MEN'S HEALTH MATTERS:Men should talk about their urinary problems as there is help available
Q I am 56 years old and have recently noticed deterioration in my urinary pattern. I saw my GP and he tells me that I have an enlarged prostate.
I spoke to a few friends about this and it would appear that my problem is very common among males. What exactly is enlargement of the prostate and how common is this problem in Ireland?
A This is a very interesting question as problems with waterworks are far more common than people think. Men, in general, are very slow to talk about their problem, which is unfortunate as there are many simple measures which can be used to alleviate symptoms.
The prostate gland (found only in men) is situated at the junction between the neck of the bladder and the water passage. The gland tends to enlarge with age (Benign Prostatic Hyperplasia (BPH)) and may obstruct the water passage which passes through the middle of it, giving rise to a diminished flow.
BPH is a spongy enlargement of the gland which is a condition intimately related to ageing. Although it is not life threatening, its clinical manifestation as lower urinary tract symptoms (LUTS) reduces the patient’s quality of life. Troublesome LUTS can occur in up to 30 per cent of men aged 65 and over.
This obstruction may also cause some bladder irritation which may manifest itself with an increased unavoidable frequency of urination. This situation is generally not harmful, but is more of a nuisance.
The enlargement of the prostate is also associated with long-term disease progression and, if left untreated, can sometimes lead to complications such as complete inability to pass urine (acute urinary retention), renal failure and infections.
The different treatment options for BPH can be separated into watchful waiting, medical treatment and surgery. Prostate surgery is frequently very effective and is often recommended for men with troublesome bladder symptoms.
Surgical intervention is generally recommended for quality of life rather than an absolute necessity for the sake of one’s health.
A recent national survey in which 360 Irish men were interviewed found that 86 per cent of men over the age of 50 suffer from broken sleep due to the fact that they have to get up at night to pass urine. Over a third (34 per cent) of these men get up to urinate up to three times each night.
This survey found that 91 per cent of men would visit their GP if they knew their symptoms could be treated. This finding highlights a concern that men may be needlessly putting up with bothersome symptoms of BPH without seeking medical advice.
This hesitancy to visit their GP may be due in part to the fact that men are sometimes worried that they may have prostate cancer. Early prostate cancer does not cause symptomsm, and generally these waterworks symptoms are due to benign prostatic hyperplasia as discussed above.
Furthermore, 65 per cent of men reported having to urinate five or more times a day, with 60 per cent reporting that at times they did not feel fully finished or that their bladder had not fully emptied.
When women were interviewed about their partners, 34 per cent of women indicated that this disturbs their sleep, but only 13 per cent complain to their partners about this disturbance. Some 95 per cent of women interviewed stated that if they knew that their doctor could
help with this problem, they would encourage their partner to visit his doctor. This was despite the fact that 84 per cent of the women interviewed had actually visited their own GP in the past 11 months.
Further details about this survey and information on prostate disease can be found on www.water-works.ie
Q I was caught short on the way home on the bus the other day and wet my clothes which was very embarrassing. This has happened to me on a number of occasions whereby I would get a sudden sensation to pass urine and then, after a few minutes, pass a small amount involuntarily and wet myself. It is never a serious wetting but nonetheless it is very embarrassing. Are there pads available for men to wear for protection?
A What you have described can easily happen and can be very embarrassing, particularly if you are wearing light-coloured trousers. You may get a sudden warning but may not be able to “hold on”, and this problem has been covered previously in this column.
There are a number of different pads designed for men who are mobile and active. These pads have a special shape and are designed to fit the male anatomy. They are generally a very comfortable fit, with an all-round protection system and a fixative strip.
The pads are designed with an absorbent core which can deal with large amounts of fluid, an odour neutraliser binds odours reliably and an elastic inner rim provides additional leakage protection. The pads can be used for the management of mild incontinence and when worn with tight-fitting underwear are generally inconspicuous. Pads from a number of different manufacturers are available from most local pharmacies and some supermarkets, and it is often best to try a number of pads to find the one which is most suitable for you.
This weekly column is edited by Thomas Lynch, consultant urological surgeon, St James’s Hospital, Dublin, with a contribution from Marion O’Brien, urology nurse specialist, St James’s Hospital.
Send your questions to healthsupplement@irishtimes.com.
