The Midnight Trot – Part Three

The contnuing saga of a dodgy prostate!

After six months , quite unexpectedly, the bursting bladder and sleepless nights returned with a vengeance.  So, my GP gave me a further course of antibiotics…..  And another….. And another. ….And I was still rushing off to the toilet every night.

Eventually, with some trepidation, I went back to my Urologist.  Barely had I enquired after his health than I was back on my side with his finger up my bum!  It’s an unusual form of greeting – but each to his own…

Later with my trousers back and my dignity nearly back, I slumped into a chair while he explained.

There were two possibilities. One: either the bacteria had developed resistance and/or we were treating it with the wrong medication, in which case he needed to grow a culture from fluid within the gland; or two, there was no bacteria now but the residual effect of a previous infection had left the prostate swollen, restricting the flow of urine which was backing-up and being forced into the prostate itself, causing ongoing inflammation. I would require a dubious sounding ‘prostate massage.’ This was basically the insertion of the digit once more into the anus and the application of pressure until the gland released some fluid, which could then be used to grow a culture.  ‘Now,’ he enquired, ‘Would you prefer a local or a full anaesthetic?’

Was he kidding?

We fixed a date for the general and he told me he would take the opportunity to check my bladder with a ‘scope at the same time. Well, whatever you want Doc – so long as I’m asleep….!

The operation  took place a week later. I won’t bore you with the sordid details – nor with the after effects. If you don’t know what it is like to pass razor blades and barbed wire in your urine for two days, then I wish you well and won’t alarm you. There were no bacteria in the culture and I confess to a slight feeling of having let the side down. But as my Urologist explained – it was probably that months of antibiotics had removed the bacteria and what he was  now  treating was the aftermath of the infection.  To do this he prescribed more drugs; something to target the actual swelling of the prostate itself and the blockage in my water works.

Today (some 60 days after the examination)  I am taking alpha blockers and anti-inflammatory drugs twice daily and I can expect to do so for the next 3 months. The alpha blockers target the alpha 1a andrenoceptors – these are specialist cells in the prostate, bladder and urethra  that cause the urethra to contract. The blockers reduce their effect and the anti-inflammatories target the swelling in the prostate and neck of the bladder.

There is apparently a 75% chance that the treatment will be effective, though 20% of those who benefit will later relapse and require further treatment.

Incidentally and significantly, I’ve now discovered that there are moves among some Urologists to re-label prostatitis as ‘chronic pelvic pain syndrome.’ I can identify with this. When you have this problem there is no pain in the prostate. Most of us don’t know where that is anyway but any sufferer will tell you about the pains in the scrotum, crotch, pelvis, back and bladder – it is indeed ‘chronic’, ‘pelvic’ and ‘painful’!

If I fall into the 25% category for whom alpha blockers don’t work then there are other possible treatments.  These seem to involve using microwaves or other ‘waves’ to heat the prostate, and are effective in most of cases of prostatitis.

Frankly, considering the possibility of having my bits ‘microwaved’ I’m hoping most sincerely that the alpha blockers are going to be just fine… in fact I’m praying for it. I definitely feel better already. I’m sleeping better and my nocturnal wanderings have almost ceased.  But there have been some odd side effects. Dizziness when standing and what the leaflet that came with the pills calls ‘..abnormal ejaculation.’ – what you and I might call a ‘dry run’ – but apart from that I am definitely getting better. Of course faced with the alternative forms of treatment this may just be wishful thinking…..But on the whole I am getting better…. Honestly, Doctor, I am getting better… I really am!

The end (I hope!)

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