What is the prostate?
The prostate is a gland found only in men. It’s located in front of the rectum and underneath the urinary bladder, and is about the size of a walnut. Cells found in the prostate produce some of the fluid that protects and nourishes sperm cells in a man’s semen.

What is prostatitits?
Prostatitis describes a wide range of disorders that can affect the prostate. There are four main types of prostate syndromes. The most serious of these is referred to as acute bacterial prostatitis. As its name implies, this syndrome is caused by bacteria and tends to come on suddenly. A second form of prostatitis is called chronic bacterial prostatitis. Although this condition is also caused by bacteria, it does not occur suddenly, but gradually gets worse over time. Another form of prostatitis is called chronic nonbacterial prostatitis or chronic pelvic pain syndrome. A final type of prostatitis is called asymptomatic inflammatory prostatitis.

What is the treatment for prostatitis?
In most cases, antibiotics are used to treat prostatitis. The duration of the treatment can vary from several weeks to several months, depending on the specific diagnosis. Prostatitis is generally not considered contagious, and the vast majority of cases are not spread through sexual contact.

What is benign prostatic hyperplasia (BPH)?
One of the most common prostate conditions, especially in men over the age of 50, is benign prostatic hyperplasia, or BPH. The term benign means that the condition is not cancerous and the term hyperplasia means abnormal or unusual growth. The result of BPH is that the prostate becomes enlarged. Because the urethra runs through the middle of the prostate, enlargement of the prostate can cause pressure on the urethra and on the opening of the bladder. This pressure can lead to urinary problems such as frequent urination, incomplete emptying of the bladder. If these symptoms become severe, medical or surgical treatment may be required.

How is BPH treated?
BPH with mild symptoms is simply observed. Routine examinations are performed to include a digital rectal exam and following the PSA values. Moderate symptoms may be treated with medications. These medications allow for improved urinary function and over time can reduce the size of the prostate. For severe symptoms, surgical treatment may be required. A common surgical treatment is known as a TURP or transurethral prostatectomy.

What is a prostatectomy?
Prostatectomy is the surgical removal of all or part of the prostate gland. There are several different kinds of prostatectomy. During an open prostatectomy, the prostate is removed through an incision in the lower abdomen or between the anus and scrotum. This procedure is done only in rare cases of BPH, when the prostate is very large with severe obstruction, or when other procedures cannot be performed.

Another is known as radical prostatectomy, which is the surgical procedure used most often to treat early stages of prostate cancer. The goal of this procedure is to remove the entire prostate gland and seminal vesicles while preserving nearby structures, such as the nerves that control urination and sexual function. There are a number of techniques that can be used to perform this procedure, including traditional surgery, robot-assisted methods, and laparoscopic procedures.

What is a transurethral prostatectomy (TURP)?
A transurethral prostatectomy or TURP is a common surgical procedure used in the treatment of an enlarged prostate. A TURP is less invasive than an open prostatectomy, but is only used to remove a small part of the prostate gland. During a TURP, a surgeon passes instruments through the urethra of the penis and removes part of the prostate gland to reduce urinary obstruction.

What is prostate cancer?
Prostate cancer is a disease in which the cells of the prostate begin to grow uncontrollably, forming tumors. A tumor is a mass or lump of tissue made of abnormal cells that can eventually spread, or metastasize, from the prostate to other parts of the body. The most common sites to which it spreads are the lymph nodes, the lungs, and bones.

What are the risks factors for developing prostate cancer?
The known risk factors for prostate cancer include:

  • Age: Nearly two-thirds of all prostate cancers are found in men over the age of 65.
  • Race: Prostate cancer occurs more often in African-American men and less in Asian men.
  • Family History: Prostate cancers appears to have an inherited or genetic factor.
  • Nationality: It is most common in men from North America and northwestern Europe.
  • Diet: Men who eat large quantities of red meat or high-fat dairy products appear to have a slightly greater chance of getting prostate cancer.

What are the symptoms of prostate disease?
The symptoms of prostate disease may include:

  • Delayed or slowed start of urinary stream
  • Urinary dribbling, especially immediately after urinating
  • Urinary retention
  • Pain with urination
  • Pain with ejaculation
  • Lower back pain
  • Pain with bowel movement
  • Excessive urination at night
  • Incontinence, or lack of bladder control
  • Bone pain or tenderness
  • Blood in the urine
  • Abdominal pain
  • Anemia
  • Unintentional weight loss
  • Lethargy, or lack of energy

What are the tests used to diagnose prostate disease?
There are a variety of tests that providers use to diagnose diseases of the prostate. The most common tests include digital rectal exams, known as DREs, and blood tests for prostate-specific antigen, known as PSA tests.

