Prostate problems in Spain: causes, symptoms, diagnosis and treatment
Benign enlargement, prostatitis and cancer: what causes them, which symptoms to watch for, what a high PSA means and when a prostate check-up makes sense.
The most common prostate problems are benign prostatic hyperplasia, also known as an enlarged prostate, prostatitis and prostate cancer. The prostate is a walnut-sized gland that sits just below the bladder. Prostate cancer is the most frequently diagnosed cancer in men in Spain: an estimated 34,833 cases in 2026, according to SEOM and REDECAN, with five-year net survival of 90.2%. Catching it early changes the outlook. See a doctor if you have urinary symptoms, from the age of 50, or earlier if prostate cancer runs in your family.
Prostate problems
What the prostate is and which prostate problems are most common
The prostate surrounds the urethra just below the bladder and produces part of the fluid in semen. It changes size with age and can cause urinary, sexual or tumour-related problems.
Many men avoid talking about their prostate out of embarrassment, but these problems are common from middle age onwards and most can be treated if they are looked into in time.
- Benign prostatic hyperplasia (BPH). Non-cancerous growth of the gland, known as an enlarged prostate. It squeezes the urethra and makes passing urine harder. It is the most common benign tumour in men over 50.
- Prostatitis. Inflammation of the prostate, sometimes caused by an infection. It causes pain in the perineum, discomfort when passing urine and, in acute forms, fever.
- Prostate cancer. A malignant tumour. In its early stages it does not usually cause specific symptoms, which is why early detection matters.
Sources: AEU consensus 2010; CUN; AECC.
Data for Spain
The prostate in Spain: the 2026 figures
Prostate cancer is the most frequently diagnosed cancer in men in Spain, and benign hyperplasia is even more common.
- 34,833 new prostate cancer cases estimated for 2026
- 1 in 5 cancers diagnosed in men (34,833 of 168,764)
- 90.2% five-year net survival (diagnoses from 2013 to 2017)
- 50% histological prevalence of BPH in men in their fifties
According to the Spanish Society of Medical Oncology (SEOM) and the Spanish Network of Cancer Registries (REDECAN), 301,884 cancers will be diagnosed in Spain in 2026. In men, prostate cancer is ahead of colorectal, lung and bladder cancer. Cancer survival has doubled in 40 years; for the prostate it exceeds 90%, partly because PSA testing picks up many cases with a good prognosis.
The consensus document from the Spanish Association of Urology (AEU) with SEMERGEN, SEMG and semFYC reports a histological prevalence of BPH of 8% in men in their forties and 50% in men in their fifties, although only half of these men ever develop symptoms. A study of 1,804 men aged 40 or over living in Madrid (Actas Urológicas Españolas, 2009, data from 1999 and 2000) found moderate or severe urinary symptoms in 16.6%, three times more common from the age of 70.
Sources: SEOM-REDECAN 2026; AEU consensus 2010; Actas Urol Esp 2009.
Risk factors
Why they develop: causes and risk factors
Each prostate problem has its own origin, but age plays a part in all of them.
Benign hyperplasia
It is driven by the hormonal changes of ageing: inside the prostate, the enzyme 5-alpha-reductase converts testosterone into a hormone that stimulates the gland's growth. In the Madrid study, a family history of urological disease, age, high blood pressure and diabetes were linked to more severe symptoms.
Prostate cancer
- Age. It is rare before 50, and 60% of cases occur in men over 65.
- Family history. A father or brother with prostate cancer increases the risk; breast or ovarian cancer in the family also counts.
- Genetics. According to the Spanish Association Against Cancer (AECC), BRCA2 mutations are linked to a lifetime prostate cancer risk of 55%.
- Ethnic background. It is more common, and often more aggressive, in Black men.
- Lifestyle. It has been linked to diets high in animal fat and to obesity, without conclusive evidence.
Prostatitis
The bacterial form develops when germs reach the prostate through the urethra; other chronic forms are not always caused by an infection.
Sources: AEU consensus 2010; Actas Urol Esp 2009; AECC; CUN.
Symptoms
Symptoms: nocturia, a weak stream and when to book an appointment
Urinary symptoms are the most common and can be caused by any of the three problems.
- A weak or interrupted stream and straining to start passing urine
- Needing to pass urine often, especially at night (nocturia), and urgency
- A feeling of not emptying fully and dribbling at the end
- Burning or pain when passing urine or ejaculating, pelvic or perineal pain
- Blood in the urine (haematuria) or in the semen (haematospermia)
- In advanced cancer: localised bone pain, weight or appetite loss and anaemia
According to the AEU consensus, nocturia and a weak stream are the symptoms that affect quality of life the most. Early prostate cancer does not usually cause specific symptoms.
