked about any previous illnesses or surgeries.

Other questions that may be asked are:

-- Do you need to urinate again in less than two hours?

-- Over the past month, how many times a night you need to urinate?

-- Have you had the feeling of not being able to empty your bladder in the last month?

-- Has your urinary stream been weak?

-- Have you had to strain to urinate during the last month?

The answers to these questions will help your health care team decide what tests may be needed or if there is a problem with your prostate.

The two most common tests performed do not need any advanced preparation. A digital rectal exam (DRE) and blood tests for prostate-specific antigen (PSA) are the two most common tests. These tests are routinely done if you are over 40 and have a family history of prostate problems, or given yearly after the age of 50. If either of these tests show you may have a problem with your prostate more tests may be ordered by your doctor.

The DRE is normally the first test done. You will be asked to bend over the examining table or lie on your side with your knees drawn up to your chest as the doctor inserts a gloved and lubricated finger into the rectum to feel the prostate. It is slightly uncomfortable but takes only a brief time. If the doctor feels an abnormality he will then order a PSA test. After the diagnosis, you and your doctor will discuss the treatment that is best for you and your prostate problem.

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