PROSTATE HEALTH: UNDERSTANDING SYMPTOMS, DIAGNOSIS AND TREATMENT A Public Health Awareness Concern

By Livy-Elcon Emereonye

The prostate is a small gland that plays an important role in the male reproductive system. Although prostate problems become more common with increasing age, symptoms affecting urination or sexual health should not simply be dismissed as an inevitable part of ageing.

Common prostate conditions include benign prostatic hyperplasia (BPH), prostatitis and prostate cancer. These conditions are different, and the presence of urinary symptoms does not automatically mean that a man has cancer. Conversely, prostate cancer may produce few or no symptoms in its early stages. This makes appropriate medical assessment particularly important.

When Should a Man Seek Medical Attention?

A man should consider speaking with a healthcare professional when he develops persistent or troublesome urinary or reproductive symptoms, including:

• Frequent urination, particularly at night.
• Difficulty starting urination.
• Weak or interrupted urine flow.
• A feeling that the bladder has not emptied completely.
• Urgency to urinate.
• Pain or burning during urination.
• Blood in the urine or semen.
• Pain in the pelvis, lower back or genital region.
• Painful ejaculation.
• Recurrent urinary infections.
• New or unexplained sexual or reproductive problems.

These symptoms can have several causes, including prostate enlargement, infection, bladder disorders, medications and other urinary-tract conditions. Therefore, self-diagnosis is discouraged.

HOW IS PROSTATE DISEASE DIAGNOSED?

Diagnosis begins with a careful clinical assessment. There is no single test that can diagnose every prostate disorder. Instead, healthcare professionals combine the patient’s history, physical examination and, where appropriate, laboratory and imaging investigations.

1. Medical History and Symptoms

The healthcare professional will usually ask about:

• The nature, duration and severity of symptoms.
• Urinary frequency and nighttime urination.
• Difficulty initiating or maintaining urine flow.
• Previous urinary or prostate problems.
• Episodes of urinary infection.
• Current medications and supplements.
• Previous medical procedures or surgeries.
• Sexual and reproductive health where relevant.
• Other medical conditions that may affect urinary function.

Keeping a record of urinary symptoms can be useful because it helps the healthcare professional understand how the problem affects daily life.

2. Family and Personal Health History

Family history can be particularly relevant when assessing prostate-cancer risk. A healthcare professional may ask whether close relatives have had prostate cancer and, in some circumstances, whether there is a history of other cancers associated with inherited genetic changes.

Personal health history, age and other risk factors may also influence decisions about whether further evaluation or prostate-cancer screening is appropriate.

3. Physical Examination

A physical examination may include an abdominal and genital examination and, when clinically appropriate, a digital rectal examination (DRE).

During a DRE, the healthcare professional gently inserts a lubricated, gloved finger into the rectum to assess the accessible portion of the prostate for abnormalities such as enlargement, asymmetry or unusual firmness.

A DRE is only one component of assessment. It does not, by itself, diagnose prostate cancer or determine the exact cause of urinary symptoms.

IMPORTANT TESTS THAT MAY BE CONSIDERED

Depending on the symptoms and clinical findings, additional investigations may be recommended.

Blood and Urine Tests

Urinalysis and other laboratory tests can help identify infection, blood in the urine and other conditions that may contribute to urinary symptoms.

Blood tests may also be used to assess general health and, where appropriate, prostate-specific antigen (PSA).

PSA TEST

The prostate-specific antigen (PSA) test measures the concentration of PSA in the blood.

An elevated PSA level can occur with prostate cancer, but it can also occur with benign prostate enlargement, prostatitis and other conditions. Conversely, a PSA result within a particular range does not completely exclude prostate cancer.

Therefore, PSA testing should be interpreted in the context of the individual’s age, symptoms, family history, previous PSA results and other clinical information.

The decision to undergo PSA-based screening should ideally be made through shared decision-making between the individual and a qualified healthcare professional, taking into account potential benefits, limitations and harms of screening.

Ultrasound and Other Imaging

Ultrasound may be used to examine the prostate, bladder and urinary tract. Depending on the clinical question, other imaging techniques may be considered.

Imaging can provide useful information about prostate size, urinary retention and other structural abnormalities, but the appropriate imaging method depends on the suspected condition.

Urodynamic Testing

Urodynamic tests assess how well the bladder and urinary system store and release urine.

These tests are not required for every man with urinary symptoms. They may be considered when the healthcare professional needs additional information about bladder or urinary-tract function, particularly when the diagnosis is uncertain or symptoms are complex.

Cystoscopy

A cystoscopy allows a healthcare professional to examine the inside of the urethra and bladder using a thin instrument with a camera.

It may be recommended in selected circumstances, such as unexplained urinary symptoms, blood in the urine or suspicion of abnormalities within the lower urinary tract.

Prostate Biopsy

A prostate biopsy involves obtaining small samples of prostate tissue for examination under a microscope.

Biopsy may be recommended when the overall clinical assessment—including PSA, examination and, where appropriate, imaging—raises sufficient concern about prostate cancer.

A biopsy is the procedure used to obtain tissue for pathological confirmation of prostate cancer. It is not routinely required for every man with an enlarged prostate or urinary symptoms.

WHY EARLY MEDICAL ASSESSMENT MATTERS

One of the most important messages in prostate health is that symptoms should not be ignored and should not automatically be attributed to ageing.

Benign prostatic hyperplasia can cause significant urinary problems without being cancer. Prostatitis may cause pain and urinary symptoms and can have infectious or non-infectious causes. Prostate cancer, on the other hand, may remain clinically silent in its early stages.

