SPENDING A PENNY

Let us now move on a stage further and assume that you have recognised three of the symptoms given in the symptoms page, visited your doctor or urologist and he has diagnosed B.P.H. The P.S.A. and other tests including an M.R.I. scan which may have been performed have proved negative and this means you DO NOT have cancer. Your physician might point out that in almost every case prostate cancer is on the outside of the prostate lobes, whereas the enlarged prostate grows outward and inward. There is no connection whatever between the two. Also, it is important to bear in mind that cancer can strike at any time of life and any part of the body. In addition to this, nowadays cancer is not as fatal as it was a few years ago, especially when it is discovered during its early stages. Indeed, the number of people who are being cured of this once dreaded disease is increasing all the time.

At this stage you needn't get into a panic, after all you could have already had B.P.H. for a number of years without realising it, and it could be ten years or more before you need worry about the possible consequences of surgery.

The important thing is that you now know what has been causing these little problems or irritations and coping with them is largely a matter of common sense. Your body needs water and fluids to survive, but it would obviously be quite foolish to deliberately overload your urinary system by drinking several pints of beer.

Remember what goes in must come out. A wise policy is to discuss with your doctor or urologist how much fluid you require and what the minimum daily need is for intake of fluids for a man of your size. Obviously this will vary and depend on you occupation and haw active you are, also it might be far less than you think.

Patients with B.P.H. do not need any more stimulations in their urinary tract than necessary, and neither any more volume. Hence the need to avoid caffeine fluids and not to drink any more than you need. Actually the former should not pose any major problems because there are many caffeine free products available such as decaffeinated coffee and caffeine free cola etc. so it's just a matter of checking the labels. Many people claim that after a week or two of using these products they don't notice the difference. Also remember that many pain killer pills for headaches and so on contain caffeine so once again keep an eye on the labels. Regarding the intake of fluid, your body will tell you when you need a drink, so try to cut down on liquids gradually. Should having to get up several times during the night bother you, try to make a point of not drinking any fluids for four hours before you go to bed. By doing this the fluids will be processed and passed before it is your sleeping time.

Nervous tension can also increase the need to urinate and many people in show business get this problem just before they go on stage. If you decide to see a film or a play that is full of suspense make sure you take an aisle seat, or one in the back row of the theatre. Once again it should go without saying that it would not be a good idea to sit guzzling pop during the performance or have a pint of beer at the bar during the interval, which brings me to the next item which you've probably been expecting.

Alcohol can cause serious problems with the liver and some urologists have been saying for years that it irritates the prostate. In addition to this some alcoholic flavours can effect the prostate to such an extent that a sort of chronic prostatitis can be caused. However, if you still insist on drinking beer use some common sense, but remember that too much or the sudden use of alcohol can bring on a surprise attack of acute urine retention which was covered previously, even if you only have early B.P.H.

No matter how many precautions you take regarding the aforementioned, sooner or later a situation is likely to occur when you've left it too long to urinate and this need not be your own fault. Just suppose you are driving home and get stuck in a traffic jam perhaps on a motorway. By the time you get home or to a service station to use the toilet your whole crotch is burning. Instead of standing at the urinal go into one of the toilets and sit down to urinate and if possible bend forward towards your knees. For some unknown reason, possibly because it relaxes a circular muscle called the urinary sphincter which contracts when the urine is shut off, sitting down this way makes urination much easier at times as difficult as this.The next time such a situation arises try it.

Incidentally, this is a good moment to put the record straight about another couple of myths or half truths regarding the possible consequences of prostate surgery. One is the fear of incontinence, ( Being unable to control the voiding of urine or faeces ) and the other is impotence ( Being unable to get an erection or keep it long enough for vaginal penetration ). Let me deal with the former first.

By the way if it will make you feel any better, researchers say that only four percent of B.P.H. surgeries will result in the patients having trouble retaining their urine and many urologists claim it is less frequent than that.

The urinary sphincter, which was mentioned a few moments ago, surrounds the urethra just beyond the prostate gland towards the penis. Now the problem occurs when, during the operation, the electric knife cuts to near the sphincter voluntarty muscles which control the flow of urine, and if these muscles are damaged the patient may become incontinent.

It should be pointed out here that incontinence after surgery does not have to be permanent or irreversible because there are drugs that can be used to relieve the situation, and even the possible use of an artificial sphincter.

Impotence is a very touchy subject with most men, and some psychologists tell us that sex is 75% mental. It is not uncommon for example for a YOUNG MAN not to achieve an erection at times, but this does not mean he is impotent. There could be many reasons for this which could range from nervousness to being too intoxicated.

On the other hand it is not uncommon for a man, or sometimes a woman either for that matter, to have an orgasm by sometimes simply thinking about sex, providing the emotion is strong enough.

For this reason impotence is difficult to pinpoint, especially with men over sixty. A man's sexual habits change as he gets older. If for instance he is in his sixties or seventies when he has B.P.H. surgery he could have been impotent before his operation and only notice it afterwards.If the truth be told, such an operation has been a good scapegoat for the sudden realisation of impotence.

It is true that if damage is done to one or both of the nerve bundles that are on each side of the prostate this will result in the patient being impotent. However, these bundles are well outside of the true capsule of the prostate. In other words they are well outside the area where a surgeon's electric knife should be operating to remove the prostate tissue clogging the urethra. In short, B.P.H. surgery properly carried out, should not harm these nerve bundles and this operation should NOT be the reason for impotency.

On many occasions the reason is purely psychosomatic. If a man has a mental fixation prior to the operation that it will make him impotent, the chances are that it probably will. The constant taunting of a partner who is unsympathetic can also be instrumental in bringing about a negative psychological effect.

If this should happen to be your problem see your doctor or urologist because there are some drugs which can defeat impotence by being injected directly into the side of the penis. A dilation of the arteries is caused thereby increasing the flow of blood to the penis and also causes less blood to leave the penis.

As it is blood that causes an erection, and with the increased flow, many impotent men are able to achieve a firm erection and subsequent intercourse.

It should be carefully noted here that the aforementioned only applies to surgery for B.P.H. and NOT cancer. Stage A and B cancer of the prostate for instance usually involves a radical prostatectomy or the complete removal of the prostate. This nearly always harms the nerve bundles on both sides of the prostate and results in a man being impotent. In a case such as this the surgeon has to consider the patient's life rather than his sexual ability.

We will now move on a stage further and assume that a few years have slipped by, and during this time you have been having regular checks on your prostate by your physician.

It must be stressed once again that once the prostate begins to enlarge it will continue to do so. You cannot take a pill like you do for a headache and expect it to go away. Sooner or later it will be necessary for you to undergo some kind of surgery.

It is true that one day a less intrusive cure for B.P.H. may be available but that could be years away, and this is no consolation to someone who needs treatment NOW.

You have probably been wondering, quite understandably, what is likely to happen once you get on the operating table. To give you some idea a brief outline is given on the Surgery page...