Dr. Ram Naresh Daga

Cancer is the most dangerous disease noticeable throughout the world. The most common type of cancer that affects men is prostate cancer. Prostate is a small exocrine gland situated directly below the bladder and in front of the rectum. This is gland is approximately in size of a walnut and plays an important role in production of a milky fluid during orgasm of sex in which the semen travels. During the climax stage of the prostate gland is forced to push the fluid and remove the semen out of the reproductive structures.

Prostate gland is a slow progressive disease which makes many males left unidentified even the presence of prostate cancer even until they die. 6 out of 100 male over the age of 60 are getting prostate cancer. Though prostate cancer can be cured at a better rate when compared to other type of cancer it is always best to stay protected. Prevention is always better than cure. Here are few tips to keep your prostate healthy.

Signs and symptoms of prostate cancer-

During the early stages of prostate cancer there are usually no symptoms. Most men at this stage find out they have prostate cancer after a routine check up or blood test. When symptoms do exist, they are usually one or more of the following:

1. The patient urinates more often

2. The patient gets up at night more often to urinate

3. He may find it hard to start urinating

4. He may find it hard to keep urinating once he has started

5. There may be blood in the urine

6. Urination might be painful

7. Ejaculation may be painful (less common)

8. Achieving or maintaining an erection may be difficult (less common).

If the prostate cancer is advanced the following symptoms are also possible:

1. Bone pain, often in the spine (vertebrae), pelvis, or ribs

2. The proximal part of the femur can be painful

3. Leg weakness

4. Urinary incontinence

5. Fecal incontinence

Ways to have a healthy prostate –

1. Diet and weight – the most important factor is the diet to maintain a healthy weight. Avoid fatty food items and take fats from vegetables than from animals. Avoid dairy products and increase the intake of fresh fruits and vegetables.

2. Exercise – have a regular practise of doing exercise at least for 30mins a day. This really helps you to keep your body fit.

3. Be precautious – if you have a family history of prostate cancer or if you feel you are at high risk of getting prostate cancer talk with your doctor about it and take preventive drugs as per the doctor’s advice.

4. Red foods – research shows that men who consume red foods like watermelon, tomato and other red fruits are at lower risk of getting prostate cancer as they contain a powerful antioxidant called lycopene

5. Caffeine – three to four cups of coffee per day reduces your risk of getting prostate cancer.

6. Stop smoking – if you are at high risk of getting prostate cancer it is best advised to quit smoking and alcohol.

Urinary incontinence is the unintentional passing of urine. It's a common problem thought to affect millions of people. There are several types of urinary incontinence, including:

1. Stress Incontinence– when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh.
2. Urge Incontinence– when urine leaks as you feel a sudden, intense urge to pass urine, or soon afterwards.
3. Overflow Incontinence (chronic urinary retention)– when you're unable to fully empty your bladder, which causes frequent leaking.
4. Total Incontinence– when your bladder can't store any urine at all, which causes you to pass urine constantly or have frequent leaking.

It's also possible to have a mixture of both stress and urge urinary incontinence.

What causes urinary incontinence in men?

Urinary incontinence in men results when the brain does not properly signal the bladder, the sphincters do not squeeze strongly enough, or both. The bladder muscle may contract too much or not enough because of a problem with the muscle itself or the nerves controlling the bladder muscle. Damage to the sphincter muscles themselves or the nerves controlling these muscles can result in poor sphincter function. These problems can range from simple to complex.

A man may have factors that increase his chances of developing UI, including

1. birth defects—problems with development of the urinary tract
2. a history of prostate cancer—surgery or radiation treatment for prostate cancer can lead to temporary or permanent UI in men

UI is not a disease. Instead, it can be a symptom of certain conditions or the result of particular events during a man’s life. Conditions or events that may increase a man’s chance of developing UI include

1. Benign prostatic hyperplasia (BPH) — A condition in which the prostate is enlarged yet not cancerous. In men with BPH, the enlarged prostate presses against and pinches the urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty, leaving some urine in the bladder. The narrowing of the urethra and incomplete emptying of the bladder can lead to UI.
2. Chronic coughing — Long-lasting coughing increases pressure on the bladder and pelvic floor muscles.
3. Neurological problems — Men with diseases or conditions that affect the brain and spine may have trouble controlling urination.
4. Physical inactivity — Decreased activity can increase a man’s weight and contribute to muscle weakness.
5. Obesity — Extra weight can put pressure on the bladder, causing a need to urinate before the bladder is full.
6. Older age — Bladder muscles can weaken over time, leading to a decrease in the bladder’s capacity to store urine.

Treating Urinary Incontinence

Initially, your GP may suggest some simple measures to see if they help improve your symptoms. These may include:

1. lifestyle changes – such as losing weight and cutting down on caffeine and alcohol
2. pelvic floor exercises – exercising your pelvic floor muscles by squeezing them, taught by a specialist 
3. bladder training – where you learn ways to wait longer between needing to urinate and passing urine, guided by a specialist
4. You may also benefit from the use of incontinence products, such as absorbent pads and handheld urinals.
5. Medication may be recommended if you're still unable to manage your symptoms.
6. Surgery may also be considered. The specific procedures suitable for you will depend on the type of incontinence you have.
7. Surgical treatments for stress incontinence, such as tape or sling procedures, are used to reduce pressure on the bladder or strengthen the muscles that control urination.
8. Operations to treat urge incontinence include enlarging the bladder or implanting a device that stimulates the nerve that controls the detrusor muscles.

