MEN'S HEALTH MATTERS:Your health questions answered
Q I am 52 years old and recently visited my doctor and had the prostate blood test (PSA). I have been told that it is a little bit raised and have been advised to have a biopsy of my prostate. What exactly does this entail?
A If a transrectal ultrasound (TRUS) and biopsy has been recommended, the reason is that you may have an abnormality within the prostate gland. Transrectal ultrasound of the prostate allows the doctor to see deep into the prostate, perhaps revealing abnormal areas that are difficult to find by digital rectal examination.
Transrectal ultrasound can also tell us whether the seminal vesicles are normal, the size of the prostate, and, in some cases, can suggest if any other abnormalities are present.
No special preparation is required prior to your biopsy and you do not need to be fasting. Initially, you will be given antibiotics to help prevent infection because the procedure is done through the back passage.
You will then be asked to lie on your side. The ultrasound instrument is placed into the back passage in a similar fashion to the doctor examining the prostate with a finger. You will then be given a local anaesthetic and a fine biopsy needle is guided with the help of the ultrasound probe and multiple biopsies are taken.
The entire procedure takes less than 15 minutes and may be a little uncomfortable but is not usually painful. In general, this is a very safe procedure and most people have no trouble.
Occasionally after a biopsy, some bleeding will occur. There may be blood in the urine, mixed with the sperm or blood on the bowel motions. If this occurs it usually settles after a day or two and increased fluid intake helps. You may also experience some mild transient difficulty passing urine.
Q I'm in my late 20s and I am still getting spots. I use antibacterial face washes but they don't seem to be working and are difficult to use on my back. I have tried cutting out greasy foods and chocolate but that didn't help much. Is there something else I can do?
A Acne mainly affects people in their teens and early 20s. Acne will clear but in about 5 per cent of men it can persist or become worse in adulthood. It is caused by a combination of hormones, sebum (oil produced by the skin), blocked pores and bacteria.
It can be made worse by stress, depression, genetics (bad acne can run in families), high humidity and some creams, which can block pores. Diet doesn't seem to play a role in acne, according to trials, so you don't need to deprive yourself of chocolate.
Treatment of acne depends on how severe it is and where on your skin is involved. Acne can be treated effectively but it may be slow. All forms of treatment work on preventing the spots you are going to develop in the next few months and not the ones you have now, so you need to persist and be patient with any treatment.
There are a few general precautions you can take - avoid humid conditions, irritating creams and oil- containing moisturisers/hair gels and so on. Abrasive creams and skin treatments can make things worse. Try to avoid scratching or picking spots.
Mild acne, especially if it is only affecting the face can be treated by topical agents (lotions, creams), which can be obtained over the counter without a prescription. Before applying the acne treatment treat the affected area twice daily with a mild cleaner or antiseptic wash, and then apply the acne treatment to the whole of the area affected.
Ask your pharmacist for treatments that contain salicylic acid or benzoyl peroxide. There are treatments your doctor can prescribe for you which contain antibiotics or retinoids.
For more severe and widespread acne affecting the face, chest or back, I would advise you see your doctor or dermatologist, who may prescribe oral medication. You usually need to take medication for at least six months.
This column is edited by Thomas Lynch, consultant urological surgeon, St James's Hospital, Dublin with contributions from Dr Patrick Ormond, consultant dermatologist and dermatological surgeon
Please send your questions to healthsupplement@irish-times.ie