The Road to Prostate Health

Regarding prostate health, I put the core answer directly at the top - for more than 90% of adult men, you don't need to spend a lot of money on supplements or physical therapy. As long as you "avoid clear harmful habits, do annual screenings as needed, and don't resort to indiscriminate treatment if you feel uncomfortable", you can avoid most prostate problems. This is the most practical conclusion I have drawn after talking to several urologists for nearly a year, combined with the real experiences of more than a dozen friends around me who have had related diseases.

Last week I went with my 32-year-old operator to get the reexamination report. He had been in meetings for three consecutive days on a project, and he had to hold his urine for more than four hours at the longest time. When the meeting ended, he couldn't stand straight, and his perineum hurt. For three days in a row, he had to urinate frequently and had to go to the toilet every half an hour. He went to the hospital because he couldn't bear it anymore. He was found to have acute bacterial prostatitis, and he needed to take medicine for 10 days. The doctor who treated him was familiar with him, and I was listening when he was scolding him: "How dare you hold it in? The prostate has rich blood supply. If you hold it down and don't allow the urine to be emptied, who are you looking for if the bacteria don't find you?"

Speaking of which, we have to mention the most commonly asked question: "Does sitting for a long time hurt the prostate?" In fact, there is no completely unified conclusion in the industry. The consensus of traditional urology is that sitting for more than 2 hours continuously will slow down the pelvic blood circulation and continue to congest the prostate, which will indeed increase the risk of inflammation. Especially in the kind of sitting position where the whole person is nestled in a gaming chair or a soft sofa, with all the weight pressed on the perineum, the damage will be doubled. But last year I read a follow-up study published in the field of sports medicine. It said that if you sit with a correct posture, get up every 40 minutes to get a glass of water and shake for 2 minutes, even if you sit for a total of 8 hours a day, the impact on the prostate will be minimal. Even the doctors' recommendations are different. Some strongly recommend buying hollow prostate cushions to disperse pressure, while others say it's purely an IQ tax - if you sit on it and still don't move for three or four hours, even the spring cushions are useless.

What is more controversial than sitting for long periods of time are the various supplements that claim to "support the prostate." The most exaggerated fan I have ever seen sent me a list of lycopene, pumpkin seed oil, saw palmetto, and all kinds of messy herbal extracts, which cost less than 2,000 a month. Regarding this, I specifically asked doctors from different departments: Evidence-based medicine currently only confirms that ingredients such as lycopene and pumpkin seed oil may be able to slightly relieve the symptoms of frequent urination and incontinent urination for middle-aged and elderly men who have been diagnosed with benign prostatic hyperplasia (BPH). However, for young men who do not have any problems, taking them does not have any clear benefit other than costing money. The year before last, my distant cousin heard someone promote a certain "prostate maintenance powder". After taking it for three months, he went for a physical examination. His PSA (prostate specific antigen, an important screening indicator for prostate cancer) soared to more than twice the normal upper limit. The whole family was frightened and thought it was cancer. He stopped taking supplements for two months and then checked again, but it fell back to normal levels. Not to mention that he spent thousands on further examinations and was frightened to death.

Compared with random supplements, what is really useful is regular screening. Last year, I forced my 52-year-old father to add PSA items to the physical examination package. At that time, he even scolded me for spending money indiscriminately, saying that he didn’t feel anything and would only get up once at night, so there was no need to check. The results showed that the PSA was 0.4 higher than the critical value, and further B-ultrasound and digital examination were performed. It was found to be mild benign hyperplasia. The doctor prescribed some medicine and took it for three months. After another check, everything was normal. Now he tells everyone he meets that he still needs to listen to the regular physical examination of young people. Regarding the age of screening, there are now different voices in the industry: the mainstream recommendation is to check PSA and digital rectal examination once a year for those over 50 years old, and those with a family history of prostate cancer can do it earlier to 45 years old. There are also many young urologists who suggest that these two items can be added to the annual physical examination for those over 40 years old. After all, a tube of blood and a three-minute finger examination do not cost much. If problems are discovered early, the prognosis is completely different.

Many people have a strong sense of shame about prostate problems. If they feel a little bit of frequent urination and urgency, their first reaction is not to go to the hospital, but to secretly check "whether they have kidney deficiency" and buy various kidney-tonifying health products. In fact, there is really no need. If you have recently stayed up late at night, drank a lot of wine, and held in your urine several times, and suddenly develop perineal swelling, frequent urination and painful urination, it is most likely an acute inflammation. Go to the hospital and prescribe medicine for a week and it will basically be cured. If you drag it out and drag it out to become chronic prostatitis, it is really torture to repeat it over and over again. If middle-aged and elderly friends find that they urinate more at night and wake up three or four times a night, don't think it's "normal for old age". Go get a B-ultrasound. If it's hyperplasia, take appropriate medicine and you can sleep through it without having to sleep hard.

Finally, let me talk about a question that everyone is curious about but embarrassed to ask: Does the frequency of sexual intercourse have an impact on the prostate? There is no unified standard for this. Some doctors say that regular ejaculation will help flush the prostate ducts and reduce the risk of inflammation. Some say that excessive ejaculation will cause repeated congestion of the prostate, which is not good. In fact, to put it bluntly, your own comfort is the most important thing. As long as you don’t feel discomfort like perineal swelling or backache after the exercise, it doesn’t matter if you do it once a week or three times a week. Don’t deliberately hold it back, and don’t hold it too hard. That’s enough.

I had a barbecue with Dr. Li from the urology department a while ago. He said that after working as a clinic for more than ten years, he had seen too many people make prostate health too mysterious, using massages and supplements, and some spending tens of thousands on physical therapy. In fact, it boils down to these few words: don’t hold in your urine, drink less alcohol, feel swaying after sitting for a long time, and go to a regular hospital if you feel uncomfortable. It is more effective than any other folk remedies.