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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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The prostate gland is a chestnut-shaped gland that is located at the base of the bladder and surrounds the urethra that allows urine to pass out of the bladder. The prostate is actually made up of multiple small glands that produce a milky-white fluid secreted into the urethra when a man ejaculates sperm through the urethra; the fluid and sperm mixture is known as semen or ejaculate. A normal prostate gland is small and soft when digitally palpated during a rectal examination.

Benign prostatic hyperplasia (BPH) is the abnormal proliferation of prostate cells (non-cancerous) and usually cause progressive enlargement of the prostate gland. The most common clinical manifestation of BPH is a set of voiding dysfunctions due to the squeezing pressure on the urethra. Untreated, obstruction resulting from BPH can lead to slow, intermittent urinary flow or acute urinary retention, which can require surgical interventions such as transurethral resection of the prostate (TURP) or prostatectomy. BPH is not a source of prostatic cancer. Usually, BPH can be managed medically with medications such as alpha-blockers and 5-alpha reductase inhibitors. In BPH, the gland is often enlarged and soft or "boggy" when digitally palpated during a rectal exam.

Prostatic cancer is a disease in which cells of the prostate gland become abnormal and start to grow uncontrollably, forming tumors in the prostate and in some men, prostate cell tumors in other organs, especially the bones. Prostatic cancer can have the same symptoms as BPH, but if the tumors proliferate, can cause death. In prostate cancer, the gland may be enlarged and have firm or hard areas when digitally palpated during a rectal exam

Men, please note the last sentence in the above three paragraphs. Yes, you should get a digital rectal examination done as part of any man's yearly physical exam especially after age 50; for some men at higher risk (African American men and men that have a family history of prostate cancer) they should get routine digital exams starting at age 40 or even earlier. Not getting the digital exam is like driving any type of used or "vintage" car in California through the mountains, deserts, and seashore for years and never stopping to check the oil level (another imperfect analogy).

Treatment for BPH ranges from watchful waiting (no treatment, observation ) to medication to reduce symptoms or surgery. Treatment for prostatic cancer ranges from watchful waiting (no treatment, observation), to surgery, radiation therapy, hormone therapy, chemotherapy and biologic therapy while new treatments are being developed (cryotherapy, high intensity ultrasound, and proton beam therapy).

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