Award-winning urologist - and pioneer in Men’s Health - Dr. Paul Turek blogs weekly about issues such as infertility, vasectomy and vasectomy reversal, sexual and hormonal dysfunction and more. Keep up with latest in this fascinating field of medicine.

The Prostate: All You Ever Wanted to Know

One famous fountain: the mannequin pis in Belgium

One famous fountain: the mannequin pis in Belgium

As a man ages, he is more likely to look at travel experiences as a series of restroom stops. He might begin navigating his way to the grocery store, the gas station or to a friend’s house for poker based on whether or not there’s a restroom conveniently located nearby. This may sound like the end of the world, but it’s not. It may be the end of long road trips. It is also the start of the realization that, similar to needing reading glasses, he is not immortal but actually a simple human being.

The prostate is a gland the size of a walnut at the base of the penis. It wraps around the urethra (the tube that urine comes from). A prostate is essential for normal male fertility, as it is responsible for making fluid that protects and nourishes sperm. Everything is shipshape until a man gets older, when two problems can arise. One is benign prostatic hypertrophy (BPH), which is a fancy way of saying enlargement of the prostate. This occurs in about half of all men in their sixties. For reasons still unclear, the prostate continues to grow as a man gets older. It is usually symptomatic – men have urinary urgency, dribbling, weak stream and may have to get up at night to urinate. The other problem is prostate cancer. Most commonly, cancer has no symptoms.

BPH is not preventable, but prostate cancer may be. Following a heart-healthy, low-fat, low carbohydrate diet is key to the prevention strategy, as are exercise, weight management and stress reduction. Concentrate on fruits and vegetables, which are high in antioxidants that protect the cells of your body from becoming cancerous. Soy and green tea may also protect the prostate. Sugar intake should also be limited, as it often ends up stored in your body as fat, and obesity is linked to prostate cancer.

That said it may surprise you to know that prostate cancer doesn’t always kill. Cancer is no one’s friend, but prostate cancer is not as deadly as lung cancer, colon cancer or breast cancer. It is much more slow-growing than these other cancers, doubling in size every 2-3 years instead of every 4-6 months. As such, a man is eight to ten times more likely to die of heart disease than prostate cancer. Even more interesting, some believe that prostate cancer is really a disease of age in men, as the likelihood of having small amounts of cancer in the prostate goes up with age. That means that about 80% of 90 year old men will have prostate cancer, and may never know it. They will likely die of unrelated causes. It also means that there are many prostate cancers occurring in men that are “clinically insignificant,” a rare term in cancer medicine. So, many prostate “cancers” actually don’t act as such.

Although diseases of the prostate are rarely lethal, they can affect your quality of life…and your road trips. Men over forty should start to have the prostate checked regularly, although most men would rather spend quality time with the dentist’s drill than go in for that exam. Blood tests for a substance called PSA, can also help detect cancer. The symptoms of prostatic enlargement can treated with pills; if these don’t work, various, safe but indescribable procedures can remove the symptom-causing prostatic tissue. Some of the FDA approved pills to treat BPH also prevent prostate cancer. Now that’s a pill that men might want to swallow. So, for all kinds of reasons, don’t ignore the prostate. Try to attend to it before it disrupts the flow of your daily life.

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About Dr. Turek

A founder of the male fertility and male sexual healthcare movement, Dr. Paul Turek is also an internationally recognized master microsurgeon who specializes in vasectomy and vasectomy reversal, FNA testicular mapping, sperm retrieval and male erectile and sexual dysfunction.

He is a former Academy of Medical Educators Endowed Chair Professor of Urology, Obstetrics & Gynecology at UCSF and while there, directed a National Institutes of Health (NIH) grant for training new leaders in men's reproductive health. He has authored more than 175 publications on genetic, urological and epidemiological issues in men's reproductive health and regularly consults for the Centers for Disease Control and Prevention (CDC) and the NIH and other branches of the US government and industry on matters relating to men's reproductive health. He currently holds an NIH grant to create a human artificial testicle to make sperm.

He is Past-President of the American Society of Andrology, a Fellow of the American College of Surgeons, the Société Internationale d'Urologie and the Royal Society of Medicine (London). Dr Turek is also Editor of the Reproductive Volume of Netter's Images, 2nd Edition. His hobbies include vintage cars and long board surfing.

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