Many men worry about prostate and testicular cancer, erectile dysfunction and the symptoms of an enlarged prostate. Some are embarrassed to talk to either female or male providers about their concerns, but they need to overcome embarrassment. And yes, that means probably having the dreaded digital rectal exam (DRE). The only way to examine the prostate directly is by way of the rectum. Hopefully, this article will facilitate a more open dialogue.

If you were to come to my office suspecting any prostate condition this is what you could expect: First, of course, there would be the urinalysis to look for obvious signs of infection. Then we would do the digital rectal exam, the purpose of which, ironically, is to see if the prostate is tender and/or enlarged. A blood test would be ordered: the PSA (Prostate Specific Antigen) the level of which would be elevated for any prostate problem.

About 5 to 9 percent of men will experience Prostatitis in their lifetime so it is a relatively common male condition. It is associated with pain in the lower abdomen or lower back and is usually caused by bacteria, but can also evolve for "no reason." Sometimes, these latter situations come about due to prolonged heavy lifting or sitting. Physical activities that may irritate the prostate such as jogging or biking can also precipitate an episode of Prostatitis. Symptoms of Prostatitis typically include flu-like symptoms of fever, chills, aches and pains. Painful urination, bloody urine or frequent urination may also be symptoms. Some men may even complain of pain with ejaculation. Prescribing antibiotics for Prostatitis depends on the presence of bacteria. Other treatments could include pain medicines, warm baths or certain prescriptions that can alter the urinating pattern.

As far as cancer is concerned, whether it is prostate or testicular, the earlier found, the better are chances for a cure. Prostate cancer was once considered an older man’s cancer. Unfortunately, men in their 40’s and 50’s are discovering they have prostate cancer. Why this is happening is for epidemiologists to study. All that can be said is that prostate cancer in the U.S. is now second after lung cancer for causing deaths in men, especially African-American. Being African-American is just one of the risk factors for prostate cancer. Family history is another.

Testicular cancer is the other cancer men don’t like to talk about. This cancer is potentially more devastating as it occurs most commonly in younger men, which then can lead to infertility. In fact, it can be found in teen-aged males. It can be rapidly fatal if ignored, but curable when detected and treated early. Hence, we begin teaching teen-aged boys how to do monthly self-testicular exams. Just as women are urged to do their own monthly breast exams, all males should learn to check their testicles monthly and have a medical professional do an annual exam.

The other two male specific problems are erectile dysfunction (ED) and benign prostatic hyperplasia, or BPH (benign means it is not cancerous and hyperplasia just means bigger tissues). If there are two men now reading this over the age of 50, one of them has a prostate that is enlarged to some degree. With a man’s life expectancy now approaching 80 years, it is believed that up to 90 percent of the male population will experience symptoms of BPH from mildly annoying urination problems to more serious complications. And as for ED, we cannot prescribe Vitamin V if you do not tell us you are having difficulties. More to the point, more serious medical conditions must be ruled out as causes for ED. Help us gather the right information so that we can help you. If your provider does not ask about ED or BPH, or is uncomfortable if you ask or too quick to offer a prescription, stop and take the first steps to ensuring your own health.


Agnes Oblas is a nurse practitioner with a private practice and residence in Ahwatukee Foothills. For questions, or if there is a topic you would like her to address, call her at (602) 405-6320 or e-mail Her website is

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