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SPENDING A PENNY

a polite old English phase meaning to Urinate

YOU MEAN YOU'VE BEEN TO THE TOILET NINE TIMES RUNNING?
YES DOCTOR, I COULDN'T HAVE MADE IT IF I'D BEEN WALKING! .

What every man should know about his Prostate 

SYMPTOMS OF BENIGN PROSTATIC HYPERPLASIA

These are the usual symptoms of B.P.H. and as you will see they are all connected with the waterworks.

1. The desire to urinate frequently during the day.
2. Waking several times during the night to urinate. (This is know as Nocturia or Nocturnal Polyuria)
3. A hesitation to begin urinating.
4. A slowing of the urine's stream force.
5. Being unable to shut off urine, or a dribbling after trying to stop it.
6. A tightness and being unable to urinate at all.
7. The feeling that the bladder has not been completely emptied.
8. If the kidneys have been damaged by the retention of urine this can be responsible for dizziness, nausea and feeling sleepy.

If you have three or more of the above symptoms make an appointment with your family doctor.

He will then most probably perform what is know as a digital rectal examination which is not in the least painful but slightly uncomfortable. As the prostate is next to the rectum it can be palpitated and your doctor will just want to check to see if it feels enlarged and at the same time find out if there are any lumps or hard spots on the two lobes he can touch.
As stated previously a healthy prostate is about the size of a chestnut or walnut, and smooth and elastic. If you have B.P.H. it will still feel the same but obviously bigger.

Generally speaking a patient is not a good candidate for surgery during the early stages of B.P.H., he is more than likely to be put on a kind of maintenance programme which entails annual checks by a urologist for any developments of the condition. There are case histories of men in their fifties who have been on maintenance care for up to fifteen years before the prostate has become sufficiently enlarged to require surgery or one of the new alternative treatments or drugs which are still being developed. Incidentally, the notion that B.P.H. is a leading cause of prostate cancer is a complete myth. The cause of the former is unknown but the cause of the latter is and they are no way connected. It is true that in some cases during some surgery for the relief of B.P.H. the prostate has been discovered to be cancerous when it has not been diagnosed initially. Actually one of the benefits of surgery is that cancer can often be detected in its early stages before it spreads.

Although certain operations will be covered in greater detail at a later stage, this is an ideal opportunity to explode another two myths associated with prostate surgery. Namely that after such an operation the patient becomes sterilized or that an orgasm doesn't feel the same.
When all or some of the prostate is removed by prostatic surgery, with about fifty percent of the patients, a disruption in the normal course of semen and other fluids usually ejaculated, occurs. An orgasm feels just the same, it is simply that instead of the fluid going down the urethra and out of the penis, it takes the course of least resistance by flowing upward into the bladder. On the face of it this might seem to end the patients prospects of becoming a father, but it must be pointed out that the semen can be rescued from the next urination after the orgasm, and can be artificially inseminated. However, as in the majority of cases this situation is most likely to occur when the patient is in his forties, fifties or sixties, this should not be of great importance.

There are some other fallacious notions associated with prostate disorders but these will be dealt with in due course, in the meantime I will move on to a few other tests which are available.

If, during the digital examination, the doctor has discovered hard lumps or nodes on the prostate, of which he was suspicious, then a biopsy will normally be performed. However, today we are fortunate that an Englishman, Sir Peter Mansfield and an American Paul Lauterbur developed Magnetic Resonance Imaging M.R.I. so that an image can be made of the prostate before any invasive procedure.

Also, as about one in ten cases of surgery for the relief of B.P.H. result in the discovery of prostate cancer in its early stages, the patient may have to undergo further tests in order to establish that the prostate is not cancerous as well.

P.S.A. are the initials of a blood test called the prostate specific antigen test. The elevation of antigen can reveal a possibility of the presence of cancer in the prostate, and an accompanying test for prostatic acid phosphate. (P.A.P.) may reveal whether the cancer has spread to other parts of the body.

Another test which might be made is the peak flow test which can be done with an instrument that will record the flow of urine. The timing of urination into a glass with a stopwatch can also obtain similar results. A weak flow for example, that takes two or three times the normal length of time, can reveal a serious blockage in the urethra and would most certainly be followed up by further tests.

One method of testing which is becoming more popular with urologists is the use of ultrasound or sonography, as it is sometimes called.
Testing by this means is not only simple and quick but also painless. In addition to this it is now available at most hospitals.

If you need to visit your doctor, having read this far, ask him about the possibility of having one or more of these tests or to tell you exactly what they entail. Actually he will probably recommend a consultation with a urologist who has this equipment if he considers if necessary and if this facility is available.

Incidentally, unless your doctor is a clairvoyant, which is most unlikely, please remember that he can only give you a proper diagnosis and prognosis by asking you a number of questions.
Some of these might seem unconnected with your ailment, personal or even impertinent. For goodness sake tell him or her the truth, whatever it is or how bad it might sound.

Just suppose, for the sake of argument, that you are fifty five and have been happily married for about thirty years. Your wife's ability as a cook and housekeeper is beyond reproach but over the years, especially since the change or menopause. she has let herself go and doesn't pay the same attention to her appearance as she used to. One day you suddenly notice that the bloom of youth has faded, as light from the darkening sky. She has perhaps become fat or slovenly and instead of having the face of a Madonna like when you first fell in love with her, it now looks more like a bag of chisels. (Remember that women usually age much quicker that men ). Worse still, the thought of making love to her is, and may have been for some time, just about as appealing as going nude hang gliding in the Himalayas. An attractive divorcee twenty years her junior comes on the scene and before you realise it, you find yourself having sex several times per week and sometimes during the day. This woman has given your sexual prowess, which you thought might have gone, a new lease of life. You then begin to find it difficult or even painful to urinate and decide to visit your doctor.

At this point it is a very good time to make it emphatically clear that a man's sex life is NOT connected with the cause of B.P.H. or prostate cancer, but a sudden upsurge in sexual activity OR CELIBACY can and often does, affect the prostate.

Consequently, if your doctor asks if you have had a recent bout of sexual activity, perhaps with another partner, it is not because he wants to pry into your personal life.

Fortunately there are very few doctors in the blackmail business, so you should be quite safe in thinking that your doctor's vocation is not to judge you but to help and cure you. However, with the best will in the world, he or she can only do this with your FULL co-operation.

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