prostate overview for patients

Overview

The prostate is a small, walnut-sized gland found only in males. It sits below the bladder and surrounds the tube that carries urine out of the body (the urethra). Its main job is to make fluid that mixes with sperm to create semen.

Prostate conditions are very common. About 1 in 3 men over 50 will have symptoms of an enlarged prostate, and many others will experience prostatitis at some point.

Anyone born with a prostate. Prostatitis is most common in men under 50, while an enlarged prostate usually appears after 40 and affects more than half of men over 60. Prostate cancer is more common in older men, particularly those over 65.

Symptoms

Common symptoms

• Needing to urinate more often, especially at night
• Difficulty starting to urinate or a weak urine stream
• Feeling that your bladder doesn't empty completely
• Pain or a burning feeling when urinating
• Blood in the urine or semen

Causes

Main causes

• Prostate enlargement (BPH): As men age, the prostate often grows, squeezing the urethra and causing urinary symptoms. Hormone changes are believed to play a role.
• Prostatitis: Inflammation of the prostate, which can be caused by a bacterial infection or other non-infectious factors.
• Prostate cancer: Abnormal cells grow in the prostate. The exact cause is not fully understood, but changes in a cell's DNA play a part.

Risk factors

• Age over 50
• Family history of prostate problems (especially father or brother with prostate cancer)
• Obesity
• Smoking
• Certain lifestyle factors, like a diet high in processed foods

When to see a doctor

See a doctor urgently if:

• If you have blood in your urine, see a doctor that day.
• If you have pain when urinating or a fever, see a doctor that day.
• If you have sudden worsening of urinary symptoms, see a doctor that day.

Book a routine appointment if:

• If you are over 50 and haven't had a prostate check, talk to your doctor.
• If you have a family history of prostate cancer, ask your doctor about screening.
• If urinary symptoms are bothering you or getting worse, make an appointment.

Diagnosis

Your doctor will start by asking about your symptoms, medical history, and any family history of prostate disease. They may recommend a digital rectal exam (DRE), a blood test called PSA, and a urine test. Depending on the results, you may need further tests such as a urine flow study or an ultrasound, and in some cases a biopsy.

Tests that may be done

• Digital rectal exam (DRE) – a doctor inserts a gloved finger into the rectum to feel the prostate for hard areas or lumps.
• PSA (prostate-specific antigen) blood test – measures a protein made by the prostate; a high level may signal a problem but does not always mean cancer.
• Urine test – checks for infection or blood.
• Urine flow test – measures how fast you pass urine to see if the prostate is blocking the flow.
• Ultrasound – uses sound waves to create an image of the prostate.
• Prostate biopsy – a small sample of tissue is taken for examination under a microscope, usually only if cancer is suspected.

What to expect at your appointment

A prostate exam may feel uncomfortable but is usually quick. For a PSA test, a simple blood sample is taken. A biopsy may be done by a specialist and can cause some temporary side effects like blood in the urine or semen. Your doctor will explain the results and next steps clearly.

Treatment

Treatment depends on what is causing your symptoms and how severe they are. Some prostate conditions need no treatment at all, while others benefit from lifestyle changes, medication, or surgery. Your healthcare team will tailor the plan to you.

Self-care at home

• Drink plenty of water, but limit bladder irritants like caffeine, alcohol, and acidic foods.
• Don't drink large amounts before bedtime to reduce nighttime trips.
• Try double voiding: after you pee, wait a few seconds and try again to empty your bladder more fully.
• Stay physically active and maintain a healthy weight.
• Talk to your doctor before taking any over-the-counter medicines, as some can make urinary symptoms worse.

Medical treatments

For an enlarged prostate, doctors often prescribe medications that relax the prostate muscles or shrink the prostate. For prostatitis caused by bacteria, antibiotics are commonly used. For prostate cancer, treatment may include active surveillance (monitoring without immediate treatment), surgery to remove the prostate, radiation therapy, or hormone therapy to slow cancer growth. The choice depends on the stage, your age, and your personal preferences. No single treatment is best for everyone, so ask your specialist about the benefits and risks of each option.

When is surgery considered?

Surgery may be considered for an enlarged prostate when symptoms are severe, or for prostate cancer if it is still contained. Techniques can be minimally invasive, using a telescopic tube through the penis, or more extensive surgery to remove the prostate. Your doctor will explain what is needed.

Living with this condition

Many men with prostate conditions continue to live full, active lives. It helps to keep a symptom diary, take medications as prescribed, and attend follow-up appointments. If you have urinary symptoms, simple changes like using a bathroom whenever available and planning trips around restrooms can reduce stress.

Lifestyle tips

• Exercise regularly – it supports overall health and may reduce prostate problem risks.
• Eat a balanced diet full of fruits, vegetables, and whole grains.
• Limit red meat and dairy, and avoid processed foods when possible.
• Quit smoking and limit alcohol, as both can worsen urinary symptoms.
• Practice relaxation techniques like deep breathing to manage stress.

Diet and exercise

A heart-healthy diet and regular exercise are also good for your prostate. Some studies suggest that tomatoes, green tea, and foods rich in certain plant compounds may help, but the evidence is not strong. Focus on healthy eating patterns rather than specific 'superfoods.'

Mental health and emotional wellbeing

Living with prostate symptoms – especially urine problems or a cancer diagnosis – can cause stress, embarrassment, anxiety, or sadness. These feelings are normal. Talking to a counsellor, joining a support group, and opening up to family or friends can help. If you feel overwhelmed, tell your healthcare team; they can connect you with support.

Prevention

There is no guaranteed way to prevent all prostate problems. But a healthy lifestyle – including a balanced diet, regular exercise, and not smoking – may lower your risk of prostate issues and help you stay healthier overall.

Screening programmes

Routine prostate screening for all men is not recommended in every country. In the UK, for example, men over 50 can ask for a PSA test after discussing the benefits and risks with their GP. Your doctor can help you decide if screening is right for you based on your age, family history, and general health.

Complications

If left untreated

• An enlarged prostate can lead to sudden inability to urinate (acute urinary retention), which is a medical emergency.
• Chronic urine blockage can cause bladder stones, bladder damage, or kidney damage over time.
• Untreated prostatitis can become chronic and cause repeated pain and infection.
• Prostate cancer may spread outside the prostate and become harder to treat if not detected early.

Long-term outlook

The outlook for most prostate conditions is positive. Even prostate cancer, when caught early, has a very high survival rate. Many men with prostate problems live for decades without serious complications. Modern treatments are effective, and your healthcare team will support you every step of the way.

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