Get it checked! All about diagnosis for prostate problems

Written in association with: Mr Biju Nair
Published:
Edited by: Karolyn Judge

Whether prostate problems lead to a benign or cancerous diagnosis, it's always a good idea to get it checked. 

 

Here to discuss what's involved in prostate health assessment tests, how often should men undergo prostate health checks and what happens after a diagnosis, among many other interesting points, is leading consultant urologist Mr Biju Nair

Man with prostate problems looking concerned

Which tests are usually performed to assess prostate health? How are these tests performed?

 

You do blood tests to assess how the prostate is functioning, which is called a PSA. This is a synonym for prostate specific antigen. Prostatic health is collective testing where you look at PSA, other blood tests for renal parametres and also you do a flow test to see how the person is passing urine, especially if they're symptomatic.

 

Of all these tests, the PSA gives you a clue of whether the prostate is benign or cancerous

 

How often, and at what age, should men undergo prostate health checks?

 

According to the current evidence, there's a Scandinavian study that has shown it's best to check the PSA at 40. If the PSA at 40 is normal, which is 1.7 or under, then you wait until 50. If it's normal then, then unless you become symptomatic then you don't need to get it checked. If it's abnormal or if you have a family history of it; you're of Afro-Caribbean descent then you need it checked more frequently.

 

What are the signs and symptoms of prostate problems?

 

Quite a lot of the time, the prostate doesn't become symptomatic especially as prostate cancer is diagnosed with a blood test and a rectal exam, these days. 

 

The common symptoms of prostate problems are:

 

  • Urinary symptoms, where you notice changes in your urinary habits like you're going more frequently to the toilet, day time or night - there's sudden evidence of urgency;
  • sometimes there's blood in the urine, and;
  • sometimes there's blood in semen.

 

These are just heralding signs of something wrong with the prostate

 

What are the next steps after a diagnosis?

 

It all depends on whether it's benign or you're looking at cancer. If your PSA is high, you would get an MRI scan and then proceed to have a prostate biopsy for the diagnosis of prostate cancer

 

On the benign pathway, again PSA is important in terms that it would give you a clue of whether your symptoms would deteriorate much quicker than in a normal person. Then you'd assess the prostate with a rectal exam on both occasions (benign/cancer). In the benign set up, you'd do a flow study and what is known as a international prostate symptom score or an IPSS score, which is a guide to help you with management. 

 

Are there any lifestyle modifications which can help to maintain a healthy prostate?

 

Metabolic syndrome and prostate problems go hand in hand. If you're diabetic, you should get your sugar levels under control, if you have obesity you should lose weight, and if you're hypertensive, manage your blood pressure levels

 

Obesity and metabolic markers are quite important markers that could suggest that your prosthetic health can deteriorate. It's important that you look after yourself. 

 

 

 

If you're concerned about prostate problems and want to get them checked, arrange an appointment with Mr Nair via his Top Doctors profile

By Mr Biju Nair
Urology

Mr Biju Nair is a highly-experienced consultant urologist based in Newcastle-under-Lyme and Stafford, who specialises in kidney stones, prostate problems and prostate diagnosis alongside female urology, andrology and general urology. He privately practises at North Staffordshire Hospital and Rowley Hall Hospital while his NHS base is Royal Stoke University Hospital. 

Mr Nair has an impressive educational history. He has an MBBS and MS from the University of Kerala in India, a Diploma in Urology from the University of London and has completed fellowships in general surgery and urology. 

Mr Nair takes pride in his clinical achievements to date, with a detailed approach to his work. He has expertise in managing all complex stones and is currently involved in all aspects of treatment and follow up of urinary tract stones. The placement of PCNL tracts he undertakes are done by interventional radiology.

Mr Nair currently focussed on management of complex stones doing PCNL and FURS for upper tract stones and is the lead for prostate diagnostic services for his NHS trust. Alongside this, he does local anaesthetic trans-perineal prostate biopsies, manages prostate problems and is the sole clinician on his team conducting large prostate surgery.

Mr Nair has developed a special interest in prostate diagnosis, and has completed large numbers of TRUS and prostate biopsy procedures. He is also trained in Artemis-guided fusion biopsies of the prostate, is skilled in visual and cognitive targeting for prostate biopsies, and currently studying the transperineal prostate biopsy technique.

He also has significant expertise in erectile dysfunction management and does penile straightening surgery (Nesbitt's corporoplasty) for Peyronie's disease. Mr Nair also has expertise in surgically managing large prostates, management of all aspects of peno-scrotal surgery, and all general urological procedures. 

Mr Nair is also a respected leader in female urology. He has experience in treating urethral diverticulum, urethral mucosal prolapse and urethral caruncle alongside Skene's & Bartholin cyst surgery and fistula repair. He regularly performs continence procedures with the latest bulking agents (Bulkamid) and has extensive experience with intravesical Botox injections. 

Mr Nair is involved in clinical education and has been assigned the role of clinical supervisor for ST trainees at Royal Stoke University Hospital, while he's due to be involved in undergraduate teaching for third and fourth year students. Furthermore, he will be involved in the supervision of fifth year postgraduate medical students during their transition phase. 

He is fellow of the Royal College of Surgeons, Ireland, and the Royal College of Surgeons, as well as member of various professional organisations. These include the British Association of Urological Surgeons (BAUS), the General Medical Council (GMC), the British Medical Association (BMA) and the Medical Defence Union (MDU).

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