Director, Emergency Services, Bikur Cholim Hospital
Now to answer questions about the prostate gland. This gland
sits at the base of the bladder and is the only internal
organ that is exclusively male. A thin wall separates it from
the rectum and that is the only way to examine it on physical
exam. Since it is so close to that area, it can easily get
infected and since its blood supply isn't the best,
antibiotics do not penetrate well, and chronic prostatitis
can occur. Fortunately, newer antibiotics have come along
which penetrate this gland better.
If we all lived to be more than 90, almost all men would
suffer from enlarged prostates since they can expand as men
grow older. Since they sit at the base of the bladder, they
can literally strangle the urinary tract and prevent the flow
of urine. In fact, straining, delayed and incomplete emptying
and urinary tracts infections in men are early signs of
malfunction of this organ. Operations to reduce its size are
commonplace although they can grow back. Occasionally, there
are bad side effects to the operation including incontinence,
but these are getting rarer. Fortunately new drugs are now
available for reducing their size although catheters are
often needed in the short term.
The bigger scare is cancer. This is a vicious cancer which
often causes severe pain. Many experts recommend regular
rectal exams, but this is obviously not popular. There is a
marker for cancer in the blood but it is often not too
specific meaning that it can be falsely elevated. It goes up
in many conditions, including even constipation. Ultrasound
works well. I would say these three exams complement each
other. Screening is critical. All men of age 45 and up should
be screened.
On other matters, drinking fluids heavily before a fast will
not help much. This fluid is directed to the bladder within
hours and will leave the body. For those fighting fat and
wanting to fast better, I find many fruits — such as
oranges and many vinegar-containing vegetables such as
pickles — very filling.
My mother asks: since we develop resistance to microorganisms
as we are exposed to them, do we get resistant to most of
them by the time we reach older age? Unfortunately not, for
two reasons. First, the immune system weakens and many times
cannot deal even with a microorganism it recognizes. Second,
these microorganisms have the ability to change themselves so
they are not recognized. Write me in care of the Yated
or at jbleibmd@yahoo.com.
A message from GlaxoSmithKline, sponsor of this
column. Avodart is Glaxo's solution to prostate problems
and it is state-of-the-art. Its effectiveness is unquestioned
and it is safe.