The prostate gland, an essential part of the male reproductive system grows throughout your life. As you grow older, it becomes imperative to keep this organ healthy.

Here's what you can do to maintain a healthy prostate:

• Workout to stay fit - Exercising regularly and maintaining an optimum weight can help to keep your prostate gland at an optimal health. Several types of research have revealed the beneficial aspects of exercising. It's said that physically active men are less likely to suffer from enlarged prostate if they performed a physical activity of low to moderate intensity. Likewise, physically active men who ran for 90 to 108 minutes are 20% less likely to develop erectile dysfunction.

• Eat fruits and vegetables - Including fruits and vegetables in your diet can help to maintain a healthy prostate. Guava, papaya, tomato and watermelon are some of the options that spell good for your prostate. Vegetables like cabbage, cauliflower, broccoli and Brussels sprouts should also be included to boost the health of the gland. Ideally, you should have about 5 servings of fruits and vegetables daily.

• Say yes to healthy fats and no to trans and saturated fats - Choosing healthy fats like avocados, nuts, and olive oil can aid in boosting prostate health. At the same time, limiting saturated fats and trans fat intake are vital for keeping the prostate gland healthy.

Urinary incontinence is the inability to hold urine in the bladder because of loss of control of the bladder. The severity may range from temporary to chronic, depending on the cause of this disease. Urinary incontinence is more common in women than men and can be categorized into three types.

Types and symptoms of urinary incontinence

Stress incontinence: this incontinence may occur while participating in any physical activity such as a sudden cough, laugh, sneezing or exercising. The stress here refers to the sudden physical pressure that a person experiences, leading him/her to urinate involuntarily.

Urge incontinence: a sudden, involuntary contraction of the muscular wall of the bladder causes an urgency to urinate. This urgency can be formed by a sudden change in position or sex.

Overflow incontinence: this is more common in men with prostate gland problems, damaged bladder or blocked urethra. The person has an urge to urinate frequently but in small amounts.

Causes of urinary incontinence

There are a number of causes of urinary incontinence ranging from aging to cancer and physical damage to the neurological disorder.

1. Aging: with age, the bladder muscle weakens and the chances of incontinence increases.

Damage: since the pelvic muscles support the bladder any damage to it (surgeryor any procedure to remove the uterus) can lead to urinary incontinence.

2. Enlarged prostate: enlargement of the prostate gland in older men may give rise to this condition.

Cancer: urinary incontinence may be associated with untreated prostate cancer, which is a side effect of treatments for it.

3. Menopause: estrogen is a hormone that keeps the lining of bladder and urethra healthy. After menopause the production of estrogen is decreased, increasing the chances of urinary incontinence.

4. Prevention: urinary incontinence is not preventable but some steps can be taken to reduce the risk of it. Maintaining a healthy lifestyle, avoiding smoking, practicing pelvic floor exercises, avoiding caffeine and acidic foods and eating more fiber to prevent constipation can help decreasing the risk of it.

An overactive bladder is a condition that is characterized by a problem in the bladder storage function; a problem that eggs one on to urinate frequently. This condition can cause problems in your social and work life. You may isolate yourself from others and feel embarrassed about the situation.

Symptoms
If you have an overactive bladder, you may exhibit symptoms of frequent urination, involuntary leakage of urine and frequent urge to urinate. These symptoms might disrupt your daily life; so it is important to seek advice from a medical practitioner.

Causes
To better understand what causes an overactive bladder, you need to know how the urination process works. Urine is produced by the kidneys, which flows to the bladder. During urination, the urine is excreted from an opening in the bladder and flows out via the urethra. As the kidneys secrete urine, the bladder starts to fill up. During this stage, nerve signals are sent to the brain; signals that trigger your body to urinate. The bladder muscles tighten that pushes the urine out of the body.

An overactive bladder results from the involuntarily contraction of the bladder, which might happen even if the content of urine in the bladder is low. These contractions create the urge to urinate. The various causes of an overactive bladder are:

1. Excessive fluid intake, if your fluid intake is high, then you may have the tendency to urinate frequently.
2. Presence of tumors or stones in the bladder can make the bladder overactive as well.
3. Excessive alcohol or caffeine consumption has the same effect as an excessive intake of fluids has.
4. Urinary tract infections may interfere with the entire process of urination, thus causing your bladder to swell up and become overactive.
5. Other diseases and conditions such as constipation and an enlarged prostatecan hamper bladder functioning.

Treatment
There are multiple approaches to treat an overactive bladder; your doctor may use one or a combination of multiple methods.

1. Medications: Medications such as Trospium and Tolterodine help in relaxing the bladder. These medications help treat symptoms of frequent urination.
2. Bladder injections: Botox is a protein that is injected into the bladder that causes partial paralysis of the bladder muscles. This helps in treating the constant urge to urinate. However, its effects are temporary as they last for 6-9 months.
3. Lifestyle modifications: Certain lifestyle modifications such as incorporating exercises to strengthen the pelvic muscles, maintaining optimal weight levels and bladder training to control its functioning can help with managing an overactive bladder.
4. Surgery: If the other treatments do not produce the desired results, then surgery is usually recommended. The aim of the surgery is to enhance the storage capacity of the bladder and reduce bladder pressure.