If the results of initial tests such as the Digital Rectal Exam (DRE) or the PSA suggest that prostate cancer is a possibility, your provider may recommend other tests to confirm the diagnosis. Those tests may include a urinalysis, a transrectal ultrasound, a biopsy, or imaging scans such as an MRI or a CT scan.

What are the treatments for prostate cancer?
There are a variety of methods used to treat prostate cancer.
Treatment approaches may include:

  • Watchful Waiting
    Watchful waiting is a passive technique used when it is suspected that the cancer is growing slowly and not causing symptoms. You and your provider will carefully monitor your condition, with regular physical exams and tests.

  • Surgery
    The surgical procedure used most often to treat early stages of prostate cancer is known as radical prostatectomy.

  • External Radiation Therapy
    Radiation can be used to direct high-energy rays to destroy prostate cancer cells and shrink tumors.

  • Brachytherapy
    Brachytherapy involves the placement of radioactive material inside the patient, directly in or near the tumor.

  • Hormonal Manipulation
    Medications that lower or eliminate the levels of testosterone can be used to treat prostate cancer. These medications can shrink prostate tumors or slow their growth for long periods of time, but cannot permanently cure prostate cancer.

  • Hemotherapy
    A single drug or a combination of drugs may be used, depending on your condition. These drugs are designed to destroy cancer cells.

Your provider will review your treatment options with you, and refer you to specialists when necessary.

What are the possible side effects of prostate surgery?
After prostate surgery, the possible complications include impotence and urinary incontinence, although nerve-sparing techniques may reduce the risk of these complications.

In those few cases where removal of the testicles is required to manipulate hormones, some bruising and swelling can occur but this will gradually disappear. The loss of testosterone production can lead to problems with sexual function, osteoporosis, and loss of muscle mass.

What are the testicles?
The testicles, which are also called testes, are a key part of the male reproductive system. The testicles are two oval shaped organs that are located inside the scrotum, which is the loose sac of skin that hangs behind the penis. The testicles are located outside of the body in order to control the temperature of the sperm, which are heat-sensitive.

What is an undescended testicle?
An undescended testicle, called cryptorchidism, is a condition where the testicles fail to descend from the abdomen down into the scrotum, which normally occurs shortly before birth. An undescended testicle requires treatment due to a higher risk of the development of testicular cancer if the testicle remains in the abdomen.

What is testicular cancer?
Testicular cancer occurs when abnormal cells in the testicles divide and grow in an uncontrolled manner. Testicular cancer can develop in one or both testicles and occurs in men or young boys.

What are the risks factors for getting testicular cancer?
There are certain risk factors that increase a man’s chance of developing the disease. The risk factors for testicular cancer include:

  • Age: Testicular cancer can occur at any age, but is most commonly found in men between the ages of 15 and 40.
  • Having an undescended testicle: An undescended testicle, called cryptorchidism, is a condition where the testicles fail to descend from the abdomen down to the scrotum shortly before birth.
  • Family history: If someone in your family has had testicular cancer, you have an increased risk of developing the disease.
  • Race and ethnicity: The risk for testicular cancer in Caucasian men is more than five times that of African-American men and more than double that of Asian-American men.

Keep in mind that having one or more risk factors for testicular cancer does not mean that you will develop the disease.

What are the symptoms of testicular cancer?
Most of the time a lump on the testicle is the first sign. Unfortunately, however, some testicular cancers may not cause symptoms until after reaching an advanced stage.
The symptoms of testicular cancer include:

  • A painless lump or swelling in either testicle
  • A change in how the testicle feels
  • A dull ache in the lower abdomen or the groin
  • A sudden build-up of fluid in the scrotum, or
  • Pain or discomfort in a testicle or in the scrotum

How is testicular cancer diagnosed?
Initial signs of testicular cancer are commonly found by men and brought to the attention of their provider. During a physical exam, your provider will feel the testicles to detect any sign of swelling or tenderness and to determine the size and location of any mass. Next, the provider will examine your abdomen to feel for enlarged lymph nodes. If cancer is suspected, this could be a sign that the disease has spread.

