Prostate problems
Diseases of the prostate gland are extremely common, and can cause a lot of distress and anxiety to patients and their families. The commonest prostate problems are:
Mr Malde offers a high-quality and rapid service to investigate and manage problems related to the prostate gland. Urgent appointments can be booked at any of his private urology clinics near you.
Prostate enlargement (benign prostatic hyperplasia)
What is the prostate?
Prostate problems are common in men, especially over the age of 50. The prostate gland is a small chestnut-sized gland that sits just beneath the bladder and surrounds the first part of the water pipe (urethra). The main function of the prostate is to produce chemicals that nourish and protect the sperm and help with fertilisation.
What is benign prostatic hyperplasia (BPH)?
Enlargement of the prostate gland is considered a normal part of the ageing process and is caused by the male hormone testosterone. This growth of the prostate with age is not cancerous and is known as benign prostatic hyperplasia (BPH). Half of all men aged 65 will have evidence of BPH and this proportion increases further with age. Not all men with an enlarged prostate will experience symptoms and the severity of symptoms is not related to the size of your prostate (even a mild enlargement can cause symptoms in some men).
What are the symptoms of BPH?
As the prostate gland enlarges it may put pressure on the urethra. It can lead to symptoms such as:
Difficulty starting your urine flow
A weak urine flow or causing it to ‘stop and start’
A feeling that you do not empty your bladder completely
A need to strain to pass urine
A need to urinate more frequently
Waking up frequently during the night to pass urine (nocturia)
A sudden urge to urinate, which can result in leakage if you cannot get to the toilet quickly enough
Recurrent urinary infections
What should I do if I have any of these symptoms?
Although these symptoms are commonly caused by BPH, there are a number of other conditions that can also cause the symptoms described above. A detailed assessment is required to identify the underlying cause of your symptoms and to treat them most effectively. You should therefore contact us for further investigation and treatment.
Mr Malde offers specialist appointments for further investigation and treatment at his private urology clinics across London.
How can BPH be treated?
There are a number of treatment options depending upon the underlying cause. General measures that may improve your quality of life include fluid and diet modification, double voiding techniques and bladder training. If these measures fail, you may require medications to help relax the muscular part of the prostate and reduce the size of the prostate gland.
Surgery is recommended if your symptoms are very bothersome and do not improve with medications or if you have developed other complications due to BPH (urinary tract infections, blood in the urine, kidney failure, bladder stones). The procedure is minimally-invasive and is performed through a telescope that is passed into your water pipe under anaesthesia. Depending on the underlying cause, the prostate or bladder neck can then be treated (transurethral resection of the prostate or bladder neck incision).
How we can help you
Mr Malde specialises in the investigation and treatment of men with urinary symptoms. You will undergo a detailed history and physical examination. Further urology tests include an examination of the prostate, PSA test, blood tests to check kidney function and urine tests to exclude infection. He will undertake urinary flow tests and urodynamic tests to accurately identify the cause of your urinary symptoms where appropriate, prior to treatment. An ultrasound scan to check the kidneys and to measure the size of the prostate is also performed.
He performs specialist minimally-invasive surgery to treat benign prostatic enlargement or to treat a tight bladder neck, using newer technology to reduce blood loss and complications compared to standard transurethral resection of the prostate (TURP).
Mr Malde provides first-class urological care in his specialist private urology clinics across London.
Prostatitis
What is prostatitis?
Prostatitis is inflammation of the prostate gland, a chestnut-sized gland that sits just beneath the bladder. It can occur in men of all ages although is commonest in men under the age of 50 years. There are four types of prostatitis:
Acute bacterial prostatitis
Chronic bacterial prostatitis
Chronic pelvic pain syndrome
Asymptomatic prostatitis
If the symptoms come on very quickly this is known as acute prostatitis. If they come on more gradually or come and go over a period of months, this is known as chronic prostatitis. If the symptoms occur in the absence of proven infection, this is known as chronic pelvic pain syndrome. In some cases, the prostatitis causes no symptoms and is found by chance on prostate biopsy specimens. This is known as asymptomatic prostatitis.
What causes prostatitis?
Prostatitis can be caused by a bacterial infection or can occur in the absence of an infection.
Risk factors include recurrent urinary tract infections, sexually-transmitted infections, indwelling urinary catheters, disorders affecting bladder emptying and previous prostate surgery or biopsy.
What are the symptoms of prostatitis?
Prostatitis can cause a wide range of symptoms which vary between individuals. Common symptoms include:
Pain around your testicles, penis, anus, lower back and lower abdomen
Pain on passing urine
Difficulty passing urine
Pain on ejaculation
Fevers, chills
Joint pains
Feeling generally unwell
How can prostatitis be treated?
Treatment depends on the underlying cause and so you should undergo a full assessment to target treatments most effectively.
Mr Malde offers specialist appointments for further investigation and treatment at his private urology clinics across London.
How we can help you
Mr Malde provides a comprehensive assessment for men with suspected prostatitis in order to rule out other conditions and treat symptoms most effectively. He offers high-quality urology care in his leading private urology clinics across London. The assessment will include a detailed medical history and physical examination, including examination of the prostate. Urine and semen samples will be analysed for signs of infection and a urine flow test will be performed to ensure your bladder is emptying normally. Further investigations such as blood tests, state-of-the-art CT or MRI scans and urodynamic tests may also be undertaken if required.
Prostate assessment for prostate cancer
What is the prostate?
The prostate gland is a small chestnut-sized gland that sits just beneath the bladder and surrounds the first part of the water pipe (urethra). The main function of the prostate is to produce chemicals that nourish and protect the sperm and help with fertilisation.
What is prostate cancer?
Prostate cancer is the commonest cancer in men, affecting about one in eight men in the UK at some point in their lives. The risk of prostate cancer increases with age (especially over 50 years old) and it may not produce any symptoms until it is at an advanced stage.
What causes prostate cancer?
The exact reason why a prostate cell becomes cancerous is unclear. It is thought that something damages the genes in the cell and this causes it to multiply out of control. Risk factors for prostate cancer include:
Increasing age
A history of other family members (brothers, father, uncles) having prostate cancer
Race - it is more common in Afro-Caribbean men
How can prostate cancer be diagnosed?
If you are worried about prostate cancer you should seek medical advice to have further urology tests performed. The prostate specific antigen (PSA) blood test can help to assess your risk of prostate cancer and a multiparametric MRI scan will help to identify any abnormal areas in your prostate. If there is a suspicion of prostate cancer you will be recommended to have a prostate biopsy (taking small samples of tissue from your prostate) to check for cancerous cells.
Mr Malde offers specialist appointments for further investigation and treatment at his private urology clinics across London.
How can prostate cancer be treated?
The treatment for prostate cancer depends on how aggressive the cancer cells are, whether they have spread outside the prostate and your general health. You will have a full discussion regarding pros and cons of all the available options in your particular case at your consultation.
How we can help you
Mr Malde offers a rapid service to see patients worried about the risk of prostate cancer or those with elevated PSA levels.
He will perform a thorough history and detailed physical examination, including examination of your prostate gland. Mr Malde will perform urine tests to rule out infection and perform blood tests including PSA. If elevated, you will require a state-of-the-art MRI scan and biopsies of your prostate.
Mr Malde provides first-class urological care in his specialist private urology clinics across London.