Who do we recommend should have a prostate check-up ?

All men aged more than 50 years can benefit from a general urological review. If the man have a family background of cancer of the prostate, we suggest such reviews should begin at 40 years of age.

What are the possible diseases the urologist looks for in a prostate check-up?

The main object is to discount two disorders: prostate cancer and benign hyperplasia of the prostate. However, in the same check-up, the doctor also investigates other disorders including infections, lithiasis, and erectile dysfunction.

Why do you recommend the earliest possible detection of prostate cancer?

The implementation of programs designed for the early detection of prostate cancer is currently a very controversial topic in urology; in Spain, the total number of men who could potentially benefit from of this program exceeds five million. Various programs of early detection, among them that proposed by the American Cancer Society, have demonstrated that between 85% and 93% of all the cancers detectable with current methods are of clinical importance; that is, they have a significant probability of progressing and causing harm to the individual. In this case, the tumours detected by applying the PSA (prostate-specific antigen) test have a greater probability of being confined to the organ. When a man is enrolled in a detection program, if he has prostate cancer this is detected in an earlier phase than when he is symptomatic.

What is benign hyperplasia of the prostate and why do you recommend that a man should be assessed for this possible disorder?

Benign hyperplasia of the prostate (HBP) is the most frequent benign tumour in men aged 50 years or more, and the second most frequent cause of admission for surgery. As the prostate grows, it can progressively compress the urethra, thereby causing difficulty in urinating. This happens because the compression impedes the flow of urine from the bladder along the urethra to the exterior. The possible consequences are the retention of urine in the bladder or the reflux of urine back towards the kidneys, and the need to urinate more frequently than normal. If the inflammation is very serious, the urinary system may be blocked completely. It is very rare for this disorder to occur before the age of 40 years, but more than half of men with aged 60 or more years, and more than 90 % of those aged between 70 and 80 years, present some symptoms of benign hyperplasia of the prostate.

For this reason, we recommend that all men older than 50 should have a clinical assessment. In fact, 70% of men older than 70 develop this disorder, and of these between 35% and 40% will suffer disease of the prostate due to this benign tumour.

What does the prostate check-up consist of?

In our centre we perform prostate check-up that include all the following:

• Clinical history and IPSS questionnaire (International Prostatic Symptoms Score, which measures urinary symptoms and quality of life, and is validated by the WHO).
• Physical exploration and digital rectal exploration
• Urological ultrasound scan (prostate, bladder and kidneys)
• Uroflowmetry
• Analytical
  • Analysis of the urine
  • Creatinine in blood
  • PSA in blood (total and free on occasions)
• Urological health advice