THIS week I answer two questions from readers on the subject of bladder issues. As always, my advice reflects current guidelines and practice, but cannot be a substitute for consulting your own GP.
Question – Do I need to be screened for prostate cancer. I don’t think I have any symptoms and I’m not aware of anyone in my family with it, but it’s all my mates seem to talk about. – Ryan, 48
Answer – Routine screening is not recommended for any male without symptoms, unless they have a strong family history of prostate cancer. This means a first degree relative like father or brother who developed the disease at an early age. If your father had prostate cancer at 70, this would not cause the same concern as if he had developed it in his 50s.
The prostate is a donut shaped structure, with the water pipe (urethra) passing through the hole in this donut. With age, the prostate enlarges, such that the hole gets narrower and the pipe gets nipped.
Benign prostatic hypertrophy (BPH) symptoms are struggling to start passing urine, a poor flow and dribbling at the end. You may also notice that you need to get up several times a night because of the urge to urinate.
In the early stages the symptoms of prostate cancer and BPH are similar hence the importance of not ignoring these.
Testing for prostate issues requires a blood test and a rectal examination.
The reason we do not routinely screen for prostate cancer is because at 50, half of men will have some abnormal/cancerous cells in the prostate and at 80, this increases to four fifths.
If you don’t have symptoms, it is likely that it is a disease you will die with, rather than from.
Question – I seem to be struggling with a lot of water infections. But every time I send in a water sample, I’m told its clear. How can that be? I went through the menopause at 50 – Kate. 54
Answer – As you helpfully mention, you had your menopause at 50. The tissues of the vagina, bladder and urethra (water pipe) may suffer as a result of reduced levels of oestrogen.
Sufferers may report vaginal dryness, difficulty with sexual intercourse, and cystitis, but a urine sample may show no sign of infection. If this occurs regularly it may be worth a trial of oestrogen pessaries.
Pain passing urine, a low-down dragging sensation, needing to pass urine frequently with a feeling that you still need to go, fever and low back pain may all suggest a urinary tract infection (UTI).
These should not be ignored. Ideally a urine sample positive for infection should be obtained to reduce antibiotic use. However, if you are unwell or frequently get UTIs, it may be appropriate to issue a prescription immediately.
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