Basically BPH is caused by an enlarged prostate that cuts
off the flow of urine from the bladder.
According to the Hopkins Medicine Organization, the condition is called
BPH, or Benign prostatic hyperplasia.
“Benign prostatic hyperplasia
(BPH): An age-related enlargement of the prostate that isn't malignant.
BPH is the most common noncancerous prostate problem, occurring in most men by
the time they reach their 60s. Symptoms are slow, interrupted, or weak urinary
stream; urgency with leaking or dribbling; and frequent urination, especially
at night. Although it isn't cancer, BPH symptoms are often similar to those of
prostate cancer.”
There are several
treatments for it: it can be able to
be treated with drugs or several surgical treatments. The most common treatment is called TURP or Transurethral
resection of the Prostate – or as my late uncle Alfie used to call it, “The
Ream Job.”
This is an operation a lot of guys need - but don’t want
to admit– or even discuss. After all we
are we basically view ourselves just an extension of our dicks: anything that reflects badly on our penis
reflects badly on us. I don’t know of
any organ in the human body (including the vagina) that has more nicknames
attached to it: member, cock, dick,
dink, pecker, peter, prick, putz, tool, Johnson, schlong, willy, wood - to mention
just a few of the common ones. If you
want to get more esoteric consider: ankle spanker, one eyed snake, burrito,
bratwurst - or my personal favourite, ding dong McDork. We’ve all heard the term “pissing contest,”
well it’s hard to have a pissing contest when you can’t hit the end of your
shoes.
It’s not so much having the actual operation; it’s the
run-up to the operation that’s the problem.
It’s bad enough just having your prostate checked - the finger up the
butt - but if you actually need something done to your prostate it’s how they’re
going to get there – and that’s through your penis. As the
saying goes, “Getting there is half the fun.”
Let’s face it, guys like to stick their penis into things – they
don’t like having things stuck into it – and therein lies the rub. (Sorry
- couldn’t resist). Guys won’t even to
talk about a TURP. As my friend Larry
says, the very thought of it makes him nauseous.
But after a while questions quietly come up…. “So what are the symptoms?” I had all the classics:
1. Problems
getting a urine stream started.
This is usually standing in front of a urinal or toilet for prolonged periods of time waiting “for something to happen.” In my case, I was in the bathroom so long when I came out my grandchildren failed to recognize me.
This is usually standing in front of a urinal or toilet for prolonged periods of time waiting “for something to happen.” In my case, I was in the bathroom so long when I came out my grandchildren failed to recognize me.
2. Having to urinate frequently at night.
We’re not talking about once or twice a night – but hourly. You can actually see where I’ve worn a trail in the carpet marching back and forth to the bathroom. Coupled with item 1 above means you barely get back into bed when it’s time to go again.
We’re not talking about once or twice a night – but hourly. You can actually see where I’ve worn a trail in the carpet marching back and forth to the bathroom. Coupled with item 1 above means you barely get back into bed when it’s time to go again.
3. Dribbling after finish urinating.
In this case a little rhyme is in order:
“No matter how much you shake your peg
Some always drips down your leg”
…or on the floor in front of the toilet.
In this case a little rhyme is in order:
“No matter how much you shake your peg
Some always drips down your leg”
…or on the floor in front of the toilet.
So when you finally have had enough you screw up your
courage and go and see your friendly urologist (try and pick one with thin
fingers) you figure the worst thing that would happen would be “the finger” – but I was wrong. He actually wanted to have a look at my
prostate.
“…and how are you going to do that?” I asked.
“With a cystoscope,” he replied.
“Is that like a telescope?”
“Sort of - it’s a camera on a long tube we insert up your
penis….”
At this point I
put my hands over my ears and began to chant, “La-la-la-la-la-la-la-la”
It’s like a colonoscopy, where they shove a camera up
your rear end on the end of forty miles of cable. Except this time it’s up your penis which, in
most of our cases, is a much smaller orifice.
I duly show up at the hospital for the cystoscopy which
should take about ten minutes– a very LONG ten minutes!
“Do I get an anesthetic like I received when I had the
colonoscopy?” (Which I mercifully remember absolutely NOTHING about.)
“Nah, it’s not necessary,” my cheerful urologist replies.
“We’ll just spray a little local anesthetic on the end of your penis. You won’t feel a thing – maybe a little
pressure – that’s all.”
“Have you actually had this procedure yourself?” I ask skeptically.
“No,” he admits.
“But everyone tells me it’s not that bad.”
“Perhaps we should wait until you’ve had it done.” I suggest.
“You can watch the whole thing on TV right over there,”
he says, pointing to a huge TV monitor off to the side.
