If you are over 45 — or your father is — there is one small gland you should understand before it ever gives you trouble. As a urologist in Lucknow at Medanta Hospital, I see the same story every week in my OPD: a man who ignored night-time urination for two years, or a family that assumed "weak flow" was just age. Almost none of them could tell me what the prostate actually is. This article — and the Hindi video below — fixes that in about thirteen minutes, without medical jargon.
This is awareness, not treatment. Nothing here replaces a consultation. The goal is simpler: that you or your loved one reach the right doctor at the right time.
What is the prostate, and where is it?
The prostate is a small gland found only in men. In a young adult it is about the size of a walnut and weighs roughly 20 grams. It sits just below the bladder and in front of the rectum, and — this is the important part — it wraps around the urethra, the tube that carries urine out of the body.
That position explains almost every prostate symptom you will ever hear about. When the gland grows or swells, it squeezes the urethra from the outside, like a hand tightening around a garden hose. The bladder then has to work harder to push urine through a narrower channel.
What does the prostate actually do? Two jobs
- It makes fluid for semen. Prostatic fluid forms roughly a fifth to a third of the total volume of semen. It nourishes sperm and protects them on their journey, which is why the prostate matters for fertility.
- It helps with ejaculation and keeps urine and semen separate. The gland contains muscle fibres that contract during ejaculation, and it works with the bladder neck so that urine does not flow at the wrong moment.
Notice what is not on that list: the prostate has no role in passing urine. It only sits next to the urinary passage. That is why its problems show up as urinary symptoms even though it is a reproductive organ.
What happens to the prostate as you age?
The prostate is one of the few organs that keeps growing through adult life. Under the influence of male hormones, it begins to enlarge slowly from around the age of 40. Microscopic enlargement is found in about half of men by age 60 and in the large majority of men in their 80s. Growth itself is not a disease — but because the gland surrounds the urethra, even benign growth can start to obstruct urine flow. This is why 45 is a sensible age to start paying attention.
The three problems a prostate can have
Almost everything that goes wrong with the prostate falls into one of three categories. They are very different conditions, and confusing them causes needless fear.
Problem #1 — Benign prostatic hyperplasia (BPH)
BPH is the medical name for a non-cancerous enlarged prostate. It is by far the most common prostate problem in men over 50. The word benign is the key: BPH is not cancer and does not turn into cancer. It is a plumbing problem — a growing gland pressing on the urethra — and it is treated according to how much it bothers you. Lifestyle changes and tablets help many men. For those with persistent obstruction, modern options such as HoLEP laser prostate surgery or Rezum water-vapour therapy can restore normal flow without open surgery. You can read more about all the options on our prostate treatment in Lucknow page.
Problem #2 — Prostatitis
Prostatitis means inflammation of the prostate, sometimes from a bacterial infection and sometimes without any infection at all. Unlike BPH, it can affect younger men in their 20s, 30s and 40s. It tends to announce itself more loudly: burning while passing urine, pain in the pelvis, the lower back or between the legs, and — in the acute bacterial form — sudden fever and chills. Acute prostatitis needs prompt antibiotic treatment; chronic prostatitis needs a patient, structured approach rather than repeated courses of antibiotics.
Problem #3 — Prostate cancer
Prostate cancer is among the most common cancers in men worldwide, and Indian urban cancer registries show its incidence steadily rising. Two facts about it matter more than anything else. First, many prostate cancers grow slowly, and when found early they are highly treatable — with excellent long-term outcomes, including robotic prostatectomy where surgery is needed. Second, and this is the uncomfortable part: early prostate cancer usually causes no symptoms at all. By the time it causes urinary trouble or bone pain, it may already have spread. This is exactly why doctors talk about PSA testing — the subject of my next video. If you want to understand the advanced form of the disease, I have written about metastatic prostate cancer separately.
When should you see a doctor? Five signs
You do not need to self-diagnose which of the three problems you have. That is the urologist's job. Your job is to notice these signs and act on them rather than wait:
- Getting up two or more times a night to urinate, especially if this is new or getting worse.
- A weak, slow or interrupted stream, or having to strain and wait for urine to start.
- A feeling that the bladder never empties, sudden urgency, or dribbling after you finish.
- Blood in the urine or in the semen — even once, even if painless.
- Burning, fever, or pain in the pelvis, lower back or perineum, particularly with any of the above.
And one emergency: if you suddenly cannot pass urine at all, do not wait for morning. Go to the nearest hospital — this is called acute urinary retention and it needs a catheter the same day.
What about the PSA test?
PSA (prostate-specific antigen) is a simple blood test that is often the first clue to prostate cancer, but it is also one of the most misunderstood tests in medicine. A raised PSA does not mean cancer, and a normal PSA does not fully rule it out. Who should be tested, at what age, how often, and what to do with the result deserves its own detailed explanation — which is why it is the subject of the next video in this series. Subscribe on YouTube if you want to be notified.
Watch the full Hindi explainer
The video below covers everything in this article in spoken Hindi, in about 13 minutes, with chapters so you can jump to the part you need — what the prostate is, its two jobs, what changes with age, the three problems, and the five signs. Share it with your father, your brother, or a friend who has been "managing" his symptoms quietly.
A note on the evidence
The medical content in this article and the video follows current international guidelines rather than opinion: the European Association of Urology (EAU) guidelines on male lower urinary tract symptoms (2025) and on prostate cancer (2024), the American Urological Association (AUA) guideline on BPH (2023 amendment), the NCCN prostate cancer guidelines (2025), and GLOBOCAN 2022 cancer statistics. Where guidelines differ from common practice in India, I say so in the video.
Key takeaway
The prostate is a walnut-sized gland below the bladder that wraps around the urine pipe. It grows with age, and its three problems — BPH, prostatitis and cancer — are different conditions with different treatments. Night-time urination, a weak stream, incomplete emptying, blood in urine or semen, and pain or fever are the five signs to act on. If any of them apply to you or someone you love in Lucknow, book a consultation — an early visit is a short conversation; a late one is a much longer road.
About Dr Manmeet Singh
Dr Manmeet Singh, MS, MCh (SGPGIMS Lucknow), is Director of Urology, Robotics & Kidney Transplant at Medanta Hospital, Lucknow, and was previously faculty at King George's Medical University. He treats the full range of prostate conditions — from medication and minimally invasive BPH procedures to robotic surgery for prostate cancer — and publishes weekly evidence-based Hindi and English videos on urology. Website: urologybymanmeet.com