DEAR DR. DONOHUE: I am 88 and have an enlarged prostate gland, which gives me urination problems in spades. I am up often during the night.

I would greatly appreciate hearing your comments on the options available to me. – L.L.

ANSWER: The prostate gland is directly beneath the urinary bladder, and it completely wraps around the urethra – the tube that drains urine from the bladder to the outside world. You can see why an enlarged gland interferes with urination. Men with big glands have a hard time starting the flow of urine, cannot completely empty their bladders of urine and have to take frequent trips to the bathroom because their bladders never completely get rid of urine.

Oral medicines are one easy option for men with large prostates. One kind of medicine relaxes prostate gland muscles that have a chokehold on the urethra. Flomax and Uroxatral are two such medicines. The second class of oral medicines is ones that shrink the gland. They take three months to a year to work – unlike the first class, which works right away – but they actually change the gland’s size. Proscar and Avodart are examples. Some men have found that herbs like saw palmetto work.

Surgical procedures are numerous. Many are done in the doctor’s office. Instruments are passed into the penis and upward to the gland without having to make a skin incision. TUMT – transurethral microwave therapy – pares the gland with microwaves. TUNA – transurethral needle ablation – shaves the gland with radio waves and heat. PVP – photoselective vaporization – vaporizes gland tissue with a high-energy laser beam.

TURP – transurethral resection of the prostate – has been a reliable procedure for many, many years. An instrument called a resectoscope is passed through the penis to the prostate, and excessive gland tissue is cut away.

Your doctor is the best one to advise you which of the many procedures is most suitable for you. With very large glands, you might have to start with the most invasive procedures. With smaller ones, noninvasive methods might do the trick.

DEAR DR. DONOHUE: I love chocolate. Is it OK to eat a serving every day? I wonder how much I can eat without overindulging. – J.K.

ANSWER: Chocolate hasn’t quite been elevated to the status of a health food, but it’s not far from reaching that position. It has a lot of good things going for it. I’m talking here of dark chocolate. It has antioxidants and flavonoids that keep arteries soft and supple, protect against heart attacks and strokes, and lower blood pressure. Furthermore, the fats in chocolate don’t raise blood cholesterol like other fats do.

A 3.5-ounce serving a day is OK.

On the downside, most commercial chocolate has lots of sugar and calories, so you have to pay attention to what the label says about these.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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