WATCH: Urologist Answers Your Questions about Prostate Health
Dr. Joseph V. Ditrolio answers some of the most common questions about prostate health and signs of an aging prostate. Click any question for a short video.
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Who is Dr. Joseph V. Ditrolio, MD?
Dr. Joseph V. Ditrolio is an urologist in Roseland, New Jersey. He's is affiliated with the Veterans Affairs New Jersey Health Care System-East Orange and Hackensack Meridian Health Mountainside Medical Center and many other area hospitals. He received his medical degree from from New Jersey Medical School, which is currently part of Rutgers. When asked why he chose urology as his specialty, Ditrolio says, "It's probably one of the areas that patients are most sensitive and concerned talking about, because it really gets to the core of their personality. For that reason I selected urology, and I've been extremely happy with that. I'm the senior professor of Urology at New Jersey Medical School."
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What is the role and function of the prostate gland?
Urologist, Dr. Joseph DiTrolio discusses the role and function of the prostate, "The prostate is a gland unique to men and responsible for most of the fluid that we produce during intimacy. When a sexual encounter occurs, the fluids of the prostate which are rich in sugar, bathe the sperm in that fluid, the sugar is absorbed, which then turns the motors on and allows them to accomplish their mission." Get his full answer in the video.
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Where is the prostate located?
Urologist, Dr. Joseph DiTrolio discusses the location of the prostate in the body. "Prostate is located directly below the bladder, in between the bladder and the pelvic diaphragm which is the floor of the pelvic cavity. Through the pelvic diaphragm passes the urethra which is the tube that carries urine to the end of the male organ and the prostate occupies that space where the bladder meets the urethra. It's just north of the sphincter that voluntarily controls the flow of urine." Get his full answer in the video.
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How big is a healthy prostate gland, and why does it grow as we age?
Urologist, Dr. Joseph DiTrolio discusses the size of a healthy prostate and why it may grow as we age. "The prostate is basically a donut for which urine flows through. Any growth in that prostate would be directed internally because there's a very strong jacket around the prostate. So as we age, our prostate will increase in size. As that growth is directed inwards, it offers resistance to the flow of urine from the bladder to the urethra. As that occurs, you'll notice a slowing of your stream or an incomplete voiding, which means you won't be able to empty your bladder completely, which in effect reduces the time it takes for the bladder to refill again. You'll notice a decrease force in your stream and an increase in urinary frequency, going to the bathroom more frequently." Get his full answer in the video.
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Why does an enlarged prostate restrict urine flow?
Urologist, Dr. Joseph DiTrolio discusses how an enlarged prostate can restrict the flow Of urine. "In the mature adult male the prostate is roughly the size of a walnut. Under the stimulation of testosterone, and the genetic profile of the person that's affected on the rate of growth of the prostate. Keeping the prostate healthy is probably one of the best things we can do to allow the body to function normally." Get his full answer in the video.
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Can you tell us about prescription drugs that treat enlarged prostates?
Urologist, Dr. Joseph DiTrolio discusses prescription treatment options for prostate symptoms. "If we look at the two main groups of prescription drugs. The first one is designed to relax the muscles around the prostate, basically loosening the jacket so that the inward growth of the prostate allows more room for the urine to pass. Those are called alpha blockers. The second group of drugs are hormonal enzymatic blockers. Now what that means is that testosterone is produced by the testicles, it is converted to dihydrotestosterone, which most men now affects balding of hair, because dihydrotestosterone is 1,000 times stronger than regular testosterone. Well, it also stimulates the growth of prostate. And because it stimulates the growth of prostate, the blocking of that enzymatic process from testosterone to dihydrotestosterone would prevent the prostate from increasing in size. And in a good one third to one half of the cases it will actually shrink the prostate." Get his full answer in the video.
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How can a growing prostate impact my sex life?
Urologist, Dr. Joseph DiTrolio discusses the impacts of an aging prostate on your sex life. "A growing prostate affects us sexually. And the way it affects us sexually is that the ejaculatory force that we generate when we climax in the sexual encounter is greatly reduced because of the enlarged prostate. Not only is it reduced, but it may affect the inability to void completely. I mean completely voided bladder has the natural tendency to suppress an erection because the body knows that once you get an erection, you close the bladder neck and therefore voiding becomes more difficult." Get his full answer in the video.
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Do failed sexual encounters bring men to your office?
Urologist, Dr. Joseph DiTrolio discusses the common changes to your sex life that will cause men to meet with a doctor. "Usually when a patient presents at the office with a failed sexual encounter, that has a habit if not dealt with quickly and effectively can set a pattern in the patient's mind of failure. That is a situation that you really, really have to avoid, because the underlying cause may not be that severe." Get his full answer in the video.
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Why do men avoid going to doctors?
Urologist, Dr. Joseph DiTrolio discusses why men of a certain age may avoid going to see a doctor. "Well, the first problem is dealing with men. Women, just by their biological function are forced to see doctors through puberty in their early years, they're the ones who are vulnerable to impregnation, they're the ones who are vulnerable to bladder infections and gynecological infections, some of which are extremely serious, whether it be viral or bacterial. Men really don't live in that world. So that's the first problem is that they've had no experience with doctors. They rarely see doctors on a regular basis." Get his full answer in the video.
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What happens when a comedian meets a urologist? #FU!
