EN 
AR The prostate is a cone-shaped organ with an upward base surrounding the posterior urethra in the space between the neck of the bladder and the external valve that governs urine. It is penetrated by the last part of the spermatic cord and the ejaculatory ducts that transport semen to its natural exit from the penis. It secretes prostate fluid, which contributes 20% of the components of semen.
The prostate begins to grow in the fifth week of the fetus’s life, and the growth process proceeds very slowly until puberty. It increases rapidly in size over the course of months to reach full size and function, and its size reaches an average of 15-20 grams after puberty. By the middle of the fourth decade of life, the prostate either begins to gradually increase in size (senile enlargement) or gradually atrophy.
Diseases that may affect the prostate include acute and chronic inflammation, and an abscess may form in the prostate. There is senile enlargement of the prostate, as well as cancerous tumors.
Prostate diseases often affect the process of urination to varying degrees, and they all share what are called symptoms of lower urinary tract disorders (LUTS) to varying degrees, but in many cases prostate diseases are silent, without pathological symptoms, and are discovered incidentally during periodic examination. This is why it is recommended for men, especially at the beginning of the fourth decade of life, to periodically examine the prostate for maintenance and early detection of diseases, and not for treatment only when symptoms are present.
Firstly,prostatitis: –
It is a common disease, as prostatitis represents 8% of all visitors to urology clinics, and statistics indicate that 50% of men are exposed to prostatitis at some point in their lives. Inflammation may be acute or chronic. It may be caused by some types of bacteria and is called bacterial prostatitis, but in many cases the inflammation is non-bacterial, caused by some viruses and microorganisms, or it has no known cause at all and is called chronic pelvic pain caused by the prostate. These cases require careful examination to rule out all possible causes of these symptoms before Jump to this diagnosis.
Secondly, prostate abscess: –
It often results from a bacterial infection and is accompanied by severe pain in the perineum and lower back, burning and frequent urination, and sometimes leads to retention and may be accompanied by general illness symptoms.
Thirdly, senile enlargement of the prostate: –
It is one of the most common diseases in men in the fourth decade of life. Modern statistics indicate that the infection occurs in 30% of men aged 40-50 years and gradually increases to 50% of men aged 50-60 years and reaches 80% of men 70-80 years old. Symptoms range from disturbances in the urination process, such as an increased frequency of urination and a feeling of incomplete emptying of the bladder, to weak and difficult urinary flow, and sometimes up to acute or chronic urinary retention. The patient may be exposed to complications such as recurrent urinary tract infections and urinary bleeding, which may lead in some cases to a deficiency in kidney function.
Fourthly, prostate cancer: –
It represents the most common cancer that affects men and is the second cause of death from cancer in men after lung cancer. Symptoms of the disease often appear in the fifth decade of life, and the incidence increases with age. However, recent studies have proven that it begins at an early stage of life and symptoms do not appear until the fifth or sixth decade. Prostate cancer may be silent, with no symptoms at all in its initial stages, but it expresses itself in a dramatic, violent and sudden manner, such as obstructive urination symptoms, urinary bleeding, and excruciating pain, especially in the bones, in its later stages.
To diagnose the various diseases that affect the prostate, the following procedures must be followed:
Studying the patient’s history in detail and carefully, as well as the family’s medical history. It was found, for example, that if there is prostate cancer in one of the patient’s first-degree relatives, the probability of him contracting the same disease increases to two times, and the probability increases to nine times if there are more than two cases of prostate cancer in a first-degree relative.
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- Clinical examination of the patient, especially the rectal examination of the prostate, which every doctor must insist on (and which many patients in our Arab societies do not accept) because of the utmost importance it represents. This examination may be the key to the initial diagnosis of prostate cancer.
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- Follow the international symptom scale adopted by the World Health Organization and various urological societies to evaluate prostate symptoms, at the patient’s first visit and at all follow-up times, and take it as a basic measure in determining diagnostic and therapeutic procedures.
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- Gradual diagnostic examinations must be performed that are appropriate for each individual case, which may include analyses, x-rays, bladder scans, urination dynamics, and prostate x-rays through the anus or laparoscope.
Every man, at the age of forty, must undergo a prostate tumor marker analysis (P.S.A.) every year for early detection of prostate cancer, and this matter must not be neglected because early diagnosis leads to simple and curative treatment, God willing, before complications occur. This analysis is performed for patients at any age, even in Young men if there is any abnormality in the nature of the prostate tissue during the anal examination. It is also recommended to monitor the results of treatment in cases of prostate cancer.
With the third millennium and the introduction of modern technologies in diagnosis and treatment, methods of treating prostate diseases, medicinal and non-surgical, as well as surgical treatment, have developed significantly. To talk about the method of treatment and its modern techniques is an upcoming article, God willing.
Dr. Nabih Karim
Consultant in Urology and Andrology