Because these conditions can overlap in their presentation, professional assessment is essential.

HOW IS PROSTATE DISEASE TREATED?

Treatment depends on the specific diagnosis, severity of disease, symptoms, age, overall health and individual preferences.

Benign Prostatic Hyperplasia (BPH)

For men with mild symptoms, healthcare professionals may initially recommend lifestyle and behavioural measures, monitoring or watchful waiting.

Depending on symptom severity, medicines may be prescribed to improve urinary flow or reduce prostate-related obstruction. Some men with significant or persistent symptoms may eventually require minimally invasive procedures or surgery.

Prostatitis

Treatment depends on the type and cause of prostatitis. Bacterial prostatitis may require appropriate antimicrobial treatment, while chronic pelvic pain syndromes may require a different combination of approaches.

The important principle is that antibiotics should not be taken routinely without appropriate clinical assessment.

Prostate Cancer

Treatment for prostate cancer depends on factors such as the cancer’s stage, grade, extent, overall health and individual circumstances.

Possible management strategies include active surveillance for selected cancers, surgery, radiotherapy, hormone therapy and other systemic treatments. Treatment decisions should be made with an appropriately qualified healthcare team.

BE CAREFUL WITH SELF-MEDICATION

Urinary symptoms are common, and many men may be tempted to purchase medicines, antibiotics or herbal preparations without first establishing the underlying cause.

This can delay diagnosis, expose individuals to unnecessary adverse effects and, in the case of antibiotics, contribute to antimicrobial resistance.

Natural does not automatically mean harmless, and a product marketed for prostate health should not be assumed to treat prostate cancer or replace appropriate medical evaluation.

Men experiencing persistent or worsening urinary symptoms should seek professional medical advice rather than relying solely on self-treatment.

PROSTATE HEALTH: A PUBLIC HEALTH MESSAGE

Prostate health is not simply about treating disease after symptoms become severe. It is also about health literacy, timely medical assessment and informed decision-making.

Men should become familiar with changes in their urinary and reproductive health and discuss persistent or concerning symptoms with a healthcare professional.

Families also have a role to play. Encouraging men—especially older men—to seek medical attention when necessary can help overcome embarrassment, misinformation and the tendency to postpone healthcare.

Most importantly, a urinary symptom is a signal for assessment, not a diagnosis.

The appropriate response is neither unnecessary fear nor careless dismissal. It is informed evaluation.

KEY TAKE-HOME MESSAGES

1. Prostate problems are common, particularly with advancing age, but they are not all the same.
2. BPH, prostatitis and prostate cancer require different approaches to diagnosis and treatment.
3. Persistent urinary symptoms should be medically evaluated.
4. PSA is a useful clinical tool, but an abnormal PSA does not automatically mean cancer.
5. A DRE is one component of assessment and should be interpreted alongside other clinical information.
6. Not every man with urinary symptoms needs every available test.
7. Prostate biopsy is used when there is sufficient clinical concern to investigate for cancer.
8. Treatment should be based on an established diagnosis and individual clinical circumstances.
9. Self-medication—whether with antibiotics, conventional medicines or unverified herbal products—can be harmful.
10. Early and appropriate medical assessment can help identify problems and guide timely management.

CONCLUSION

Prostate health deserves greater attention as part of men’s health and preventive healthcare. The objective should not be to create unnecessary anxiety about prostate disease, but to promote awareness, early recognition of concerning symptoms, appropriate investigation and evidence-based treatment.

Men should feel comfortable discussing urinary, sexual and reproductive symptoms with qualified healthcare professionals. A simple conversation can be the first step towards identifying a manageable condition—or, where necessary, detecting a more serious disease at a stage when appropriate treatment options can be considered.

Know the symptoms. Know your risk. Ask questions. Get appropriately assessed.

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About the Author

Livy-Elcon Emereonye is a pharmacist, researcher, writer and health educator with professional interests spanning pharmaceutical sciences, public health, integrative medicine and herbal medicine. He is the founder of Herbaceutics, a concept focused on the science and art of herbal dosage-form formulation.

Through his public-health education initiatives and professional writings, he advocates greater health literacy, preventive healthcare and responsible integration of scientific evidence into health decision-making.

PS: Dr. Emereonye could be reached on: +234 803 392 2445

References

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2. National Cancer Institute (NCI). Prostate Cancer Screening. U.S. National Institutes of Health. https://www.cancer.gov/types/prostate/psa-fact-sheet
3. American Urological Association. Benign Prostatic Hyperplasia (BPH) Guideline. American Urological Association. https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline
4. American Urological Association/Society of Urologic Oncology. Early Detection of Prostate Cancer: AUA/SUO Guideline. https://www.auanet.org/guidelines-and-quality/guidelines/early-detection-of-prostate-cancer
5. National Cancer Institute (NCI). Prostate Cancer Treatment (PDQ®)–Patient Version. U.S. National Institutes of Health. https://www.cancer.gov/types/prostate/patient/prostate-treatment-pdq
6. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Prostatitis: Inflammation of the Prostate. U.S. National Institutes of Health. https://www.niddk.nih.gov/health-information/urologic-diseases/prostatitis
7. European Association of Urology (EAU). EAU Guidelines on Non-neurogenic Male Lower Urinary Tract Symptoms, including Benign Prostatic Obstruction. https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts
8. U.S. Preventive Services Task Force. Prostate Cancer: Screening. JAMA. 2018;319(18):1901–1913. doi:10.1001/jama.2018.3710. https://www.uspreventiveservicestaskforce.org/This version is suitable for a public-health lecture, WhatsApp health-education programme, newsletter, newspaper article or health-awareness presentation.