Depending on the results of the physical exam, your provider will sometimes recommend one or more of the following tests:

  • Ultrasound
    An ultrasound is a test that uses sound waves and a computer to create a picture of your internal organs. This enables your provider to more closely examine any abnormality of the testicles.

  • Blood Tests
    Certain blood tests are sometimes helpful in diagnosing testicular tumors. Many testicular cancers secrete high levels of certain proteins, and the presence of these proteins can help your provider diagnosis your specific condition.

  • Biopsy
    In rare cases, especially when a diagnosis of testicular cancer is uncertain, the provider may perform a biopsy before removing the testicle. During this procedure, a surgeon makes an incision in the groin, withdraws the testicle from the scrotum, and examines it without cutting the spermatic cord. If suspicious tissue is seen, a portion of the tissue is removed and examined under a microscope.

  • Surgery
    It is more common for the testicle and spermatic cord to be surgically removed in order to obtain an accurate diagnosis, and to prevent any cancer cells from spreading. In this case, the entire specimen is sent to the lab, where a pathologist can determine the type and extent of testicular cancer.

  • Imaging Tests
    Tests such as chest X-rays, MRIs, CT scans, and PET scans are often used to give providers a better understanding of where the cancer may have spread.

What is a Testicular Self Exam (TSE)?
Some providers recommend monthly testicular self-examinations, or TSEs, for men over the age of 15. To detect testicular cancer, all men should be familiar with the size and feel of their testicles, so they can be aware of any changes. A TSE should be conducted following a warm bath or shower, when the skin of the scrotum is relaxed. After looking for any changes in appearance, carefully examine each testicle by rolling it between the fingers and thumb to check for any lumps. If you discover any irregularities during a TSE, or if you experience any symptoms, be sure to notify your provider immediately.

What is a PET scan?
PET stands for Positron Emission Tomography. In a PET scan, radioactive glucose, or sugar, is injected into the patient’s vein. Because cancers use sugar much faster than normal tissues, the cancerous tissue accumulates more of the radioactive material than normal cells. A scanner can identify the radioactive deposits. This test can be useful for detecting cancer that has spread beyond the testicles. Often the PET scan is combined with a CT scan. This combination can help your provider determine whether or not abnormalities found on the CT scan are cancer.

How is testicular cancer treated?
The three most commonly used methods for treating testicular cancer are surgery, radiation therapy, and chemotherapy. Surgery is used to remove the cancerous testicle or, in some cases, both testicles. This procedure is known as a radical inguinal orchiectomy. Radiation therapy uses high-energy radiation to kill cancer cells. When treating testicular cancer, radiation is used primarily to destroy cancer cells that have spread to lymph nodes. Chemotherapy uses special drugs to destroy cancer cells. Usually the drugs are given intravenously, although some chemotherapy drugs can be taken orally.

How does testicular cancer affect fertility?
Testicular cancer or its treatment can make a man infertile. Before treatment starts, men who wish to have children later may decide to save sperm in a sperm bank for future use. In some cases, this may be difficult because testicular cancer can cause low sperm counts. If one testicle remains, fertility may return, either temporarily or permanently after treatment. If both testicles are removed, sperm cells cannot be produced and a man becomes infertile.

What is hypogonadism?
Hypogonadism is a condition that occurs when a man’s testicles do not produce an adequate supply of testosterone. Primary hypogonadism occurs when there is an abnormality in the testicles themselves. Secondary hypogonadism occurs when there is a problem with the pituitary gland in the brain, which sends chemical messages to the testicles to produce testosterone.

When it occurs in adult men, hypogonadism may cause the following problems:

  • A painless lump or swelling in either testicle
  • A change in how the testicle feels
  • A dull ache in the lower abdomen or the groin
  • A sudden build-up of fluid in the scrotum
  • Pain or discomfort in a testicle or in the scrotum
  • Erectile dysfunction, or the inability to achieve or maintain an erection
  • Infertility
  • Decreased sex drive
  • Decrease in beard and growth of body hair
  • Decrease in size or firmness of the testicles
  • Decrease in muscle mass and an increase in body fat
  • Enlarged male breast tissue
  • Mental and emotional symptoms similar to those of menopause in women, such as hot flashes, mood swings, irritability, depression, and fatigue