DEAR DR. DONOHUE: I am 77 and have been “watchfully waiting” with an enlarged prostate for 20 years. Is there sex after prostate removal? – M.B.

ANSWER: Yes, there’s sex after prostate surgery. The inability to attain an erection after prostate surgery hinges mostly on damage done to nerves serving the penis during surgery. Those nerves lie in close proximity to the gland, and keeping them intact during surgery can be difficult. Damage mainly occurs when the entire gland has to be removed. That’s something rarely done for prostate enlargement – it’s done for prostate cancer. Even then, modern surgery is careful to preserve those nerves.

Less-radical surgery, like a TUR – transurethral resection – is not likely to lead to postsurgery impotence. Here the gland is pared down using instruments passed into the urethra, the tube draining the bladder. About 4 percent find having an erection difficult after this procedure. There are even-less-invasive procedures than a TUR. TUNA, for example, is transurethral needle ablation of the prostate. Laser reduction of the prostate is another less-extreme attack on the gland.

Why are you considering surgery? Have you tried medicines? Flomax and Uroxatral relax nerves that clamp the bladder shut and that constrict the prostate gland. Proscar and Avodart are medicines that actually shrink the gland, but it can take as long as six months before results are seen. Medicines rarely lead to erectile dysfunction.

The pamphlet on the prostate gland deals with prostate cancer and prostate enlargement. Readers can obtain a copy by writing: Dr. Donohue – No. 1001, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: There are conflicting opinions on the subject of an ulcer diet. I hope you can offer some clarification.

Years ago, a member of my family was diagnosed with a serious case of ulcers. He was placed on a strict dairy diet, which included lots of milk. Now he is told that milk is one of the worst things people with ulcers can drink. Several people have been provided with the same opinion.

I recently called a reputable health hotline and was informed that a bland diet, including diary products and milk, are recommended. – B.M.

ANSWER: In bygone years, milk was recommended for ulcers. It was believed to coat the stomach and to soothe ulcers. It does neither. In fact, it promotes acid secretion, something you don’t want to do with ulcers. The milk recommendation has gone the way of dinosaurs.

Ulcers are not thought of in a new light due to new information. Partly they’re due to a bacterium called Helicobacter pylori, a germ that can withstand the stomach’s hostile acid environment. If this bacterium isn’t gotten rid of, the chance for ulcers to return is quite high. New ulcer treatment, therefore, includes the prescription of antibiotics.

There is no special ulcer diet. The bland diet died along with milk treatment. People can eat whatever they want so long as the food doesn’t upset their stomach. The ulcer diet has become a personal matter.

DEAR DR. DONOHUE: What makes my nose run when I eat? – E.B.

ANSWER: That’s gustatory rhinorrhea, a reflex many have and one many find most embarrassing. Taking a decongestant or an antihistamine about an hour before meals can stop the drip. Your pharmacist can direct you to the ones stocked in his or her drugstore.

Don’t take a pill every time you eat. Save it for situations that can be socially mortifying.

DEAR DR. DONOHUE: A bone density test showed that I don’t have osteoporosis, but I do have osteopenia. What is it? I called the doctor’s office and was told I don’t need to do anything for it as far as medicines go. I’m not sure what I should do as far as things that aren’t medicines. What are those things? – R.S.

ANSWER: Osteopenia is one step behind osteoporosis. People with osteopenia – and they’re usually women – might not need medicines, but they can’t neglect this warning or they will find themselves facing osteoporosis.

You must make an estimate of how much calcium and vitamin D you’re getting. You should aim for a calcium intake of 1,200 mg to 1,500 mg a day. If you can get your calcium from food, that’s great. Food calcium is better absorbed than supplement calcium. Dairy products are the best sources of calcium. One cup of milk has 300 mg. However, not many adults are into milk-drinking. (If you are, make your milk the low-fat or skim variety.) Cheese has a good supply of calcium. There’s 204 mg in an ounce of cheddar cheese. Three ounces of sardines with bones has 371 mg, and 3 ounces of salmon with bones has 181 mg. One cup of cooked spinach provides 245 mg. Even though calcium in calcium supplements isn’t absorbed as well as food calcium, you can meet your calcium requirements with calcium tablets.

As for vitamin D, the recommended amount is 400 IU for people between the ages of 51 and 70, and 600 IU for those older than 70. Many would recommend a higher dose for all — 800 IU.

You must start to exercise, and weight-lifting exercise is the best kind for building strong bones.

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