If you’re a man in your 50s, 60s, or 70s waking up at night to pee, planning your day around bathroom access, or quietly worrying about erections and testosterone, this episode is for you. Dr. Geo sits down with Dr. Ravi Munver (Hackensack University Medical Center) to break down what’s actually driving urinary symptoms, how to tell “prostate vs bladder,” when waiting too long can permanently weaken your bladder, and how today’s BPH procedures compare—especially Aquablation (high-pressure, room-temperature waterjet therapy).

What you’ll learn in this episode

• Why BPH symptoms can start earlier than most men think (and why more men are finally talking about it)

• Why prostate size does NOT equal symptom severity (big prostate ≠ big problem… always)

• How to distinguish “prostate obstruction” vs overactive bladder—and why you can’t reliably do this without proper testing

• The “danger zone”: when untreated obstruction can lead to a weakened/crippled bladder

• Medication options: what each class does, who it’s for, and the most common side effects

• The full “toolbox” of procedures—from office-based options to the most durable surgical solutions

• Why Aquablation is changing the conversation (symptom relief + low sexual side effects + broad size range)

Episode chapters (timestamps)

00:00:00

00:02:00 Why younger men are showing up with urinary symptoms Prostate growth patterns (growth early, pause, then growth again in the 40s); increased awareness, openness, and access to information.

00:07:00 “Blame the organ you have” — prostate vs overactive bladder Why symptoms overlap; why only a clinician can truly differentiate causes.

00:10:00 When should a man see a urologist? When symptoms interfere with life (work, travel, sleep). The real issue is often difficulty returning to sleep.

00:13:00 The risk of waiting: bladder decompensation How long-term obstruction can lead to a weakened bladder and urinary retention.

00:18:00 The holistic patient scenario + why objective testing matters Why symptoms can “seem better” while retention worsens; importance of measuring PVR and other tests.

00:21:00 Medications for BPH—pros/cons

• Alpha blockers: tamsulosin (Flomax), alfuzosin, silodosin (Rapaflo)

• 5-alpha reductase inhibitors: finasteride, dutasteride

• Tadalafil (Cialis) daily 5 mg: dual benefits for BPH + erectile function

00:31:00 The modern BPH procedure toolbox TURP as the historical “gold standard,” plus lasers, robotic options, office-based procedures, and newer technologies.

00:36:00 What men care about most when choosing a procedure Incontinence risk, erectile dysfunction risk, ejaculatory changes, irritative symptoms, and durability/retreatment rates.

00:38:00 Robotic Simple Prostatectomy — what “simple” actually means Removing the obstructing inner tissue while leaving the capsule; major symptom relief for large prostates, with tradeoffs (especially ejaculation).

00:43:00Aquablation explained (high-pressure water therapy) Image-guided treatment planning + robotic waterjet tissue removal with minimal thermal damage.

00:48:00 Durability and size range Discussion of longer-term data vs TURP and why Aquablation can treat very large prostates.

00:51:00 If Aquablation isn’t available—what’s next best? How options shift based on prostate size and the priority to preserve ejaculation vs maximize durability.

00:54:00 Final guidance + where to find Dr. Munver Individualized care; find a urologist who can offer a broad set of options.

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🔹 Register FREE for the Prostate Summit 2.0:

👉 https://drtalks.com/summit/prostate-cancer/?oid=104&ref=3642&uid=918

In this special session from the upcoming Prostate Summit 2.0, Dr. Eric Zielinski sits down with Dr. Geo for a rare, vulnerable and informative conversation about the why behind his life’s work in prostate cancer care.

Key Points

• The emotional and spiritual side of working with thousands of men
• Why your why matters more than the diet, protocol, or treatment choice
• The 3 buckets of prostate cancer and why care must be personalized
• His 4 pillars of healing: lifestyle, nutrition, fitness, and stress mastery
• How fasting, cruciferous veggies, mushrooms, herbs, and targeted nutraceuticals help build resilience
• Why exercise is non-negotiable, and how sitting all day harms prostate and metabolic health

This episode blends heart, science, and practical strategy to help men live longer and better with prostate cancer.

