Patients are often confused about the prostate, the walnut sized gland that surrounds the urethra. Often times patients discuss the size of the prostate and “wear its size emblazoned across their chest” However, this is one of those times when more is not necessarily a good thing. Large sized prostates usually are associated with more bothersome symptoms including nocturia (waking at night to urinate), incontinence and recurring urinary tract infections. Many times patients with small sized prostates can also experience similar prostatic symptoms. Conversely, some patients with very large prostates may not be symptomatic at all. Who is going to be effected by the size of the prostate?
Various theories exist as to who is going to be symptomatic. The consistency of the prostate may have something to do with this. Prostates consist of various cell types, some spongy and some more rigid. It has been proposed that patients with a larger proportion of the rigid tissue (stroma) may be at increased risk for the development of symptoms. This group of patients can be more resilient with regards to treatment as this cell type may not respond as favorably to the various drugs that are used, and may be likely to require a minimally invasive or surgical treatment. A patient’s bladder capacity or the bladder’s elasticity are other factors that also have a bearing on the extent of a patient’s symptoms.
Further confusion about the prostate exists regarding PSA (prostate specific antigen), a protein that is secreted by the prostate. This substance is measured with a blood test and is widely utilized as a screening tool for prostate cancer. Although this protein is exclusively made by the prostate, the fact that it is elevated does not always mean that the patient has prostate cancer. Conditions other than prostate cancer may be associated with an elevation of the PSA. Some of the more common conditions are prostatitis (an infection and/or inflammation of the prostate) and BPH.