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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⚠️ 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.

Is Vapor Therapy Right for Your BPH ? with Dr. Robert Caruso