Chapters

00:00 – Intro

02:00 – The “why” behind Dr. Geo’s work

07:00 – A powerful patient story & legacy

12:00 – The 3 buckets of prostate cancer

18:00 – Food, fasting & “It Days”

23:00 – Exercise, sitting & movement

32:00 – Mushrooms, herbs & targeted nutraceuticals

From the upcoming Prostate Summit 2.0

🔶 FREE EVENT – PROSTATE SUMMIT 2.

👉 https://drtalks.com/summit/prostate-cancer/?oid=104&ref=3642&uid=918

___________________________________

ProLon 5-Day Fasting Mimicking Diet — Enjoy fasting benefits with food. Supports cellular renewal, metabolic health, and fat loss. Special offer for our listeners: Get the ProLon kit for $148 → https://bit.ly/3TVehAx

AG1 by Athletic Greens — 75 high-quality vitamins, minerals, probiotics, and adaptogens in one daily scoop. Supports gut health, immunity, energy, and focus. Try it here → https://bit.ly/3mA2tVV

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Want deeper insights? Join The Dr. Geo Prostate Podcast Exclusive Membership for curated transcripts, detailed show notes, expert resources, and member perks. → https://drgeo.com/membership

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📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast

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Dr. Geo and Dr. Robert Caruso dive deep into what really causes urinary symptoms in men—and why prostate size alone doesn’t tell the full story. Dr. Caruso shares how his “blue zone” Italian upbringing, his 98-year-old mother, and even a family story involving a bear shaped his holistic view of urology, where diet, movement, spine health, constipation, and sleep apnea all matter.

From there, they walk through medications (alpha-blockers, 5-alpha-reductase inhibitors, daily tadalafil) and when each actually makes sense, including surprising cardiovascular and nocturia benefits of PDE5 inhibitors. The conversation then shifts to procedures: bipolar TURP vs classic TURP, and in-office options like UroLift, Rezūm steam therapy, and the newer iTind device—who they’re for, how they’re done, and what to expect for recovery, ejaculation, and long-term results. By the end, you’ll know what questions to bring to your urologist, how to think beyond “just the prostate,” and when vapor therapy or other minimally invasive treatments may be the right next step for your BPH.

Time-Stamped Highlights

00:00 – Why surgery isn’t the only answer for BPH-Dr. Geo introduces Dr. Caruso and frames the episode around minimally invasive, real-world solutions for urinary symptoms.

05:00 – Blue-zone lifestyle, Italian roots, and holistic urology-Dr. Caruso’s upbringing, his 98-year-old mother, and how growing food, movement, and nature shape his approach to men’s health.

15:00 – It’s not “just the prostate”: spine, sleep, and metabolism-How back and neck issues, constipation, diabetes, and sleep apnea can drive frequency and nocturia just as much as gland size.

25:00 – Meds that do more: tadalafil, alpha-blockers, and 5-ARIs-When daily tadalafil can help erections, BPH, and nocturia; who might benefit from alpha-blockers or finasteride/dutasteride—and who probably shouldn’t.

35:00 – From TURP to in-office options: choosing the right procedure-Bipolar TURP for large prostates and median lobes vs. office-based UroLift, Rezūm steam therapy, and iTind—what they are, how long they last, and what to ask your urologist about ejaculation, catheters, and recovery.

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🌱 Partner Offers

ProLon 5-Day Fasting Mimicking Diet → https://bit.ly/3TVehAx

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💪 Exclusive Membership

Unlock curated transcripts, detailed show notes, expert resources, and perks.

Join here → https://drgeo.com/membership

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📣 Hashtags

#EnlargedProstate #ProstateHealth #MensHealth #DrGeoEspinosa #ProstateProblems #BPH #ProstateEnlargement #UrinaryHealth #IntegrativeUrology #ProstateCancerAwareness

⚠️ Disclaimer

This episode is for educational purposes only and not medical advice. Always consult with a qualified healthcare provider. Geovanni Espinosa, N.D., assumes no liability for outcomes based on this content.