When to book an appointment: if urinary symptoms last more than a few weeks, if there is blood in your urine or semen, if prostate cancer runs in your family, or from the age of 50 even if you feel well. In our online Men's Health consultation a doctor assesses them by video call.
Sources: AEU consensus 2010; AECC.
Prostatitis
Prostatitis: symptoms and treatment of an inflamed prostate
Prostatitis is inflammation of the prostate gland. Unlike BPH and cancer, it is not limited to older men: it also affects young adults.
The most typical symptoms of an inflamed prostate are perineal pain, pain when passing urine and painful ejaculation; the University of Navarra Clinic (CUN) lists perineal pain as one of the most common.
- Acute bacterial. An infection with fever, feeling unwell and severe urinary discomfort.
- Chronic bacterial. Repeated infections of the prostate.
- Chronic pelvic pain syndrome. Pelvic or perineal pain lasting at least three months, with or without inflammation.
Treatment depends on the type: antibiotics when there is an infection (for 6 to 12 weeks in chronic forms), anti-inflammatories and lifestyle changes. Prostatitis can also raise PSA.
Diagnosis
How it is diagnosed and what a high PSA means
Diagnosis combines your medical history, an examination and simple tests; more complex tests are kept for specific cases.
| Test | What it shows |
|---|---|
| Medical history and IPSS questionnaire | Measures how severe the urinary symptoms are |
| Digital rectal examination | Size, consistency and possible nodules |
| PSA (prostate-specific antigen) blood test | Can rise with cancer, BPH or prostatitis; it is not a diagnosis on its own |
| Urine test and uroflowmetry | Rules out infection and blood; measures the strength of the stream |
| Ultrasound | Prostate volume and urine left in the bladder |
| Multiparametric MRI | Locates suspicious areas and helps avoid unnecessary biopsies |
| Targeted biopsy | Confirms cancer and how aggressive it is (ISUP grade group or Gleason) |
A high PSA does not mean cancer. The AECC points out that a large-volume hyperplasia, an infection or inflammation of the prostate, urinary retention or a catheter can also raise it, and that a normal PSA does not completely rule out a tumour. Your doctor interprets it alongside your symptoms, your age and the examination.
The AEU consensus recommends referral to urology when the digital rectal examination is abnormal, the IPSS score is above 20, PSA is above 10 ng/ml, or above 4 ng/ml with free PSA below 20%. Going on to further tests is an individual decision made with your doctor.
Sources: AECC, PSA; AEU consensus 2010.
Prevention
Prostate check-up: when to have one and why
Check-ups help detect tumours of the prostate, bladder or testicle in time, as well as benign problems such as BPH or erectile dysfunction.
“It is advisable for men aged 50 and over to have an annual urological check-up.” — Dr Daniel Gallego, urologist at Vithas Castellón
In the same article, Dr Gallego advises starting at 40 if there is a family history of prostate or kidney cancer. If you have symptoms, do not wait.
Screening: in Spain PSA testing is used opportunistically, without an organised population programme. The Ministry of Health assessed it in 2011, with unfavourable reports, and, based on the latest European recommendations, has requested an update; at the end of 2022 Member States were advised to study its feasibility. The European PRAISE-U project is testing risk-based screening (PSA, risk calculators, MRI and biopsy only when needed): in Ferrol (Galicia), as of March 2025, 7.2% of men in the pilot had a PSA above 3 ng/ml; in Manresa (Catalonia), 9.9% of participants.
A prostate check-up helps you decide with your doctor which tests are right for you: the AECC warns that PSA screening increases overdiagnosis and overtreatment of clinically insignificant tumours.
Sources: Valencia Plaza; Spanish Ministry of Health; Gac Sanit 2025; Gac Sanit 2026; AECC, PSA.
Treatment
Treatment of an enlarged prostate and prostate cancer
Treatment depends on the problem, how severe the symptoms are and each man's preferences.
Benign hyperplasia (enlarged prostate)
- Monitoring and lifestyle. With mild symptoms: being more active, drinking less fluid in the evening and cutting down on coffee and alcohol, with regular check-ups.
- Medicines. Alpha-blockers, which make it easier for urine to flow; 5-alpha-reductase inhibitors, which shrink the gland; or both.
- Surgery or minimally invasive techniques. Transurethral resection, laser or adenomectomy if medication is not enough or there is urinary retention, stones, repeated infections or kidney damage.
Prostate cancer
- Active surveillance for low-risk tumours: close monitoring with PSA, MRI or biopsies, and treatment only if the tumour progresses.
- Radical prostatectomy, often with robotic surgery, or external beam radiotherapy or brachytherapy.
- Hormone therapy and, in disease that has spread, chemotherapy and newer drugs.
- Targeted therapies, such as PARP inhibitors in men with BRCA1 or BRCA2 mutations, or radioligands such as 177Lu-PSMA in selected cases of advanced disease.
