June 13, 2016

Prostate Check – How to Tell When You Should Worry

By Jason Schneider

June is Men’s Health Month — a good time to think about something you probably don’t think about too often: your prostate.

“Typically, men aged 50 and above are at risk for prostate issues,” said Brian L. Cohen, MD, MPH, of Victoria Urological Associates, an affiliate of Mission Health. “As men get older, prostates typically will enlarge. We will see men in their 40s with some difficulty voiding [their bladder] due to an enlarged prostate, but this certainly becomes more common as men age into their 50s and above.”

Symptoms of an enlarged prostate include:

  • Difficulty initiating the urine stream (hesitancy)
  • Straining to empty the bladder
  • Weak or intermittent stream
  • Incomplete emptying of the bladder
  • Waking at night to urinate (nocturia)
  • Increased daytime urination frequency and/or urgency

“When we see patients with symptoms due to an enlarged prostate, the first thing we must determine is how much of a bother this is to their quality of life,” said Dr. Cohen. “For men that are minimally bothered and are able to empty their bladder, observation may be reasonable. For other men, a discussion about medications and surgical procedures is often necessary in order to improve the quality of life due to the enlarged prostate symptoms.”

Dr. Cohen said a lot of men are choosing a minimally invasive office procedure called Urolift® as a first-line treatment along with medications. Urolift® lifts and holds enlarged prostate tissue out of the way so it doesn’t block the urethra.

“The key is trying to determine who may need treatment and who does not, and making sure they are comfortable with the therapies that are offered,” said Dr. Cohen.

How often should you have your prostate checked?

The American Cancer Society recommends talking with your healthcare provider about prostate cancer screenings, taking into account your medical history and risk factors. They suggest having this discussion at:

  • Age 50 for men at average risk and who are expected to live at least 10 more years
  • Age 45 for men at high risk, including African Americans with a first-degree relative (father, brother or son) diagnosed with prostate cancer before age 65
  • Age 40 for men at even higher risk, such as those with more than one first-degree relative who had prostate cancer at an early age

Brian L. Cohen, MD, MPH, is urologist at Victoria Urological Associates, an affiliate of Mission Health. (828) 254-8883


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