Urologist, Dr. Joseph DiTrolio discusses his encounter with stand up comedian Bill Engvall. "Bill Engvall the comedian and I were working on this project to get men aware of the changes in their body that take place with the natural aging process. And he has taken ownership of getting out there and getting the information so that people are much more comfortable to talk about FU. Hearing it, first off the top catches your attention. But the reality is it's a real problem. And if you don't deal with the frequent urination, FU is going to mean a lot worse for you, than just frequent urination." Get his full answer in the video.
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How can I say #FU to frequent urination?!
Urologist, Dr. Joseph DiTrolio discusses options for eliminating frequent urination. "Urinary frequency, FU. FU is a catchy way to identify Urinary Frequency and what it means is that you're voiding more frequently than you used to when you were younger. Some people urinate frequently, because that's just the way they are. They're a high strung type A personality, they're going to urinate frequently. Other people who did not urinate frequently find as they age and the prostate enlarges, they're at risk for FU. What Fu is, is the brain receiving messages from the bladder, that there is urine in the bladder, and it's time to go void." Get his full answer in the video.
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What else could be causing my frequent urination?
Urologist, Dr. Joseph DiTrolio discusses the causes of frequent urination. "If you see some urinary frequency, the first question comes up. Are we making too much urine? Or are we irritated or voiding incompletely? And that unfortunately forces you to see a doctor again, because those are not information that you're going to be able to evaluate it all. A frequent urination because of increased volume could be an underlying diabetic condition, which forces the body to get rid of the excess sugar through frequent urination." Get his full answer in the video.
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Why is frequent urination worse at night?
Urologist, Dr. Joseph DiTrolio discusses why frequent urination symptoms see to get worse at night. "Part of that can be because of an enlarged prostate. And what it prevents, is the incomplete emptying of your bladder and the body has a way of just jogging your memory that, you didn't finish go back in the bathroom and try again. Well, if the bladder cannot generate enough pressure to overcome the enlargement in the prostate, you're going to be doomed to getting up every hour or two or three, four times a night to urinate. Add to that the natural process of brain production of antidiuretic hormone." Get his full answer in the video.
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How does the body know not to urninate at night?
Urologist, Dr. Joseph DiTrolio discusses how your body knows to shut down urination when you sleep. "The combination of fluid retention and lack of ADH, antidiuretic hormone production causes urinary frequency at night known as nocturia. It is not unusual for older people to get up once or twice at night. It is unusual to get up every hour or three to four times a night. Prostatic enlargement is a life altering event. The problem is it's usually not a dramatic event. It happens over time. We as humans, have a way of adapting to how our life adapt over time." Get his full answer in the video.
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How does our diet impact prostate health?
Urologist, Dr. Joseph DiTrolio discusses how what you eat can affect the health of your prostate. "If you look at the human experience, since the beginning of time, our evolution, our genetic survival has been modified by the exposure to different chemicals, different life experiences, different food supplies. And we have evolved over the previous two million years to be the humans we are today. If you fast forward to the last 50, 60 years, the human diet has changed more in that time than it didn't the previous two million years for that matter. Our bodies were designed to be extremely fuel efficient." Get his full answer in the video.
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What should I eat and drink to keep my prostate happy?
Urologist, Dr. Joseph DiTrolio discusses the beverages you should be reaching for to treat your prostate right. "We're not designed to run on all this processed hormone and antibiotic manipulative food. You should run on what you're designed to run. And if in fact, some of the nutritional support has been processed out of the food we need to supplement it. Let's think about the happy prostate and how the prostate is happy and how the prostate is unhappy. I think probably the first thing you want to know is, it's a lot easier for us to find out why the prostate is unhappy, than why the prostate is happy. Because we know things that we take in will irritate the prostate." Get his full answer in the video.
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What is the 7-question IPSS test?
Urologist, Dr. Joseph DiTrolio explains the International Prostate Symptom Score. "American Urological Association has come up with the International Prostate Symptom Score, the IPSS Score. It's a seven question questionnaire,You as the patient possess all the information that is necessary to diagnose and come up with a solution for your condition. Without passing that information to the doctor, that information is lost. You can't expect anyone to come up with a solution without all the information." Get his full answer in the video.
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Is a rectal exam really necessary? What about PSA tests?
Urologist, Dr. Joseph DiTrolio discusses why and when a rectal exam is needed. "Because we talked about the location of the prostate, that it's below the bladder, above the pelvic floor. It's a very hard place to evaluate. I'm sure most of you have heard that the only way they evaluate is with a rectal exam, which is true. I mean, that's the best way. But if you think of the prostate is a bagel with a hole in the middle. If you feel the backside of a bagel, you have no idea what's going on the lateral sides, or the front of the bagel or what's going on in the middle of the bagel." Get his full answer in the video.
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What else should I know about the PSA test, prescription drugs and nutrition?
Urologist, Dr. Joseph DiTrolio shares his thoughts on the test, the drugs and the things we eat for best prostate health. "The PSA blood test, prostatic specific antigen is a blood test that does not require you to fast when it's done. It would be smart to avoid sexual contact for 48 hours before the test is performed because that will cause it to elevate. So that's critical. Understanding that the PSA is not 100% accurate test. Just realize that whatever tests we use are man-made tests looking for a God-given disease. The God-given diseases are a lot smarter than the man made tests. We are trying to find the secret of life and the code of how to keep us healthy. And even though this is not a great test, it is a good screening test to allow your information and your examination to be directed in a position that best gives the doctor the knowledge he needs to treat you appropriately." Get his full answer in the video.