I am not a Christian, but I celebrate Christmas. In the Lee household, we have a tree set up in the living room and we buy presents for each other. It has no religious meaning, but it has the warmth and tradition that brings the whole family together at the end of the year.

I guess this is something we demonstrate how much we value each other in a form of gift and appreciation.

It’s what the American Playwright and Novelist, Edna Ferber said: “Christmas isn’t a season, it’s a feeling.”

Norman Vincent Peale, the author of The Power of Positive Thinking and a progenitor of positive thinking added: “Christmas waves a magic wand over this world and behold, everything is softer and more beautiful”.

On this day of magic when everything is softer and more beautiful, it is important to think of the gift of life. A quote from Voltaire once states: “God gave us the gift of life; it is up to us to give ourselves the gift of living well.”

One this festive season, lets address a question from a reader about the gift of living well.

Dear Dr. G,

Thank you so much for a whole year of article. I must say I have learnt a great deal about men’s health and sexual health.

I read a lot about prostate health and how that may impact men.

Since Christmas is a season of giving, I thought I would give my sixty-year-old father a treat and take him to have a prostate and general check-up.

My Dad is generally healthy and I don’t think he is on any medication. I wonder what tests will be appropriate for him and how invasive/ expensive would that be?

I am also thinking accompanying my Dad to the clinic; will the prostate check up be the same? And will the doctor ask many awkward sexual health questions?

I am twenty-eight and unmarried, what addition tests do you think will be done?

I really hope you can help. And of course, wish you and your family an amazing Christmas and New Year.


The prostate is a walnut size (I guess over the festive seasons, probably better to compare to chestnuts) organ that is situated between the base of the bladder and the penis.

This organ is responsible for the production of semen, which provides the nutrients for sperms and the enzymes to digests the hostile barriers created by the cervix.

The vast majority of the amount of ejaculates produced by men is derived from the prostate; hence men will continue to have unaltered semen after a vasectomy. (Visually, anyway).

As the prostate in inconveniently located between the penis and the bladder, the passage of urine must go through the prostatic urethral before leaving a man’s body.

Therefore, an enlarge prostate will result in poor flow, difficulty initiating and residual urine that will cause day and nighttime frequency in some men. As the age progresses, the enlarge prostate may not just cause urination trouble, there is also an increasing risk of prostate cancer.

In view of the close association of the prostate with sexual and reproductive health, urination pattern and cancer, the prostate check up is usually geared towards the above matter.

The assessment for younger men may not gear so much towards the blockages of the piping work and cancer risk, however the issues of sexual performance and previous sexually transmitted infections may need to be revealed.

Most doctors are tactful enough not to put their patients in an awkward position; needless to say one can also come clean about their naughty pasts in private.

On the other hand, we also cannot assume a sixty year old do not view sexual health (or reproductive ability) as equally important!

Thankfully, the assessment of men’s health is made less uncomfortable for certain men with the utilization of questionnaires. The doctors will usually begin the assessment with IPSS (International Prostate Symptoms Scores) and IIEF (International Index of Erectile Functions) symptoms scores.

This will allow the patients to outline the subjective severity of their problems. The scoring system also allows the doctors to monitor the progression of the condition objectively.

After the evaluation of the medical history, the general examination is usually conducted with overall abdominal examination followed by the dreaded DRE (digital rectal examination).

This is what most men have apprehensions when visiting a doctor, in reality, the index fingers of the doctor is really not that big, besides many of the problems in health will arise in the bottom end, we might as well get use to it!

The doctors may ask for some tests following the initial consultation, these may include the PSA (prostate Specific antigen) blood test, and ultrasound scan, semen analysis or urine analysis.

One of the most important tests is a uroflowmetry tests. Men are asked to pee into this machine to gauge the degree of prostatic obstruction. It may seem a bit geeky and unnatural to measure the urine flow like this, the science has outlined such test is valuable in predicting progression of prostate problems.

Overall, the prostate assessments for both young and older men are generally straightforward and painless. Most men are surprised when they realized the process is less horrific than they anticipated.

Needless to say, many men are grateful when prostatic problems are detected and treated early upon screening.

I admire the thoughtfulness and love Peter offers his Dad. I also think he is making a great start in life when considering his own prostate health at young age.

As I am actually a Buddhist celebrating the spirit of Christmas, I end this year’s article with a quote from Buddha: “Health is a greatest gift, contentment the greatest wealth and faithfulness the best relationship.”

On that note, I wish all my readers and fellow Malaysians a Wonderful Christmas and New Year!

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