The decision is made by the urology and oncology team based on age, how aggressive the tumour is and the patient's preferences.
Sources: AEU consensus 2010; AECC.
Risks and myths
The risks of leaving it too late and myths about the prostate
Ignoring symptoms has consequences.
Cancer detected late can spread to the bones or lymph nodes and need more aggressive treatment. Untreated BPH can lead to acute urinary retention, repeated infections, bladder stones or kidney damage, as well as poorer sleep, sex life and mood.
Common myths
- “It only affects older men.” The risk rises with age, but prostatitis also affects young men.
- “A high PSA means cancer.” No: BPH or inflammation can also raise it.
- “BPH turns into cancer.” No. They are different conditions, although they can occur together.
- “No symptoms, no need to go.” Early cancer is usually silent.
- “Treatment ends your sex life.” It can affect it, but there are treatments and sexual rehabilitation.
Sources: AEU consensus 2010; AECC; AECC, PSA.
Sexual and emotional life
Fertility, sexuality and emotional wellbeing
The condition and its treatments can affect ejaculation, erections and desire, and also your mood.
- BPH medicines. Alpha-blockers can affect ejaculation. With 5-alpha-reductase inhibitors, the AEU consensus reports erectile dysfunction (5-7%) and reduced libido (3%). Do not stop them without medical advice.
- BPH surgery. Retrograde ejaculation is common: around 65-70% after transurethral resection.
- Radical prostatectomy. Semen is no longer produced, so natural fertility is not possible; erections often improve with rehabilitation.
- Radiotherapy and hormone therapy. These can reduce sperm and testosterone, with lower desire and weaker erections.
- If you want to become a father, ask about sperm freezing before treatment.
“Prostate cancer, whatever its stage, represents a break with the person's reality and has a profound social and emotional impact.” — Irene Lorente, psycho-oncologist at the Spanish National Prostate Cancer Association (ANCAP)
Benign problems also take their toll, for example through poor sleep caused by nocturia. Clear information, talking to your partner, psychological support or patient groups such as ANCAP or the AECC, and physical activity all help. Seek advice early if persistent low mood or insomnia appears.
Sources: AEU consensus 2010; AECC; Novartis-ANCAP.
Global Health
Online Men's Health consultation for prostate problems
Our Men's Health consultation is a convenient and confidential first step: a doctor registered in Spain sees you by secure video call.
- Assessment. Reviews your urinary and sexual symptoms, your history and your medication.
- Warning signs. Identifies what cannot wait.
- Tests. Can request blood and urine tests, such as PSA, and other tests when indicated.
- Plan. Explains your options and, if clinically indicated, issues the appropriate clinical documentation.
- Follow-up and referral. Goes through the results with you and, if needed, refers you to urology and coordinates the referral.
An online consultation does not allow a digital rectal examination or an ultrasound: if your case needs a physical examination, the doctor will tell you and arrange the appropriate in-person assessment.
Book your Men's Health consultation or first view the profile of Dr. Eduardo Daniel Rodríguez Olivas.
Next step
Talk to a doctor about your prostate
Book your online Men's Health consultation or get to know our doctors first.
- Online Men's Health consultation
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Urinary symptoms or questions about your prostate?
Book your Men's Health consultation with a doctor registered in Spain: an assessment by video call, a clear plan and referral to urology when needed.
Sources
Sources and editorial review
Sources consulted and verified on 18 October 2026.
The cancer figures come from the SEOM-REDECAN 2026 report; the BPH data from a consensus document and a study published in Actas Urológicas Españolas, some with older data; the screening data from Gaceta Sanitaria abstracts and the Spanish Ministry of Health; and the information on symptoms, PSA and treatments from the AECC and the University of Navarra Clinic. The quotes come from the linked press pages. This article does not replace an assessment by your doctor.
Frequently asked questions
Questions about prostate problems
At what age should I have a prostate check-up?
From the age of 50, from 40 if there is a family history of prostate or kidney cancer, and earlier if you have any urinary symptoms.
What does a high PSA mean?
That your prostate needs to be looked into, not that you have cancer: hyperplasia or prostatitis can also raise it. Your doctor decides whether further tests are needed.
What are the symptoms of prostatitis?
Pain in the perineum or pelvis, pain when passing urine, painful ejaculation and, in the acute form, fever.
Can prostate problems be prevented?
Not completely, but a healthy weight, exercise, not smoking and regular check-ups reduce the risks and support early detection.
Can prostate cancer be cured?
When detected early, it has a high chance of cure: five-year net survival is 90.2%, according to SEOM and REDECAN.
Who can see me first?
You can start with our online Men's Health consultation: a doctor registered in Spain assesses your symptoms by video call, can request tests such as PSA and, if needed, refers you to urology.
