A Silent Subject for men over 40

[Markus]

I went to a doctor and was referred to a Urologist. The result was that I have an enlarged prostate. Not having a clue as to what that was, I have learned some info on the subject. I had what they call a PSA exam and all was normal. The doctor gave me some antibiotics and that's what I'm doing. The reason why I went to the primary doctor was that I noticed that taking a wizz was more difficult. The doctor said these symtoms can happen to men over 40, but what I have learned is that it  mainly effects men in their 50's and 60s and higher.  What's up with this? Are there any men who have experience with prostate problems that can tell me something I should know?

Mark

[Gator]

Mark,

You just need to have someone massage it once daily, and everything will be okay.

In all seriousness, more men die from prostate cancer than any other cancer (second is colon).  The inexpensive PSA test is your best indicator for cancer, and since your PSA levels are low, you should sleep well (even if you have to get up in the middle of the night to urinate). 

[SANDRO43]

I went to a doctor and was referred to a Urologist. The result was that I have an enlarged prostate.

Mark, an enlarged prostate may be due to infection (hence the antibiotics), cancer (hence the PSA test), or to age (BPH). If antibiotics will not produce a remission of your symptoms, then yours might be an early case of Benign Prostate Hypertrophy, which can be confirmed by a simple ecography.

[Jet]

........... which can be confirmed by a simple ecography.

Good advice, but if you check out ok and still notice symptoms, as is the case with Lil's dad (BPH), you might give a Saw Palmetto & Lycopene regimen a try. Ask the urologist about it before you do, but her dad has experienced a great deal of relief over the past 2 years. We go to GNC and then ship it to him, but you should be able to find these anywhere that sells vitamins.

[I/O]

Enlarged prostate or quite commonly "Prostititis" is very often caused by the most simple chain of events.  Most commonly it is a combination of a severe head cold or Flu together with sitting on a subtly vibrating machine such as a tractor or some motor cycles and drinking alcohol that invoke the initial bout of it.  The combination of these often precipitates into a low grade, deep seated infection in the prostate gland causing inflammation.  The most noticeable symptom generally is irritation in of the urethra, inability to complete or freely urinate and so forth.

The reason for urethral discomfort is mechanically quite simple although somewhat obscure.  The prostate gland sits roughly against the underside of the urethra as it exits the bladder.  When the gland is enlarged, it places pressure on the urethra and at times can almost block any flow.  Further it restricts extension of the urethra necessary during erections and can cause discomfort during sexual activity. 

Treatments are wide a various but very often involve a cystoscopy and prostal massage.  Yes Gator although joking is right in part.  It is much more common in younger men than many realise, although they often recover without treatment as a more virile body will tend to expel infection more quickly most often. 

PSA or Prostate Specific Antigen tests are common place now and IMO all men should undergo one on a regular basis in the same way as many women have regular mammograms and pap smear tests.  No it is not the whole answer, but the success in early detection of problems negates any argument to the contrary.  Cancer is always a possability and should never be discounted, but very often it is not and one should always investigate at the first sign of discomfort.

OWW: Once you have had a bout of this, it is much more likely to occur again.  Not great news, but that is just how it is.  It is quite manageable.  A few basic do's and dont's are not eating spicy foods, severely limit alcohol consumption, if you have a motor bike, get rid of it.  Be very sure if you have a head cold, don't be sitting on vibrating type machinery.  This is an extremely common complaint among many many farmers for obvious reasons and particularly in the winter or colder months. 

This is NOT some insidious disease.  It is not often sexually related in any way shape or form.  It cannot be transmitted period. One other annoying but very real side effect can be pain during defecation due to the tender nature of the enlarged gland and it's proximity to the bowel.

I suggest you do a search and find a diagram of that part of the anatomy.  It will help you to understand the mechanics of what is happening to your body and thus place less mental stress. 

Hope that helps.  An interesting discussion on this subject can be found here http://www.medhelp.org/forums/urology/archive/300.html
I/O

[Muj]

  OWW for asking.  Men under 40 experience the prostate infections as well, as I/O posts.  The most painful part for most men is aking a doc for help or even discussing it with other men.  Good post I/O.

[Mir]

There is an unproved link between BPH and sexual activity.
So you can assume that you have developed BPH at an earlier age because you are such a stud

Treatment can be done by drugs and/or surgery, in milder cases no treatment is an option.
Interestingly one of the drugs used in its treatment 'Finasteride' is also used to treat male pattern baldness (albeit in a lower does).

[BillyB]

You just need to have someone massage it once daily, and everything will be okay.

I have relatives that had prostate problems and I sit on vibrating machinery a lot so I may have issues later on. I can find a willing volunteer but is there a better way to massage the prostate than this?

[ScottinCrimea]

I have done more than my share of digital exams.  I was told by my mentor that the only excuses for not doing one on all hospital admissions was if the patient didn't have a rectum or I didn't have a finger.

