Don’t delay if you're concerned about your prostate

Mr Paul Hegarty. Picture Dan Linehan

“THE prostate is a specialised gland normally about the size of a walnut located between the bladder and the penis. A tube called the urethra runs through the centre of the prostate, from the bladder to allow urine flow out of the body. The gland produces a secretion that nourishes and protects sperm,” says Mr Paul Hegarty, a surgeon who specialises in conditions relating to the urinary tract and reproductive system (urology). 

There are several conditions that can affect the prostate including prostatitis, which is an inflammatory condition often due to infection and in many cases treated with antibiotics.

Benign prostatic hypertrophy (BPH) is a non-cancerous prostate enlargement affecting most men aged over 50. Symptoms include difficulty passing urine which tends to worsen over time. Special medicines such as alpha-blockers or surgery can treat BPH.

Prostate cancer is the second most common form of cancer in men, however, with modern breakthroughs in treatment and surgery, only one in 35 men die early from prostate cancer. If left untreated these prostate cancer cells may spread and invade other areas of the body, particularly the lymph nodes and bones, producing secondary tumours in a process known as metastasis.

Surgery, radiation, hormone therapy, and chemotherapy can be used to treat prostate cancer.

If you are concerned about your prostate health then firstly you should understand the symptoms and discuss them with your family doctor who if needed can refer you to a urological surgeon (urologist) for a specialist opinion. Symptoms of enlarged prostate include: slow urinary stream, a feeling of incomplete bladder emptying, frequent urination, getting up several times at night to urinate and a urinary stream that starts and stops.

There are several tests that your family doctor and urologist can perform to diagnose prostate conditions and distinguish between prostatitis, BPH and cancer. They include digital rectal examination (DRE) which involves the doctor palpating the prostate via the rectum. A digital rectal examination can sometimes detect an enlarged prostate, lumps or irregularities which can be signs of prostate cancer or tenderness from prostatitis.

There is a simple blood test for a protein produced by the prostate called prostate-specific antigen (PSA). If prostate-specific antigen level is high, prostate cancer is possible, but a benign enlarged prostate can also cause a high result. If necessary, a doctor can perform in hospital prostate ultrasound where a probe is inserted into the rectum to examine closely the prostate tissue and allow access to perform a prostate biopsy. This is where a needle is inserted into the prostate to sample tissue to check for signs of cancer cells.

Surgery is an option for an enlarged prostate, however, medications usually resolve symptoms of an enlarged prostate, but some men require surgery to improve symptoms, prevent complications and treat cancer.

It can be difficult for men to discuss their health with those close to them, but Mr Hegarty would encourage all men aged 45-50 and younger men if they have a strong family history of prostate cancer to visit their family doctor and get the PSA blood test, as with all cancers the earlier the detection the better the outcomes with 98% of men surviving longer than five years with early treatment.

“Remember men if you haven’t had the test and your urine flow is slow, starts and stops, the bladder still feels full after visiting the bathroom and you wake up frequently at night to pass urine then make an early appointment with your family doctor and get checked out,” he says.

If necessary your doctor can make a referral to a specialist like Mr Hegarty, who will be happy to explain the treatment options.

  • Paul Hegarty joined the Mater Private Hospital, Cork in August 2013 with his wife Helen, also a urological surgeon. They try to balance packed days of clinics, operating theatres and the school run to find time to see each other in between.


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