Protecting Your Prostate

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As a urologist and andrologist, I often encounter patients and their loved ones who are eager to learn more about the intricacies of prostate health. The prostate, a small walnut-sized gland nestled beneath the bladder, plays a crucial role in men’s health, particularly in relation to urinary and sexual function. This article aims to equip women – whether they are daughters, wives, girlfriends or mothers – with essential knowledge about the prostate, its impact on men’s health and sex life, common conditions that affect it, and the treatments available.

THE PROSTATE’S ROLE IN MEN’S HEALTH
The prostate gland is an integral part of the male reproductive system. It produces seminal fluid, which nourishes and transports sperm during ejaculation. Thus, the prostate is often considered a sexual organ. Despite its small size, the prostate’s health can significantly influence a man’s overall well-being. As men age, the prostate can become susceptible to various conditions, which can impact urinary and sexual function. Understanding these conditions and their implications can help women to support the men in their lives more effectively.

PROSTATE HEALTH AND SEXUAL FUNCTION
The health of the prostate is closely linked to a man’s sexual function. Conditions affecting the prostate and their treatment can lead to issues such as erectile dysfunction (ED) and ejaculatory problems. For instance, benign prostatic hyperplasia (BPH) – a common condition in older men where the prostate enlarges – can exert pressure on the urethra, causing urinary problems. Men with BPH are more likely to experience problems with erection. Furthermore, common medications used to treat BPH may affect libido and sexual function.

Prostate cancer treatments, including surgery and radiation, can also impact sexual health. After treatment for prostate cancer, men might experience difficulties with erection or changes in ejaculation. Open communication and understanding are crucial during these times, as sexual health is deeply intertwined with the emotional and psychological well-being of men.

COMMON PROSTATE CONDITIONS

1. Benign Prostatic Hyperplasia (BPH)

BPH is a non-cancerous enlargement of the prostate.
Symptoms include frequent urination, a weak urine stream and difficulty starting urination.
BPH is a common part of ageing. Its symptoms can significantly affect a man’s quality of life. Men with BPH are also more likely to experience erection problems.

2. Prostatitis

Prostatitis is the inflammation of the prostate, often caused by infection.
It can lead to persistent pain in the private area (chronic pelvic pain) and discomfort during urination.
Chronic prostatitis can be more challenging to treat and may require long-term management.

3. Prostate Cancer

Prostate cancer is one of the most common cancers in men.
Early stages often present no symptoms, making regular screenings vital. PSA blood test is a useful way to detect prostate cancer.
Symptoms can include difficulty urinating, blood in urine or semen, and bone pain in advanced stages.
MRI scans and prostate biopsies are very useful in diagnosing prostate cancer. Both prostate biopsies through the skin (transperineal) and through the anus (transrectal) can be performed.

PROSTATE CARE AND PREVENTION

Proactive prostate care is essential for maintaining men’s health. Here are some strategies to support the men in your life:

1. Encourage Regular Screenings

Men over the age of 50 (or 45 for those with a family history) should have regular prostate exams and PSA (prostate-specific antigen) tests.
Early detection is crucial for managing conditions like prostate cancer effectively.

2. Promote a Healthy Diet

A diet rich in fruits, vegetables, whole grains and lean protein supports prostate health.
Foods high in antioxidants, like tomatoes and berries, are particularly beneficial.

3. Advocate for Regular Exercise

Regular physical activity helps to maintain a healthy weight, and reduces the risk of BPH and prostate cancer.
Exercise also improves cardiovascular health, which is closely linked to sexual function.

4. Reduce Risk Factors

Encourage your loved ones to avoid smoking and limit alcohol consumption.
Stress management techniques, such as yoga and meditation, can also be beneficial.

TREATMENT OPTIONS

Despite best efforts at prevention, prostate conditions can still develop. Here is an overview of the treatment options a urologist and andrologist can offer:

1. Medications for BPH

For BPH, medications like alpha-blockers can help to relax the muscles of the prostate and bladder neck, improving urine flow.
5-alpha reductase inhibitors can reduce the size of the prostate over time.

2. Minimally Invasive Procedures for BPH

Transurethral resection of the prostate (TURP) and laser therapies can effectively treat severe BPH. Newer day surgery therapies like water vapour therapy
(Rezum), prostate-lifting implants (Urolift) and microwave treatment (Prolieve) can also be used with quick recovery times in a low-risk setting.

