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The prostate gland

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I don't know much about my prostate. I've never seen it. I have used a few toys and the odd finger to stimulate it. I did this because massaging the prostate can feel good and make a man's orgasms much more powerful. 

People have called the prostate the male g-spot, perhaps because it comes from the same patch of embryonic tissue as the female g-spot (an area of nerve endings and sensitive tissue on the front inside wall of the vagina); perhaps because it can reputedly stimulate orgasm if it is massaged, much like the vaginal g-spot can. The problem is, if you are a bit squeamish about hygiene and anal play during sex, putting your own or someone else's finger up inside your rectum can be off-putting. You need to have an open mind about such things. But with a bit of care, the hygiene isn't a problem - and you can always use latex gloves.

The truth, though, for me, is that although having my prostate stimulated does feel good, especially with a suitable anal vibrator on the job, I was never able to come through prostate massage alone, as some men claim they can, and when I did come, the prostate stimulation seemed to be a distraction and in a way spoilt the orgasm itself. This was true even when the massage - well, gentle rubbing, really - was being done by a willing partner.  So I remain ambivalent about it. But it's nice to know these things. If you want to try, you'll be able to feel it through the front wall of your rectum just above your anal passage. Be careful and gentle, because everything round there is deserving of respect, especially your gut, which can easily bleed if you are too rough with it. And remember that hepatitis, if you happen to be a carrier, is associated with the waste matter in the gut. Caution at all times is advisable! And safe sex is a good idea, too. 

There's no doubt some men find stimulation of the prostate very sexy. I remember at University meeting a Christian who claimed he never masturbated because of his religious beliefs. When a friend asked him what he did with all his sexual energy, he replied that sometimes when he went for a shit, he had a spontaneous ejaculation. This must have been because of the faecal matter pressing on his prostate as it passed through his rectum - the prostate is full of nerves associated with ejaculation and sexual arousal in men. That has always struck me as a sad story. Masturbation and ejaculation surely are meant to be fun things? 

What else do I know about my prostate? So far it has been trouble-free, which is pleasing, though as a man, the odds of it remaining so for the rest of my life aren't great. (Prostatitis.org has some information on this.) I know it produces fluid which sperm swim in and which I ejaculate fairly frequently. The purpose of the prostate is to ensure reproductive success: it makes those sperm feel comfortable in the rather harsh  - acidic, actually - environment of the vagina.

And it gives me the pleasure of producing a load of ejaculate after I have been sexually aroused for any length of time (like after two hours' kissing and being generally excited with my beloved, there seems to be a bucket load of ejaculate); the same is true if I haven't ejaculated for several days. Obviously, the prostate gets busy producing seminal fluid in response to sexual stimulation, or stores it up in response to abstinence. That's fine, of course, and quite sexy, too, if you want to ejaculate over someone. But things can go wrong.

The prostate is the weak spot of the male reproductive system. A gland about the size of a walnut, responsible for producing most of the seminal fluid, its secretions are important to increase the chances of fertilization of the egg. And yet, because of its location at the junction of the urethra and the seminal vesicles, if it gets infected, inflamed, swollen, or, worse yet, cancerous, it can interfere with both urination and sexual function. The main problems are cancer, benign prostatic hyperplasia and prostatitis. Any man over 40 years old needs to have a regular check-up on his prostate (some experts say 50, but I think "better safe than sorry"). 

My uncle had his first prostate exam the other day. And it was OK, he tells me. As an experience it probably isn't as bad as the regular cervical smears that women have to go through. Lying on his side, knees hunched up, the doctor inserted a gloved, lubed finger, had a swift feel around just inside the rectum, and that was it. Not by any means a bad experience. And certainly not as bad as dying of prostate cancer. Ah ha! I hear you say, that's an old man's disease, I don't need to bother getting checked.

Update: Well, time has caught up with me. It is about 10 years since I wrote the piece above, and things have changed somewhat in the intervening years, for at least the last two of them.

For some time now, I've been having increasing difficulty urinating, especially when I've been sitting down for a time. I also seem to have developed a degree of urgency around my need to urinate. (If this happens to you, don't always assume that you have a prostate problem, however, because apparently there is a nervous condition called bladder urgency caused by muscular spasms which also produces an urgent need to urinate even if the bladder is not full. That's more of an emotional/psychological problem, probably anxiety related.) But after all, who wouldn't be anxious when they suddenly find that having a pee (a.k.a. piss) isn't the simple matter that it used to be?

I haven't yet got to the stage where I'm having to get up several times in the night, but I am having difficulty starting the flow, then when I've finished it sometimes feels like I need to pass more. All of these are clear symptoms of prostate enlargement, and I also happen to know, because I have regular blood checks, that my prostate specific antigen, or PSA, level is increasing slowly but surely, and has been for the last two years or so. Update: November 2011, and it's gone up from 2.4 to 5.4. I'm also having urinary symptoms (difficulty starting the flow, difficulty voiding completely) so I'm now being checked over by a good man in the field. The first step is a course of antibiotics to ensure that prostatitis isn't causing some of these symptoms. The prolonged use of antibiotics (a month) can cause yeast infections to develop.

