Introduction
The prostate gland is the male reproductive organ that generates semen, a liquid containing sperm. It is located just below the bladder and in front of the rectum. It is about the size of a walnut in younger men and grows with age. Prostate problems are primarily seen in older men above fifty years of age.
What Are the Common Prostate Problems?
Some common problems of the prostate include:
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Prostatitis - Prostatitis is inflammation of the prostate gland that is usually caused by bacteria.
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Benign Prostatic Hyperplasia - Also known as enlarged prostate, is a common problem in older men which causes dribbling of urine or an urge for frequent urination and usually occurs at night.
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Prostate Cancer - This is common cancer that can be treated at its best if diagnosed early.
What Are the Symptoms Seen in Prostate Problems?
Prostate problems can have a variety of symptoms. However, the most common symptoms seen in prostate problems include:
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Urine Retention: Refers to the inability to completely excrete urine from the bladder.
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Frequent Urination: Here, the individual is likely to urinate eight or more times a day.
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Urinary Urgency: The inability to postpone urination or hold urine.
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Nocturia: Frequent urination during the night.
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Pain: After urination or during urination.
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Color: Change in color and odor of urine.
Symptoms of several prostate issues may be similar, or individuals with the same prostate condition may experience different symptoms.
What Is the Primary Test Done to Diagnose Prostate Problems?
The primary test to diagnose prostate problems is a blood test to measure the prostate-specific antigen (PSA) in your blood. Both benign prostatic hyperplasia (BPH) and prostate cancer can raise your PSA level. However, this test alone cannot determine whether or not you have BPH. Other tests will be required as well. If your PSA level is high and your doctor suspects cancer, a prostate biopsy will certainly be performed.
On the other hand, a high PSA level does not always imply prostate cancer. A PSA blood test improves prostate cancer detection when used with a DRE (direct rectal examination). However, the test is recognized for having a high proportion of false-positive results.
A PSA blood test may also reveal more medically unimportant lumps or growths in the prostate, known as tumors.
What Are the Types of PSA Tests?
If you decide to get a PSA test and the result is unusual, some doctors may consider using different PSA tests to help determine if you need a prostate biopsy. There are two kinds of PSA tests which are:
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Percent-Free PSA Test: PSA occurs as two major types in the blood. One form is attached to blood proteins, and the other circulates freely (not attached). Free PSA (% fPSA) estimates how much PSA travels around free compared to the total PSA level. The percentage of free PSA is lower for men with prostate cancer than for men without cancer.
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Complexed PSA Test: This test determines how much PSA is coupled to other proteins (the amount of PSA that is not free). Although this test may be used instead of assessing total and free PSA but still provide the same amount of information, it is not generally used.
What Are the Other Tests Performed to Diagnose Prostate Problems?
The other diagnostic tests include :
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Medical History and General Physical Examination: The physician will start by asking about the health of the patient and the medications taken. Then the patient will undergo a general physical examination. The doctor will examine the belly and groin area for tumors.
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Digital Rectal Examination (DRE): The physician with a gloved hand uses a lubricated finger to inspect the prostate next to the rectum during a DRE. If the physician notices any anomalies in the prostate gland's texture, shape, or size, it may require more testing.
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Urinalysis: Urinalysis is a test that looks for abnormal chemicals or symptoms of infection in a urine sample. The urine sample is collected in a specific container in a doctor's office or other diagnostic laboratories, and it is analyzed. If the physician suspects an infection, they may request that a urine sample be collected in two or three containers. After urine is collected in the first container and before further collecting, the health care professional will make the patient stop the urine stream and give him a prostate massage. If signs of infection are seen in the first container but not the others, the infection is most likely in the urethra. If signs of infection are seen in another container, then infection is expected to be in the prostate gland.
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Urodynamic Tests: There are different kinds of urodynamic tests. Most urodynamic tests focus on an individual's ability to hold urine. If the problem is urinary retention, the healthcare provider may recommend a test that measures bladder pressure and urine flow rate.
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Cystoscopy: These procedures allow a healthcare provider to look at the lower urinary tract obstruction. A cystoscope is a tube-like instrument used for visualizing the inside of the urethra and any other obstructions. After the solution is inserted into the penis, the healthcare provider inserts a cystoscope through a hole in the tip of the penis and in the lower urinary tract. By looking at a cystoscope, a health care provider can determine the location and degree of urinary incontinence.
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Abdominal Ultrasound: Ultrasound emits safe, painless sound waves to create an image of the structure. The transducer can be moved around to test different organs. On abdominal ultrasound, the healthcare provider rubs the gel on the patient's abdomen and delivers a hand-held transducer over the skin. Pictures may show damage or abnormalities in the urinary tract caused by the blockage of urine in the prostate.
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Transrectal Ultrasound: The specialist will insert a small transducer device into your rectum. As the device moves, it will display different parts of your prostate. In order to determine if there is cancer, a biopsy is needed. For taking a biopsy, the healthcare provider uses a transducer and ultrasound imaging to direct the needle to the tumor. The hand is then used to remove a few pieces of prostate tissue for a microscope. This procedure, called a biopsy, can detect prostate cancer. A transrectal ultrasound with prostate biopsy is usually performed by a doctor in the office of a healthcare provider, an outpatient facility, or a hospital with simple sedation and local anesthesia. Biopsied prostate tissue is tested in a laboratory by a pathologist.
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Biopsy: In this test, you will be given anesthetic medication so that you do not feel any pain. The doctor will use an ultrasound, CT (computerized tomography), or MRI (magnetic resonance imaging) scan to see your prostate gland. They will then use a needle to take a piece of tissue, and the sample will be sent to a laboratory where a pathologist will look under a microscope to see if it has any cancer.
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MRI Scan: An MRI (magnetic resonance imaging) is an imaging examination that takes photographs of the body's internal organs and soft tissues. Radio waves and magnetic waves are used in MRI equipment to create detailed images.
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CT Scan: A CT (computerized tomography) scan creates three-dimensional (3-D) images by combining X-rays and computer technology. In contrast to CT scans, a dye is injected into the vein to enhance the contrast of the images captured through these scans. MRI (magnetic resonance imaging) and CT (computerized tomography) scans can assist in identifying abnormal growths in the urinary tract, but they cannot tell the difference between malignant tumors and benign prostate enlargement. These imaging techniques will show how far cancer has spread after a biopsy has proven cancer.
When Will the Test Results Be Available?
Simple medical examinations, such as various urodynamic tests, cystoscopy, and abdominal ultrasound, usually have immediate results. However, in other medical tests, such as a PSA blood test or a prostate tissue biopsy, it takes several days to get the findings.
Conclusion:
You do not need to undergo every available test. Your doctor will assist you in determining which tests are most appropriate for your case. In case of confusion about which tests to undergo and any other concerns that your doctor does not clarify, it is always best to go for a second opinion for better clarity and understanding of the problem. At icliniq, with the help of dedicated and experienced doctors in various specialties, you have a better clinical picture of your situation. For a better experience, do reach out to icliniq.