On examination, an enlarged prostate is typically due to inflammation, infection or BPH.  More typical of cancer is an irregularity or nodule that an experienced finger will easily detect.  I would absolutely not use the PSA as a screening test.  It is too sensitive and not specific enough.  What this means is that it will often be elevated from things that are not cancer.  The problem is that if the test is elevated, then the physician is obligated to move on to the next test, which is a biopsy.  This is where they go in through your rectum with a tube and take small chunks out of your prostate to send to the lab.  The majority of the time these will come back negative, so you've gone through an expensive and very uncomfortable procedure because the PSA couldn't tell if it was cancer or not causing the elevation.  I see the value of the PSA in monitoring a known cancer, especially during treatment.

Now here's little secret about prostate cancer that most doctors won't tell you.  There are basically two types:  The slow growing nonaggressive type and the fast growing very aggressive type.  If you have the bad type, usually by the time they find it, it's too late for anything but drastic procedures such as radical surgery to remove the prostate and lymph nodes in the pelvic area, chemotherapy and radiation therapy.  Even with these measures the rate of cure is not so good.  By far most prostate cancers are the more benign type that tend to stay where they are and cause problems by growing locally.  They are typically so slow growing that many men in their 70's and 80's will choose to do nothing because there is more likelihood that they will die of something else before the cancer gets them.  They may settle for only local procedures to minimize the symptoms.

So what would I do if I was found to have an enlarged prostate?  Take the antibiotics, wait for a few weeks and get checked again.  If it persisted I would get radiological studies and the PSA only as something to compare to future tests if needed, not as a diagnostic test.

[SANDRO43]

I would absolutely not use the PSA as a screening test.  It is too sensitive and not specific enough.  What this means is that it will often be elevated from things that are not cancer.

Scott, IIRC while high PSA values are ambiguous, low PSA values (say, below 5) are comforting as far as a possible prostate neoplasy is concerned.

[macman]

I can find a willing volunteer but is there a better way to massage the prostate than this?

Too funny!  My "last" examine the Doc enters the room with an intern; NOT JUST ANY INTERN - a very attractive intern about 27 yrs old (yes - a female).  Anyway, when he gave me the bend over order I asked him if I was going to get a discount today since he was training somebody - his answer was - NO! her fingers aren't long enough. . .

mm

[ScottinCrimea]

I always used two fingers.  That way they got an immediate second opinion.

[ScottinCrimea]

Gator, there are such things as false negatives, too.  There is still a lot of controversy among physicians about the value of the PSA in prostate cancer screening for a lot of reasons.  Knowing what I know, my personal opinion is that I would not choose to have it done.  Still, I would advise that anyone discuss it with their personal physician to become informed so that they can make their own personal choice.

Here's a link that might be usefull.

http://www.cancer.gov/cancertopics/factsheet/Detection/PSA

[Mir]

Now here's little secret about prostate cancer that most doctors won't tell you.  There are basically two types:  The slow growing nonaggressive type and the fast growing very aggressive type.  If you have the bad type, usually by the time they find it, it's too late for anything but drastic procedures such as radical surgery to remove the prostate and lymph nodes in the pelvic area, chemotherapy and radiation therapy.  Even with these measures the rate of cure is not so good

Scot

You sure know how to comfort someone with a possible enlarged prostate

[macman]

NEW FOUND appreciation AND respect for board members. . .

tks guys.
mm

p.s. I'll make an appointment!

[viking]

I had a male doctor for many years who did the 'old finger test' during my annnual exams. Having moved, my new doc is a very attractive, and competent, 35YO female. Just about every test she performs I am ok with but,  somehow I cannot imagine droppping my draws and bending over in her presence. Any you guys have a female doc preform this test on you?

[BC]

I have done more than my share of digital exams.  I was told by my mentor that the only excuses for not doing one on all hospital admissions was if the patient didn't have a rectum or I didn't have a finger.

A long time ago I was admitted for a bout of extrasystole (some quirky heartbeats).  The doc had me drop em and curl up on the table then 'did the deed' (with a second opinion).  I told him quite bluntly my problem was 'up here' and not 'down there..  I thought maybe he was gay.

I had a male doctor for many years who did the 'old finger test' during my annnual exams. Having moved, my new doc is a very attractive, and competent, 35YO female. Just about every test she performs I am ok with but,  somehow I cannot imagine droppping my draws and bending over in her presence. Any you guys have a female doc preform this test on you?

I'd watch out for long fingernails..  btw I love that term you used 'annnual exams'.. lol

[Gator]

Viking, Yes.   A 30-yo who is good looking, vivacious, and petite.  jewish and very smart.  She does my annual physical every year.  

She takes a keen interest in my urological functions - asking detailed questions about each function such as frequency, ease, duration, discomfort/pleasure, etc.  Meanwhile, she examines every square cm while squatting (I have to distract my brain).

I ask her why she is so interested.  She replies that I am the same age as her father, and she uses me for a surrogate because her father would never discuss such with her.  She also adds that she plans to specialize in the older popualtion (gee, thanks).

Her fingers are short. She remarks that she can not feel the entire prostate, so she asks if she should ask Dr. ____ (her boss) to examine me.  His hands are the size of hams.  I say "No".

She plans to have a baby and will take a 1-2 year sabbatical.  I will miss her, both her personality and those nimble digits.

[viking]

Gator

Ok. But when you cannot distract your brain, it could be a bit embarressing?

BC

Long fingernails. Never thought of that before!!!

[Mir]

Talk about ass kissing and ass kicking, here you guys have been discussing ass pricking