 These aren't too embarrassing, aren't they? This one is. Can your spouse check your prostate? Of course you can check your prostate. I don't know if that's what she's doing, but anybody can check a prostate who knows what they're doing because you want to feel the prostate for abnormalities. That's what a physician does. She's looking for the change in the consistency of the prostate. So it should be like the tip of your nose to a firm and rubbery, like mine, or it could be hard, like your knuckle, which could indicate cancer or other benign processes. So can your spouse check your prostate? Yes. Should she be? I don't think so, unless she's a urologist. Any questions from the audience so far? Does sex feel the same after prostate removal? Since I still have my prostate, I'm not 100% sure of this question, but I will tell you that my patients, to the most part, say there is a change in their ejaculatory function and sensation. There's going to be some change, but if your function is still normal and you're able to have an erection, penetration that satisfies both your partner and yourself, the degree of change is really individual. The nerves get changed, the anatomy gets changed after surgery, and there's radical surgery and there's non-radical surgery, that is, for benign disease. So they all have a different amount. Many men have their erections and ejaculations, and ejaculatory fluids are all connected, and the change of any of those can make some men feel different during orgasm. So, again, that's a good question, not embarrassing at all. Let's see. Does prostate cancer make it hard to ejaculate? Yes. Prostate cancer that is treated with surgery because there's no ejaculatory fluids. You've taken out the prostate, which makes 25% of the ejaculate volume. You've interacted with seminal vesicles, which makes 70%. So you have 5% of the pre-ejaculate fluid, maybe, or 3%. So there is a change in the hard to ejaculate. If, though, you were diagnosed with prostate cancer and you weren't treated, or you weren't on surveillance, or had some minimally treatment or focal treatment, no, your ejaculation should be the same. The quality of the fluid might change depending on the treatment, but prostate cancer that's not treated or minimally treated shouldn't change your ejaculatory function. So if today you're 60 years old and your sexual function is normal, and tomorrow you get a prostate exam and a week later, a month later, you've seen this as prostate cancer. Should your ejaculation change? No. It should be the exact same function. So, next question. Last question. Are prostate exams done with fingers? Well, first of all, it's one finger, not fingers. And the... That's a great debate today because a lot of doctors stopped doing prostate exams because of PSAs, prostate-specific antigen, a substance produced only by the prostate and found elevated in cancer, enlargement, infections, after ejaculation, rectal stimulation. So with the PSA being normal, is there any reason to do a digital rectal exam? And the question is ongoing. Some of the academies of American medicine have said, no, you don't have to do it and that's their recommendation. Urologists are still expected to do it since that's our specialty in our area of knowledge. If you took a large portion of men and compared those who didn't have rectal exams and those who did, would you misprostate cancers by not doing a digital rectal exam? Probably one to two percent. Very, very small portion. So that question is changing as we speak. Hope these weren't too embarrassing. Some answers to embarrassing questions. So when I see a patient in my office, I try to let them know that this area is sacrosanct. In other words, you see these four walls think Vegas. Whatever we say in here doesn't go outside. You can deny it. So we want to make someone relax because it's very embarrassing for many men to come in and say, gee, I can't get it up. My girlfriend thinks I'm having sex with someone else because I'm not having sexual function with her. That's a common problem. It's more embarrassing and or frustration. It happens more than embarrassing questions. I mean, they're embarrassing things that happen to patients or all of us. But as far as the office, I think that's where you have to make someone feel really comfortable to ask the questions so they're not embarrassed. That's how I approach it.