3. Surgical Options for Prostate Cancer

For prostate cancer, options include radical prostatectomy (removal of the prostate gland), and less invasive laparoscopic and Da Vinci robot-assisted surgeries.
Cryotherapy and high-intensity focused ultrasound (HIFU) are techniques that may be suitable for selected patients requiring focal therapy.

4. Radiotherapy for Prostate Cancer

External beam radiation therapy (EBRT), brachytherapy (internal radiation) and proton therapy are available treatments for prostate cancer.
These treatments target cancer cells while minimising damage to surrounding tissues.

5. Hormone Therapy for Prostate Cancer

Hormone therapy can be used to treat prostate cancer by reducing levels of male hormones that fuel cancer growth.
It is often used in conjunction with other treatments or for advanced cancer.

6. Treatment for Prostatitis

Depending on the kind of prostatitis and the affected areas, treatment often starts with antibiotics and other medications.
It is distressing when prostatitis develops into persistent pelvic pain. In these situations, specialised treatment such as low-intensity shockwave therapies and pelvic floor physiotherapy can help.

7. Treatment for Male Sexual Dysfunction

Erectile dysfunction (ED), premature ejaculation and low libido can significantly impact self-esteem and intimate relationships.
A full range of treatments have been developed to treat different degrees of dysfunction. These include medications, aiding devices, injections, regenerative therapy and surgical interventions, and penile implants. Open communication and professional guidance are crucial for effective management and improving quality of life.

SUPPORTING MEN THROUGH PROSTATE HEALTH CHALLENGES

When men face prostate health issues, they need support and understanding from their loved ones. Here are some ways women can provide meaningful support:

1. Open Communication

Encourage open discussions about symptoms, concerns and treatment options.
Being a compassionate listener can help to alleviate anxiety and fear.

2. Accompany Them to Appointments

Attending medical appointments together can provide emotional support, and ensure that all questions are asked and answered.

3. Educate Yourself

Understanding the conditions and treatments for prostate conditions can help you to provide informed support and make joint decisions about care.

4. Emotional and Psychological Support

Prostate conditions can affect a man’s selfesteem and mental health.
Realise that urinary issues such as frequent urination which disturbs the night, wetting of toilet floor, bedsheets and garments, and causing of bad smell, are not intentional; the man deserves understanding and support.
Encourage seeking professional counselling if needed.

5. Promote Healthy Lifestyle Changes

Work together to adopt healthier lifestyle habits, such as improved diet and increased physical activity.

The prostate plays a pivotal role in men’s health, influencing urinary and sexual function, and their overall quality of life. By understanding the common conditions that affect the prostate and the available treatment options, women can play a crucial role in supporting the men in their lives. Regular screenings, a healthy lifestyle and proactive care are key to maintaining prostate health and addressing issues early. As a urologist and andrologist, I am dedicated to providing the appropriate care and guidance to ensure that men are better understood and stay dignified as they pursue healthy, fulfilling lives, supported by the women who care for them.

Author

Dr. Joe Lee King Chien

Senior Consultant Urologist
Asia Healthcare Specialists

Dr Joe Lee is a distinguished senior consultant urologist at the forefront of Urology and Men’s Health. He is specialized in the management of complex penile disorders, male infertility, urinary stones and prostate conditions. Graduating from the National University of Singapore in 2000, he furthered his specialization with degrees in surgery from the Royal College of Surgeons of Edinburgh and a Master of Medicine in Surgery from Singapore.

Upon obtaining his specialist accreditation in 2011, Dr Lee embarked on an advanced Andrology Fellowship at Canada’s St. Joseph Hospital, University of Western Ontario, where he further honed his skills in penile implants, artificial urinary sphincters, microsurgeries and sperm retrievals under the mentorship of leading experts in the field. Prior to his current practice, he was a Senior Consultant and Director of Andrology & Male Reproductive Medicine at the National University Hospital, Department of Urology, where he spearheaded advanced research and clinical trials in the field of Men’s Health. He is currently the vice-president of the Singapore Men’s Health Society and an executive committee member of the Singapore Urological Association.
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