Prostate – common conditions

Key points about common prostate problems

  • The prostate is a small gland found in men. It secretes a milky fluid to nourish sperm in the semen.
  • Prostate problems are common, especially in men aged over 50 years as prostates get bigger with age. 
  • Sometimes it can also become swollen and enlarged causing conditions such as prostatitis and benign prostatic hyperplasia. Prostate cancer can occur without significant swelling.
  • The symptoms of all these conditions can include poor flow of urine (pee), difficulty starting or stopping peeing, a sudden need to pee, having to go more frequently in the day and night or pain when peeing.
  • See your healthcare provider to get checked if you have any of these symptoms.
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The prostate is a small gland found in men. It is about the size of a walnut, lies just below your bladder and surrounds the tube (urethra) that drains urine (pee) from your bladder. Symptoms relating to peeing occur because your prostate is so close to your bladder.

Your prostate’s job is to secrete a milky fluid, which becomes part of the semen and nourishes the sperm. Your prostate also produces an enzyme called prostate specific antigen PSA). A PSA test is used to diagnose prostate symptoms.

The symptoms of common conditions that affect the prostate can be quite similar.

Common symptoms include:

  • poor or weak flow of urine (pee)
  • difficulty starting urination (hesitancy)
  • difficulty stopping the flow of urine (terminal dribbling)
  • incontinence (wetting yourself)
  • having to go more frequently even though flow is poor
  • painful urination or burning feeling when peeing
  • getting up at night to go the toilet more than once
  • having a sense of urgency to pass urine
  • blood in your pee
  • pain during sex
  • pain in your thighs, lower back and hips occasionally.

If you have any of the symptoms above, see your GP (doctor) to get checked.

Your prostate tends to get bigger as you get older. Sometimes it can also become swollen and enlarged. This can cause the following conditions:

  • Prostatitis – the swelling and inflammation of the prostate due to any cause.
  • Benign prostatic hyperplasia (BPH) – the gradual enlargement of the prostate as men age. This often causes urinary problems but this is not due to cancer.
  • Prostate cancer – this can be life-threatening, particularly if it spreads beyond your prostate. However, in older men prostate cancer is often slow-growing and may not require treatment.


Prostatitis is the swelling or inflammation of the prostate gland. There are 2 types of prostatitis – chronic or acute prostatitis. Chronic prostatitis is the most common type of prostatitis. Its symptoms develop slowly and usually last more than 3 months. Acute prostatitis is less common but  symptoms can be more serious. It comes on suddenly and lasts for a shorter time. Read more about prostatitis.

Benign prostatic hyperplasia 

Benign prostatic hyperplasia (BPH) is a normal, gradual enlargement of your prostate. It is caused by hormonal effects. It usually starts in middle age. The condition is very common, especially with increasing age. It affects half of all men over 50 and three-quarters of those over 70 years. BPH does not lead to cancer. Read more about benign prostatic hyperplasia.

Prostate cancer

Prostate cancer is the most common type of cancer for New Zealand men. Prostate cancer is caused when some of the cells within your prostate gland start to grow out of control, invading and destroying healthy cells.

Some prostate cancers are slow growing and will never cause problems. Others are faster growing, can cause serious symptoms or even be life threatening.

Prostate cancer is most common in men aged over 50, but is more likely to cause problems if you get it when you are younger. Early diagnosis is essential to its management. Read more about prostate cancer.

Your doctor will ask you questions related to your symptoms and examine your prostate. They will usually perform an examination called digital rectal examination (DRE). This involves inserting a finger with a glove into your anus to feel your prostate through the wall of your rectum. They will check if your prostate is hard or soft, as well as the size and shape of your prostate.

Your GP or doctor may also order some of the following tests, depending on what they think is causing your problem:

  • A blood test called prostate specific antigen (PSA) – PSA is a protein made by your prostate. Higher than normal levels can occur when there is a problem with your prostate, such as an infection, an enlarged prostate or prostate cancer.
  • A urine test – this is done to check for possible infection.
  • Biopsy – this is a procedure in which a small sample of your prostate gland cells are taken for examination to check for cancer.

Your doctor will let you know if you need these tests to diagnose your condition. Talk to your doctor if you have any concerns or questions related to these tests.

Treatment will depend on the condition you have. For example, if you have prostatitis that is caused by an infection, it is treated with antibiotics. If you have prostate cancer, you will need to be referred to a specialist to discuss your next steps.

Talk to your doctor to find out the best treatment options for your condition. 

Apps reviewed by Healthify

You may find it useful to look at some Pain management apps, Pelvic floor exercise apps, Nutrition, exercise and weight management apps, and Self-management and healthy living apps.

Clinical pathways and guidelines

Diagnosis and management of prostate cancer in NZ men(external link) Ministry of Health, NZ, 2013
Prostate cancer management and referral guidance(external link) Ministry of Health, NZ, 2015
Urinary incontinence in adults(external link) BPAC, NZ, 2013
Prostatitis – diagnosis and treatment(external link) Australian Family Physician, Australia, 2013 
Lower urinary tract symptoms in men(external link) Patient Info, UK
The management of lower urinary tract symptoms in men(external link) The BMJ, UK, 2014 

See our page Men's health for healthcare professionals

Continuing professional development

Video: Goodfellow Unit Webinar: Benign prostate problems - beyond the basics

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(Goodfellow Unit Webinar, NZ, 2020)

Video: Goodfellow Unit Webinar: Common urological presentations

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(Goodfellow Unit Webinar, NZ, 2018)


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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Bryan Frost, FRNZCGP, Morrinsville

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