Prostate problems: Old age is not for sissies


MONTGOMERY VILLAGE, MD., April 18, 2015 – As men get older, we experience a new reality. Our organs start to lose function and our knowledge usually increases.This is a good compensation as it allows us to handle many things that as young men we never thought about.

Take, for example, the tiny organ known as the prostate. It is a walnut-shaped organ that sits between the bladder and the penis. Its function is to secrete fluids that protect the semen and augments the volume during ejaculation. It is one of those organs that, while performing limited functions, are fundamental for the procreation of the species.The prostate is a superstar.

It is not clear why, as men get older, the prostate increases in size. Maybe our diets — consumption of alcohol or other products — may have something to do with it. It is possible also that as it is part of our reproductive system, there could be some relationship with our sexual activity or lack of it. The fact is that a great majority of males experience some prostate-related problems as they reach old age.

Scientifically, the possible causes of prostatitis, the most common ailment for this organ in older males, are these, from

  • past bacterial infection in the prostate
  • bacteria that are nontypical (resistant to antibiotics)
  • irritation caused by backup of urine into the prostate gland
  • chemical irritation
  • problem with the nerves in the lower urinary tract
  • parasites
  • problems with the pelvic muscles
  • sexual abuse
  • viruses

Typical of scientific data, unless there is a proven cause and effect relationship, other causes can’t be listed.

However, the causes are academic once one has the affliction. It is important to have it diagnosed and to get treatment and monitoring the soonest. The specific specialist is an urologist.

Usually, the symptoms are difficulty in urination and need to urinate often. This may or may not be followed or preceded by an elevated prostate specific antigens (PSA) result from a blood test. It is not clear what PSA tests tells the urologist. A relative increase appears to be the trigger for increased monitoring. Normally PSA numbers that don’t cause alarm are less than 3. A sudden jump to 6 or 12 is cause for alarm.

Consequences can be from just minor discomfort to death. Prostate cancer is usually not very aggressive, and many old men who are diagnosed usually die of something else many years later. An aggressive cancer can kill a person very fast. We know of examples of both kinds and even of some cases in which a relatively young person has been afflicted and has died in months.

The treatment/monitoring of prostate is particularly, let’s say, uncomfortable. Males are familiar with the standard test performed during periodic physicals. While you are bent over, the urologist inserts a finger in your butt and then rotates it. The actions are somewhat forceful as the doctor needs to get a good tactile image of the prostate. It helps when the tester has small skinny fingers. It also helps when there is humor. An urologist I know is known to say something like this: “I think you need to have your tonsils removed” after the finger insertion.

This jovial approach helps and is doubly important when other more invasive procedures are necessary. One of the logical follow-up tests is a biopsy. A probe, usually with ultrasound capabilities, is inserted into the rectum. This is followed by the injection of a local anesthetic and after a short delay, the extraction of samples from your prostate. For each sample a needle, included in the probe, is forced through the prostate and retrieved. There is a clicking sound that accompanies a somewhat muted stab of pain. The number of samples is determined by the specialist; eight to 12 are typical.

While the patient lies on his side, with his knees against his chest and his butt sticking off of the side of the table, it is impossible to keep any sign of dignity. Furthermore, dignity may be the least of the person’s worries, as the test itself is very uncomfortable. This is why keeping a sense of humor helps.

In a recent test, while the patient waits for the probe to be inserted, the doctor tells him – “Here comes Bubba!” and then the probe is inserted. As if an explanation is needed, there is a follow up – “If you are ever incarcerated, this is what you will hear every night”.

Old age is not for sissies. Having a sense of humor goes a long way.

Mario Salazar, the 21st Century Pacifist, believes that a spoonful of honey makes the medicine go down in a more delightful way. He is in Twitter (@chibcharus), LinkedIn, Google+ and Facebook (Mario Salazar).


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Mario Salazar
Mario Salazar is a combat infantry Vietnam Vet, world traveler, renaissance reconnaissance man, pacifist, metal smith, glass artisan, computer programmer and he has a Master of Science in Civil/Environmental Engineering. Now retired from the Environmental Protection Agency and living in Montgomery County, Mario will share with you his life, his thoughts, his musing on living in yet another century of change. He will also try to convey his joy of being old.