The prostate is a walnut-sized gland below the bladder present in men only. It makes the fluid that carries and nourishes sperm. The prostate sits in front of the rectum ('back passage'), which is why the prostate can be felt by putting a finger into the rectum. Urine flows from the bladder through the prostate to the urethra and then to the outside world. The prostate is like a ring doughnut or polo mint with a hole in the middle.
There are three main problems that affect the prostate, prostate enlargement (benign prostatic hyperplasia, BPH), prostate cancer and prostatitis.
If the channel through the prostate gets small as the prostate enlarges, urinary symptoms can develop such as getting up at night, passing urine frequently, or a poor urinary stream. However, the prostate is not the only cause for urinary symptoms. Investigations and treatments for these problems can be found operations for the benign prostate enlargement including laser prostatectomy.
In general, prostate cancer does not cause urinary symptoms unless it is very advanced. Therefore, the majority of men with urinary symptoms do NOT have prostate cancer/
Prostate cancer is a growing problem in this country as men live longer (see graph below). When it starts there are no symptoms, but it is now the second commonest cause of death from cancer in men after lung cancer (see graphs below). Prostate cancer can be detected early using the PSA, PCA3 Score, subsequent prostate biopsies and then deciding what treatment options are best for you including observation. PSA testing is controversial and so it is important to understand the advantages, risks and alternatives to PSA testing. Multiple new treatments have arisen for prostate cancer including HIFU (high intensity focused ultrasound), laparoscopic and robotic prostatectomy.