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Prostate problems are common and treatable

Problems caused by enlargement of the prostate, which is often called benign prostatic hyperplasia (BPH), become increasingly common among men after age 40 years. Almost all men will become familiar with their prostate and the problems it causes with age.

BPH causes primarily problems of urination: the urine flow may be weak, urination stops on and off and it is difficult to start to urinate. Urination tends to take a longer time than before and there is urine leakage (dribbling) after completed urination.

Many men with BPH also experience an extreme and sudden urgency to urinate and take the habit of checking where the restroom is located when visiting new places. The need to urinate is there also nighttime and might interrupt sleep several times every night.

These problems are inconvenient and there is no reason to try to wrestle with them on your own.  It’s better to have them checked because effective help is available and there are currently many effective treatment options to select from. A visit to the doctor is needed, because it takes an outside expert to evaluate if the condition is serious or not.

-Apart from BPH, symptoms may be caused by prostate inflammation or infection and prostate cancer, possibly all at the same. About 5 000 men have prostate cancer in Finland every year. Most prostate cancers do not cause any specific symptoms and are found only when the prostate is treated or examined for some other reason, typically BPH.

-Most cases of prostate cancer are fortunately low-risk cancers which ultimately do not have very significant consequences for the patient. But there are aggressive forms of prostate cancer, and they need to be identified as soon as possible.

The prostate is examined by a digital rectal examination (DRE) made by the urologist, by ultrasound where the transducer is inserted a short distance into the rectum, by a blood test called PSA (for prostate-specific antigen) and, possibility, by magnetic resonance imaging (MRI). The urologist asks some questions to get an idea of the symptoms and of possible hereditary circumstances.

Then the urologist will recommend either follow-up or suggest some additional examinations, e.g., biopsies of the prostate to check if there is cancer or not.

At the first visit the urologist also estimates the risk for prostate cancer which helps to decides the need for follow-up visits. Mikael Anttinen recommends sufficiently frequent visits to a urologist.

-If the man does not have an increased risk for prostate cancer, the need for follow-up visit may be a few years apart, but if the risk is there, it may be worthwhile to visit a urologist every two years.