Update - March 2012. Having scared myself silly by reading this reeds-prostate-cancer-journey-process, I calmed down and kept on taking the Flomax. This is a watch and wait approach, as described in Reeds blog: avoiding the knowledge of whether I have cancer or not (no, no, I'm sure I don't) in favour of conservative management and a continuing sex life with a prostate gland that allows me to ejaculate. But the Flomax does weaken ejaculation and makes it less rewarding and pleasurable.

Update: August 2012. I've stopped taking the Flomax because sex and ejaculation is so important to me. Interestingly, after using some visualization and imagination techniques, as well as self-healing, things have improved considerably - the urgency o is less, the lack of voiding success is lower, and the sensation of difficulty peeing is less too. Update as and when, but for now this seems like great progress.

Prostate enlargement, or Benign Prostatic Hyperplasia (BPH) is a very common condition - almost all men over 50 have some degree of prostate enlargement, but it's a little unusual for somebody of 52 to have symptoms like this. So of course the thought of cancer is on my mind, even though I don't really believe that's the problem. Prostate cancer occurs in most men when they are over 70, but it kills comparatively few, because most men die of other natural causes before the prostate cancer becomes a real issue (see below).

So what to do? Well, I've been putting off the investigation for some time now, but good sense has prevailed and I'm off for an ultrasound scan. Apparently this involves a probe being pushed into my rectum, and an ultrasound investigation of my prostate will hopefully reveal whether it's enlarged or not. (Although there is comparatively little doubt that it is bigger than it should be.)

Treatment? Well initially, this might involve drugs to shrink the prostate, but I certainly don't want anything that interferes with my hormonal system: some of the drugs given to control prostate enlargement apparently deactivate testosterone in the tissue… Though I'm not sure if that applies to the whole body or just to the prostate gland (must make a mental note to check that).

If the enlargement is more serious, that involves some kind of surgery, possibly transurethral resection of the prostate (a.k.a. TURP) or laser treatment to burn away the excess tissue growth which is blocking the urethra. In either case, access for the surgeon is up the urethra. Oh dear. What I'm actually hoping is that I can use some kind of herbal or natural remedy such as saw palmetto instead of the prostate drug that might be prescribed by a doctor. I have to admit I have an aversion to taking chemical prostate pills, and I'd much prefer to deal with this in a homespun way if possible. In any event, I'll report back as soon as I have something to tell you...

 


Prostate Cancer

  • Cancer of the prostate is the most common male cancer affecting British men with the average lifetime risk of occurrence being about 1 in 12.
  • Although many important developments in treatment have occurred in recent years, over 10,000 men die from prostate cancer annually in the UK.
  • This is approximately equal to 190 deaths per week and it is estimated that this number will triple over the next 20 years.
  • In contrast to some other types of cancer, cancer of the prostate can be treated fairly effectively even when it has spread.   It is however important to catch the disease at the earliest possible stages as this may increase the number of treatment options available.

 From The UK Prostate Cancer Charity

Another test which is used to diagnose the disease in its early stages is the PSA test (prostate specific antigen). This is done with a simple blood test, although it is often combined with a rectal exam designed to check the size, shape and texture of the prostate gland. This is especially useful as the disease may grow for a while before it becomes apparent in symptoms of difficult urination, pain, poor urine flow, dribbling, or having to urinate frequently. The thing about prostate cancer is that it can be treated if it is caught early. So an annual check up from the age of 40 onwards isn't a bad idea. 

See also Prostatitis.org

Benign Prostatic Hyperplasia

From Discovery Health:

With age, the prostate gland tends to increase in size for reasons that are poorly understood at present, although it appears that the endocrine system plays a role. The incidence of this disorder, which afflicts only about 1 out of 5 men in their 40s, rises to 1 in 4 men by age 55, 1 in 2 by age 75, and 4 out of every 5 men over the age of 80. Symptoms: Reduced caliber and force of urine stream; awakening frequently to urinate at night; urgent need to urinate. Enlarged prostate on rectal exam. Occasionally: Inability to pass urine (urinary retention).

See also Prostatitis.org

Don't despair if you have this problem. There are effective drug treatments available, and surgery is another option.


Prostatitis

See Prostatitis.org

This is an ill-defined condition, or, rather, the causes are ill-defined. The problems, sadly, are only too real: pain in the groin, testicles, perineum, penis, urinary tract; difficulty with urination; a burning sensation on urination; pain after ejaculation; and disagreement between doctors on the causes and best ways to treat it. The web site link above is excellent. I recommend that you go and have a look at their diagnostic questionnaire if you think you may have prostatitis. 

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