What is the prostate?

 Before I start this post I need to restate that I am not a medical doctor. These are just my experiences and my interpretations, but if you're in any doubt go and see a medical professional. Don't be one of those people that 'Do TheiR ReseaRch' online because as we've seen recently that can end badly.

OK, with that in mind let's begin. 

The prostate is a walnut sized organ that sits between your bladder and the outside world. There is a tube called the urethra that runs through the prostate and out into the base of the penis. When you ejaculate the prostate adds seminal fluid to the mix that you expel. 

This is all well & good when everything works as planned. But as you get older the prostate can get larger (for a couple of different reasons), and when it does it can compress the urethra and reduce the flow of liquid that can pass through it. Imagine you have a tank of water hooked up to a hose. If you open the tap the water will flow out at a set rate. If you compress the hose (squeeze it or bend it) then the flow rate slows down, and at a certain point the pressure required to push out the liquid will not be enough to overcome the resistance in the hose. This is essentially what can happen when you get older. The swollen prostate compresses the urethra (the hose) so that flow rate is reduced and the bladder (the tank) can't empty completely.   

There are a few classic symptoms of an enlarged prostate, which are generally bundled into a diagnosis of LUTS (Lower Urinary Tract Sympotoms). These include  - 

  • Weak urine flow - more of a trickle than a fire hose. This trickle can also be frustrating & embaressing as it can lead to dribbling, random spraying and sometimes the retention of urine within the penis once you've finished. The easy way around this is to sit down when you urinate. Ignore the 'only girls sit to pee' crowd. If anyone judges you on your toilet habits then their opinion is worthless anyway. 
     
  • Regular and increased / sudden need to urinate. This is because your bladder does not fully empty each time you use the toilet and so fills up more quickly during the day. I get around this during days of meetings by using the toilet whenever I get the opportunity, whether I feel the need or not. Sitting down also helps empty the bladder a little more too. 

  • Dribblage - this can happen and it is mortifying when it does. But you're not a child and it is not due to  a failing on your part, it is just that part of your body is working incorrectly. There are any number of different pads you can either wear or stick into your underwear if this happens. Most types aren't not a fully absorbent nappy and you can't just relax and let it flow, but they will absorb any overflow or sneeze / cough induced dribbles. I use level 1 pads when I have a day on site with clients and to me they just feel like I'm wearing padded bike pants. As far as I know they've not been necessary but they give me confidence. Wearing dark trousers is also a good idea just in case.    

  • Nocturia, or waking up multiple times during the night to urinate. It's a wonderful word! For me this generally has minimal impact because we have a bathroom right next door to where we sleep, but it can be embaressing when we're camping as it feels like I'm constantly opening and closing the van door even though it is generally only two - three times / night. Apparently you can reduce this by limiting your fluid intake after 6pm but that would mean cutting back on beer! 

So what can cause an enlarged prostate? Primarily age. Your body puts out a balance of hormones that changes as you get older, and for reasons currently unknown this can lead to your prostate getting larger (the god recognised by christians is generally considered to be an old bloke so this puts a stick in the spokes of intelligent design, but I digress). A lot of people will suffer from an enlarged but otherwise healthy prostate as they age and it's known as Benign Prostatic Hyperplasia or BPH. It can be fixed by surgery or by drugs - oddly they prescribe drugs that make you urinate MORE so that you can empty your bladder more effectively. 

But your prostate can also develop malignant growths, also known as cancers. These will generally not affect your ability to urinate as the most common development site is at the posterior (back) of the prostate, away from the urethra. In my case the cancer is mainly at the anterior (front) of the prostate and so there is an affect on my urethra - well, that's how it feels to me, although it may also be psychosomatic.

There's no real way to identify the cause of your LUTS without medical help, and prostate cancer can also be present without LUTS. In the next post I'll look at how prostate cancer is detected by running through my personal timeline. 




  

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