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September 17, 2010 > September is Prostate Health Month

September is Prostate Health Month

There's More to Prostate Health than Cancer Screenings

There's no doubt prostate cancer is a serious health concern in the United States. The American Cancer Society estimates that one of every six men will get prostate cancer during his lifetime.

But there are other prostate conditions that warrant attention, too. Eight out of 10 men will eventually develop an enlarged prostate, also known as Benign Prostatic Hyperplasia (BPH). And prostatitis - an inflammation of the prostate usually caused by an infection - is the most common prostate problem for men under 50. About half of adult men will be treated for prostatitis in their lifetime.

Prostate Enlargement

"In its early stages, prostate cancer usually has no symptoms, so most of the time when a man experiences symptoms such as urinary frequency or an urgent need to urinate, BPH is a more likely cause than cancer," says Dr. Mark Saleh, a urologist at Washington Hospital.

Other symptoms of BPH may include:
* Weak urine stream
* Increased frequency of urination at night
* Difficulty starting or stopping urination
* Inability to completely empty the bladder
* Blood in the urine

"While these symptoms most likely would indicate BPH, a man who is experiencing such problems should definitely be examined to rule out cancer," Dr. Saleh notes. "In particular, blood in the urine - or semen - is definitely a cause for concern. Plus, the symptoms of BPH are not necessarily a natural part of aging that men must simply endure. BPH can and should be treated to improve the patient's quality of life."

Treatment options for BPH might include medications, non-invasive therapies such as ultrasound and laser therapy to shrink the prostate, or - in the most severe cases - surgery.

"Medications for BPH have improved in recent years, with fewer adverse side effects," says Dr. Saleh. "The first choice in treatment would be medications called alpha blockers, such as Flomax. These medications don't change the size of the prostate, but they relax the muscles of the prostate and the bladder neck to produce a better urine stream and reduce the 'hesitancy' in starting to urinate.

"If the patient's symptoms are more severe, or if he has a very large prostate, we would add medications called 5-alpha-reductase inhibitors such as Proscar or Avodart," he continues. "These medications actually reduce the size of the prostate. There generally are no adverse side effects, although in very rare cases, the man may experience a slight decrease in erections."


Prostatitis caused by a bacterial infection - such as E. coli infection - is the most common form of the condition. Acute bacterial prostatitis often produces a rapid onset of symptoms, including:
* Fever
* Chills
* Pain in the lower back
* Aching muscles
* Fatigue
* Frequent or painful urination

Chronic bacterial prostatitis develops slowly over several years and may not produce any symptoms other than those similar to a recurring urinary tract infection. The condition also may keep returning even after the initial infection has been treated.

"Bacterial prostatitis can be treated with antibiotics," Dr. Saleh says. "It's important to note, however, that most antibiotics have poor penetration of the prostate, so it usually requires a longer course of treatment lasting from two to six weeks."

Nonbacterial prostatitis is more complicated to diagnose and treat. Symptoms may include:
* Discomfort in the testicles, urethra, lower abdomen or back
* Discharge from the urethra
* Blood or urine in ejaculate
* Low sperm count
* Sexual difficulties
* Frequent urination

"We don't really know what causes nonbacterial prostatitis, but we believe it may be related to the interstitial cystitis experienced by many women," Dr. Saleh explains. "The diagnosis is one of exclusion, meaning that we rule out other potential causes of the symptoms. Since the condition is not caused by bacteria, we cannot treat it with antibiotics, so the primary course of treatment is to use anti-inflammatory medications."

Attention Men: Learn to improve your health from head to toe
The Third Annual Men's Health Fair at Washington Hospital will be held from 9 a.m. to 12:30 p.m. on Saturday, Oct. 2, in the Conrad E. Anderson M.D. Auditorium, located at 2500 Mowry Avenue in the Washington West building in Fremont. Registration for the free event is required. Register online at or call (800) 963-7070.

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