“I would prefer to watch something else. Do you have any movies? Maybe Fantastic
Voyage?” (That was a movie about a bunch
of doctors who were miniaturized and inserted into a human body. But if I remember correctly it wasn’t through
the penis.) Not many movies have urologists and proctologists as heroes – and
rightfully so.
Before I can protest further I feel something moving up
my penis! It doesn’t hurt, but it’s
mighty uncomfortable!
“You might feel like you have to pee,” the doctor advises
as he shoves another ten meters of hose in.
“Also it might help if you try and breathe,” He suggests.
“Just a little further to go…. HOLY COW!!!!!!” he shouts.
I nearly jump off
the table. “What is it?” I gasp, fearing the worse.
“You have the Mount Baker of prostates! Look at that!
“I don’t want to look.”
“You really should!
It’s incredible!! The only thing missing is snow!”
“I’ll take your word for it.”
With the sightseeing tour completed the “dink-a-scope “(as
I have named the device) is retracted in a manner similar to pressing the
button on the top of your vacuum cleaner and watching the cord whip back into
the machine.
“We’re definitely going to have to do something about
that,” he says rubbing his hands. “There
are a couple of options: one is to treat
the condition with drugs which might shrink the prostate – the other is
surgery. The downside of the pills is
that once you start taking it, you have to continue taking them forever. Since I’m already on some daily medication
it’s a no-brainer – opt for the pill.
The pills seem to be working on most of the symptoms -
but not the frequent night time visits.
“No problem,” he says.
“We’ll give you some terazosin for that.
It’s an alpha blocker that use to be prescribed to lower high blood
pressure. The side effect is it causes
you to pee more. Sort of like Cialis –
except you don’t get an erection.”
“Is that such a bad thing?” I ask.
The two pills seem to be doing their thing, but another
problem arises. I’m getting heart
palpitations and I’m so fatigued that I can’t even walk a block. I fear it’s my heart acting up and make an
appointment with my family doctor.
“Is there any chance it could be related to the terazosin
the urologist gave me?” I ask.
“No, impossible.
It’s probably your heart. You
better see your heart specialist.”
The heart specialist sees me almost immediately. I explain to him my symptoms. He seems concerned.
“Could it be the Terazosin?” I ask.
“No way. We better
get you scheduled for a stress test right away.
A few days before my stress test I have a scheduled
appointment with my urologist. I don’t
get half way through my spiel when he interrupts me.
“It’s the terazosin,” he states. “It’s very rare, but
I’ve seen a couple of cases of it, and you’ve got the classic reaction. The good news is if you stop the medication
and you’ll be back to normal in a couple of days. “
“…and the bad news?”
“You’re allergic to alpha-blockers which rules out using any
pills to control the symptoms. Your only
option is an operation.”
Now I have a confession to make: this isn’t the first time I’ve had the
“operation,” nor the second – nor even the third! It will be the fourth time! The problem is the prostate is the dandelion
of organs. Cut it back and it just grows
back stronger. Normally the prostate is
the size of a walnut – my urologist proudly tells me mine is the size of a
small watermelon.
He promises to do a much better job than my previous
urologist (who bore a striking resemblance to Groucho Marx – which might have
been the problem.)
The operation is preceded by the mandatory bloodwork and
ECG along with a meeting with the anesthetist
who wants to know if I have any
concerns he should be aware of.
“Two,” I state. “First of all I would like to not
wake up during the operation. This
happened to me on one of my previous operations and it was very disconcerting.”
“I can see why you
might find it upsetting,” he replies.
“Not for me -for the doctors.
(Fade back in time to the operation)
“Hello!” I shout when I realize I am awake.
“Do you hear something?” one of the doctors asks behind a screen at the
lower end of my body?
“Could be my iPod,” one of the nurses replies.
“No. It’s not your iPod,” the
doctor replies
“It’s me – the patient. Up here at the other end,” I shout. “I’m
awake if anyone cares. I’m not just another pretty penis with a face.”
Suddenly a mask is shoved over my face and I mercifully fall asleep
again.
(Ripple effect back to present time)
“That sometimes happens,” the anesthetist replies when I
finish recounting my story. “We give you
a spinal so you won’t feel anything below the waist. Some people prefer to be awake for the whole
procedure. They find it interesting.”
“I’m not one of them,” I retort. “I prefer to be asleep for the whole thing.”
“Duly noted,” he replies. “And what’s your other
concern.”
“That I wake up when it’s over.”
A week later it’s operation time. My wife escorts me to admitting like I’m a
kindergarten kid going to school for the first time.
An IV is inserted into my arm and I’m given something to
make me comfortable. I’m asked to sit up
and bend over to make it easier for them to jab a needle into my spine. Before I can ruminate on this further the
anesthetist injects something into the IV and I’m off to la-la land.
