THIS week I am very grateful to two readers who wrote in with questions on urology (waterworks). I am always delighted to hear from any reader in my capacity as an NHS GP, however my advice can only be used as a guide and for information, not a substitute for consulting with your own regular doctor.

Question – I’m in my early 40s and I requested a general check up from my GP. Why isn’t testing for prostate cancer part of this? – Suresh, 43

Answer – A general check up usually involves recording measurements of height and weight to calculate your BMI as well as a blood pressure reading. Routine blood tests check your Full Blood Count, Kidney and Liver Function Tests, as well as sugars to screen for pre or actual diabetes. These tests identify conditions that may improve with lifestyle modification.

The issue of screening for prostate cancer is contentious. Some advocate the use of the Prostate Specific Antigen (PSA) blood test, irrespective of whether a man has symptoms, whereas others advise it should be used if the individual complains of Lower Urinary Tract Symptoms (LUTS), these being trouble starting to urinate (hesitancy), a reduced flow, and dribbling after finishing urination (terminal dribbling). Needing to get up during sleep to pass water is also a sign of prostate issues.

Although a raised PSA may indicate prostate cancer, it can also be raised for up to 48 hours after sexual intercourse, after vigorous exercise, and for up to 6 weeks after a urinary tract infection.

In the UK, current advice is not to ignore any alteration in your urinary habits and seek prompt medical advice.

Question – I had my son three months ago, which was a very scary experience. It was a very long labour and, in the end, I needed to be cut and he was delivered with forceps. I’m ashamed to say that I now leak at points. Will it always be like this? – Nuala, 31

Answer – I am sorry to hear that you had a difficult time and I hope that your son is well and that you are recovering both physically and mentally. Sadly, urinary incontinence, to varying degrees, is a complication of childbirth, particularly if your labour was prolonged and you needed assistance.The pelvic floor is often weakened by the process.

Your first port of call would be a routine consultation with your GP.

First line treatment would be intensive pelvic physiotherapy. Weight loss and stopping smoking can help.