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Understanding Men's Health: Prostate

These conditions are unique to men and cause much anxiety.

THE PROSTATE IS A WALNUT-SIZED ORGAN FOUND only in the male. it is located at the door of the bladder. An essential part of the reproductive system, its main function is to secrete a slightly acidic fluid that makes up about 20 to 30 percent of semen. When this fluid is combined with the rest of the ejaculate discharge from the testes, seminal vesicle and bulbourethral glands during male ejaculation, semen becomes alkali to help counter the naturally acidic environment that is the female vagina.

However, despite its importance in the male reproductive system, the prostate can also cause a great deal of problems. As a man ages, the prostate tends to grow larger, and in men over the age of 50, the size of the prostate tends to cause intermittent obstruction of urine from the bladder into the penis, making it much more difficult for them to urinate. The prostate is also prone to harbouring bacteria, becoming inflamed and causing much pain over long periods of time if it remains untreated. Finally, the prostate is also prone to becoming cancerous: it is the third most common cancer in Singaporean men, right after colorectal cancer and lung cancer.

Prostate Blood Test or PSA

The prostate-specific antigen test, or PSA, is a blood test commonly used to detect prostate cancer. While not as accurate as some other methods, it is the most accurate blood test we currently have to detect early prostate cancer. PSA can also be used to regularly monitor how well a particular patient’s prostate cancer is responding to treatment.

Due to the lack of accuracy, PSA readings alone are not enough to conclusively prove if a patient has prostate cancer.

After reviewing the patient’s age, family history, ethnicity, the results of prior biopsy histories and al current medical conditions, if the doctor deems that there is still a reasonable risk of prostate cancer, he/she may call for a prostate biopsy.

A prostate biopsy is a procedure where small samples of the patient’s prostate is removed and tested for cancer. Usually an outpatient procedure, it can be performed transrectally (through the rectum). As there is a risk of significant infection, in one percent of the time, this task should not be taken lightly.

Enlarged Prostates

An enlarged prostate is technically known as benign prostate hypertropy, or BPH for short. BPH is not cancer, nor does it increase your chances of getting prostate cancer. What it does do, however, is make it more difficult for you to both start and stop urinating with a frequent need to strain to start and uncontrollable dribbling near the end. Patients with BPH may also wake up multiple times at night to urinate because the bladder is not fully emptied each time.

Traditionally, BPH is treated via transurethral resection of the prostate (TURP) if medical therapy fails, where a scope is inserted via the penis and the prostate removed piece by piece. However, recent advances in medical science has allowed for a new form of treatment known as bipolar prostate vaporization. While it is commonly promised to be a bloodless and near painless experience, patients should still realistically expect intermittent blood in the urine for up to two weeks and an overnight hospital stay.

Dr Michael Wong

Medical Director & Senior Consultant Urologist
FAMS (Urology), FICS (USA), FRCS (Edinburgh),
M Med (Surgery), MBBS (S’pore)

Dr Michael Wong is a Senior Consultant Urologist who is internationally recognized for his surgical expertise and academic contribution to the field of Urology, in particular the subspecialized field of minimally invasive Endourology.

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