The next thing I remember is being awakened by a nurse
asking me if I can wiggle my toes.
Mercifully I can. As I become
more awake I notice the catheter running from my penis. It’s connected to a maze of clear tubing –
sort of like a divided super highway.
One branch runs down from an IV bag into me and the other runs into a bag
in a pail. The highway interchange is
right at the head of my penis. It’s not painful
-just uncomfortable.
I’m in co-ed room with four other people who are
mercifully quiet – unlike one of my previous visits where the room was
populated with wack jobs who moaned and screamed all night, till I contemplated
putting them (and me) out of their misery with a pillow. Fortunately (for them) I couldn’t figure out
how to smother them while still hanging onto my IV in one hand and the catheter
in the other.
Every hour or so a nurse replaces the empty bag on the IV
pole with a fresh one, and empties the bucket.
Around midnight one of the nurses comes in and shut-off the waterworks
and tells me if things look good they’ll remove the catheter in the morning.
Here’s a hint for you:
never – I repeat, NEVER – let a student nurse remove your catheter. I’d rather let them perform unsupervised open
heart surgery on me than remove my catheter.
During one of my previous visits I was asked if I minded
letting a student nurse remove it. I
agreed figuring she needed to get some practice, and what could go wrong.
There are two parts to inserting the catheter. First it’s insert then a bulb inside is
filled with water to seal it and insure that nothing dribbles out and
everything goes out through the tube.
When it comes time to remove the catheter they first drain the
bulb. My student nurse must have missed
that part of the lecture. When it came to
remove mine she must have thought she was starting a chain saw. My nail marks are still in the ceiling
tiles. So no more student nurses for me.
After the catheter is removed they want to insure you can
pee okay before sending you home. At the
previous hospital they placed jars in the bathroom with our name on it. There was a red line about three-quarters of
the way up the jar. When you’d peed
enough to reach the red line you could go home.
One of my roommates was a “peeing machine.” Every few minutes he’d retreat to the
bathroom and return with a smile on his face and give us a progress
report. I wasn’t doing as well.
After his fifth visit he proudly announced he’d reached
the magic mark and called for the nurse to verify his accomplishment. While he was waiting for her to arrive I paid
a quick visit to the washroom. The nurse
arrived shortly after.
She returned from her inspection of the jars and
announced, “Well Mr. Groberman, I see you can go home now. Well done.
We’ll call your wife to pick you up.”
“Excuse me,” my roommate interrupted, but what about my
jar?
“I’m sorry, sir. You’re only halfway there.”
“I’m sorry, sir. You’re only halfway there.”
I smiled at him as I gathered up my stuff.
It takes a little longer this time without “help”; but around
noon they call my wife to come and collect me.
I have been in hospital 24 hours.
Now would come the part I dreaded more than the operation: the recovery.
The recovery usually takes three or four weeks. Based on my three previous operations there
is an initial week where you don’t feel too bad – other than the “dance.” The “dance” is caused because the urethra –
the tube that carries urine from your bladder - is irritated from the procedure
(and rightfully so!). You experience its
displeasure as a burning or tingling sensation when you pee. This discomfort is accompanied by hopping
from foot to foot or, in extreme cases – running on the spot. The good news is
that this sensation usually decreases over the first couple of weeks and the
dance becomes more of standing on your tip toes at the beginning and ending of
each pee. By the end of the third week the
dance is over. The “dance” is sometimes
accompanied by the “blood thing” (An actual medical term).
The “blood thing “can be a bit disconcerting: I don’t like blood of any description coming
from any of my orifices at any time.
Unfortunately this is not possible when you have a TURP. When you’re in the hospital you’ll notice
that there is blood in the catheter tube.
Usually when they send you home there is the fluid in the tube is clear. When
you get home you may notice that the pee in the toilet is a faint pink
color. That’s normal. There may even be a drop of pale blood when
you begin and end peeing. This comes and
goes.
However don’t get complacent about the relatively nice
clear stream. Somewhere around the
second week you’ll notice you will start to pass clots (just when you thought
you were over the whole thing). It’s a weird sensation when these pass – not
uncomfortable – just sort of weird.
The scariest time is around the third week when most of
the scabs seem to come off. You’ll be
passing a bunch of these things – again with some diluted blood. This usually lasts a couple of days. I’m usually panicked at this time and on the
verge of calling the doctor. But (again
based solely on my experience) this passes and in a day or two- and congratulations
- you’re on the other side of the whole thing - the worst is over. There may still be the odd small clot or two
that passes and by the end of other two or three weeks you should be 100%.
Is it worth it? I
think the short term discomfort is worth the results – most guys agree. And besides, my new urologist is guaranteeing me ten years on this job and I
don’t have to keep wiping off my shoes.
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