Men should consult their doctors much sooner if they have problems with urination. Fear and embarrassment often cause men to wait for years. There is no reason for this, because many symptoms are very easily treatable. However, ignorance also plays a part. The prostate in particular is a mystery for many people. This is according to urologist Dr Igle Jan de Jong of the UMCG, who is raising the issue because Wednesday 15 September is national prostate day.
Most people roughly know what a heart looks like, and most of the Dutch have a fair idea about the lungs and kidneys as well. But when it comes to the prostate, most people have no idea what it looks like or what it does. Dutch urologists think that this has to change. For the last five years they have been organizing a national prostate day to draw attention to the prostate. Igle Jan de Jong: ‘There needs to be much more openness. Embarrassment about talking about urinary problems has to stop’.
But what exactly does the organ do? Only men have a prostate, explains De Jong. ‘It is an internal gland that is located just below the bladder and adds substances to sperm to keep the sperm cells in good condition’. In other words, without a prostate, men would not be able to reproduce. But as they become older, usually at an age when most men have already done their reproducing, the primary function of the prostate becomes obsolete. That is when most problems occur.
The main symptom of ‘prostate ageing’ is urinary problems. De Jong: ‘The urine stream changes, men need to go to the toilet much more often, they need to get up in the night to go to the toilet, or they sometimes have the feeling that they cannot empty their bladder completely. They also sometimes have pain in their genitals and in the groin area’. These are generally harmless symptoms but many men are still afraid to go to the doctor. De Jong: ‘There are still many taboos concerning the reproductive organs. Men are embarrassed to go to the doctor for their “bits”. And they are often afraid of treatment or operations’.
In the vast majority of cases, simple treatment is enough. Medication can be used to shrink the prostate a little, or to relax the muscles in and around the prostate. This relieves the majority of problems. But medication is not always necessary. Food supplements, physiotherapy or lifestyle advice (such as eating less spicy food and being careful with alcohol) can bring significant relief. De Jong: ‘Operations are becoming less common. These days it is the last resort for urinary problems’.
In many cases men with urinary problems do not need to go to hospital – their GP can treat their problems. But even if they do have to go to hospital they usually only need simple checkups. No painful procedures are involved. The nature and level of the problem can be established with simple questionnaires. The strength of the urinary stream can be measured by having the patient urinate into a special toilet. A sonogram is then taken to measure how much urine is still in the bladder. All of this can be done in a single outpatient visit. De Jong: ‘Men need to know that they really don’t need to self-diagnose or to order so-called medicinal Chinese herbs via the internet’.
Many men choose to ignore their problem because they are afraid of prostate cancer. Although this is certainly a common condition, diagnosed in 10,000 men each year, the fear is unfounded. De Jong: ‘Having urinary problems says absolutely nothing about the possibility of prostate cancer. Men with urinary problems have the same chance of prostate cancer as men without urinary problems’. Men scare each other unnecessarily, according to the urologist. In southern Europe and America, men have preventative PSA scans for the most minor of problems, even though research has not yet shown that it is necessary. De Jong: ‘Luckily the Dutch, especially in the North, are much more level-headed. However, more knowledge about prostate problems wouldn’t hurt’.
Dr Igle Jan de Jong (1958) is a urologist in the Urology department of the UMCG. He specializes in oncological urology. As a member of various national and international study groups, De Jong is actively involved in the development of Dutch guidelines for prostate, kidney and testicular cancer. His academic research concentrates on the development and improvement of molecular imaging (including PET/IC scans), molecular markers and the use of new, targeted medicine and image-based surgical procedures.
More information: via Communication Office UMCG, telephonenumber: +31 50 361 22 00
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