Archive - Other Conditions of the Prostate

Questions & Answers

Does the natural size of a man’s prostate relate to later development of an enlarged prostate or prostate cancer?

The normal prostate size for an adult male is 15cc to 30cc (one half ounce to one ounce). Men whose prostate gland is larger than 30 cc are more likely to be diagnosed with either benign hyperplasia (enlargement) or prostate cancer than those whose prostate is in the normal range.

How long do the symptoms of prostatitis last – lower abdominal tenderness,penis tenderness, back and hip stiffness? I have been diagnosed last month and am still feeling some syptoms.but they are improving.

Symptoms of chronic prostatitis can last weeks to months and usually are somewhat slow to resolve. However, the safest thing to do is to be checked by a urologist to make sure that something else is not causing the symptoms.

I have been diagnosed with BPH. I am taking prostate dietary supplements right now after almost a year of different antibiotics for prostatitis. Is it normal for the ejaculate fluid to be almost clear instead of the usual milky color?

With the development of obstructive BPH, it is not uncommon for the volume of the ejaculate to decrease and for the ejaculate to become more clear. Part of the reason for this is that less of the ejaculate comes from the prostate gland itself (because the seminal fluid is trapped within the prostate gland because of obstruction of the prostatic ductal system from the enlargement). As a consequence, relatively more of the ejaculate comes from the urethral glands that secrete a clear mucus-like substance with sexual arousal and from the seminal vesicles that secrete a clear fluid

Please tell me about those calcium crystals that can appear in the prostate. How normal is this, can they indicate a benign or malignant prostate condition, do they ever cause blockage and might they be related to calcium oxalate kidney stones?

Calcifications in the prostate are very common. Usually, they are related to past episodes of inflammation in the prostate. As the inflammation subsides and the tissue heals, calcium is deposited in the tissues. Most commonly, they are calcium carbonate and are not related to calcium oxalate stone disease. They rarely cause blockage of the urinary channel.

Can the passage of kidney stones through the urethra aggravate the prostate or exacerbate prostate-related symptoms?

Yes. Often, as a kidney stone passes through the distal-most part of the ureter into the bladder, it can produce symptoms of urinary urgency and frequency. These symptoms are similar to those caused by an enlarged or an inflamed prostate gland. Passage of the stone through the prostatic portion of the urethra can cause similar symptoms.

Is there anything other than prostate cancer that would show up as a dark spot or area on ultrasound?

Yes, there are several possibilities. One would be a cyst (fluid-filled cavity, like a blister) of the prostate, another could be a focal region of inflammation, a third would be a large blood vessel.

My husband is 47 and we have a very active sex life. Sometimes after sex, he has severe pain or cramping in the prostate or rectal area. What could cause this. It is not everytime we have sex.

There might not be a simple answer. This type of pain can occur with prostatitis (inflammation in the prostate gland) or with spasm of the pelvic floor muscles, for unknown reasons. It is not a common symptom of prostate cancer. He should be evaluated by a urologist to ensure that everything is okay.

What does it mean if your semen is discolored?

It is usually a sign of inflammation in the prostate gland, but it also can occur with prostate cancer.

I have been diagnosed with BPH, and the urologist is recommending transurethral resection of the prostate (TURP). I have read about the possible adverse effects of this surgery, and I would like to know if these adverse effects occur very often. Should I worry about this?

There can be side effects of TURP, such as impotency, incontinence, bleeding, stricture, retrograde ejaculation, failure to void well postoperatively, etc. However, TURP is probably the most effective treatment for most men who require surgery (unless they have a very large prostate gland), and most patients do not have permanent side effects.

I have been waking up four times a night, and because I am up I go to the bathroom. Most times it seems I wake up with no great urge, but because of anxiety, the urge escalates. Sometimes I just go back to sleep and wake up an hour or two later. Is this common?

It is common in patients with an enlarged, obstructing prostate or with prostate inflammation or both. Sometimes, the symptoms lessen if the patients take a tamsulosin capsule at bedtime. I tell my patients that it also is important to monitor your PSA or, better yet, Prostate Health Index levels.

I have issues caused by enlarged prostate. Would you recommend removing the prostate for those reasons alone versus for the presence of cancer? If so, would I be a candidate for your “nerve sparing” procedure?

We do not perform a total prostatectomy unless there is cancer, because it poses a significant risk of erectile dysfunction. In contrast, operations for urinary obstruction that remove only part of the prostate rarely cause erectile dysfunction.

I am being bothered by my enlarged prostate and was happy to learn from my biopsy procedure that at least there was no evidence of prostate cancer. Therefore, I am hoping to get my TURP (Trans-Urethral Resection of the Prostate). What is the recovery time, and how soon would I be able to return home?

The short-term recovery time from a TURP is usually about three to four weeks, but you should be able to return home within one week if all goes as expected. However, after a TURP operation, you would have a larger new urinary channel that would improve your bladder’s ability to empty, but this channel would need to be “re-paved” with a smooth lining composed of cells that grow “down” from the bladder and “up” from the urethra. This part of the healing process can take three to four months.

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