News that the King has been in hospital for an operation on his enlarged prostate will bring a faraway look into the eyes of many a chap who, having passed his allotted three score years and 10, has heard the blood curdling offer of what is known to the medical profession as a TURP. It’s quite possible that this is the procedure that the King has undergone or will undergo.
You will, of course, have laughed with the entire Home Guard Platoon of Warmington-on-Sea as private Godfrey once again pulls a sour face and brings his arm down on parade, denied yet again the chance to go for a wee by the heartless Captain Mainwaring. Older readers will recall Bob Pullen in the Archers, his Borsetshire bladder becoming part of an ongoing national joke as he did for farmhands what Godfrey had done for part time soldiers. And who could forget watching poor President Salva Kiir of South Sudan literally pissing himself recently, listening to his very own national anthem? Hoots of laughter.
But it’s not funny, really. And for many it’s not easy to talk about either. Jimmy Perry and David Croft’s masterpieces had whole chunks of real life hacked out of the scripts in order to make sure you simply laughed and weren’t too disturbed by what was really going on all around you.
Private Godfrey undressing at night, for example, packing his sodden underwear in places where sister Dolly won’t find them. The anxious hours spent whenever he went out making sure that his routes took him past the nearest bushes/pub/ill-lit front garden or public toilet. According to the Observer the number of public lavatories funded by local authorities fell from 3,154 in 2015-16 to 2,556 in 2020-21 – a drop of 19% across the previous six years coming on top of earlier reductions – and they’re still reducing. This, the paper says, has caused “major problems for a range of people, including the homeless, disabled, outdoor workers and those whose illnesses dictate frequent toilet use.” You’re telling me!
Perry and Croft’s version of the consequences of an enlarged prostate didn’t quite capture the small, step-by-step narrowing of life’s horizons as sufferers cut their coat of social ambition according to the cloth of steadily increasing immobility brought on by the fear of wetting themselves in public. They didn’t document private Godfrey’s increasing reluctance to go to cricket or football matches, visit Warminster-on-Sea’s thriving theatre or simply go on a bus journey of more than 30 minutes’ duration. A trip to London on a 1940s lavatory-free train would have been out of the question.
And so it is today: poor old Godfrey remorselessly fell victim to what a Royal Society for Public Health report described as an “urinary leash”. One in five people say that a lack of facilities means they restrict outings from their homes. The horror is that as we age we get used to it, rationalise it. Habitually we glance around wherever fate drifts us, looking for a loo or a place to pee in an emergency ‘just in case’.
Isn’t it surprising, even shocking, to discover how brutally easy it is for the abnormal to become the new normal. If you get it, you learn to live with it and take all the precautions you need to. This inevitably means a major reduction in your social and leisure activities. Slowly and surely you become increasingly isolated. Yet pretty well all men will have an enlarged prostate if they live long enough, though it’s very seldom acknowledged, talked about or confronted.
As well as a fear of embarrassment, of course, lies the even deeper, even more enervating fear that prostate cancer is lurking ‘down there’ somewhere.
Medications can help, but none attacks the cause. They all alleviate the symptoms but as the condition worsens they become less effective. The only effective remedy is surgery. And here is where King Charles comes in. The predominant surgery is called a transurethral resection of the prostate – TURP for short – and if you suffer the condition and haven’t heard about it, find out now and try to get one. There are, of course, laser alternatives for use in certain cases.
It sounds horrifying – but it’s a life changer. In a TURP, a combined visual and surgical instrument (resectoscope) is inserted through the penis, under full anaesthetic, into the prostate area and an electrical loop cuts away excess tissue to improve urine flow. You’ll stay in hospital for a couple of nights or so before a catheter is removed and you’re sent packing.
In my case there was no discomfort despite having what my surgeon described as a prostate “the size of a pear” – not very scientific, but I got what he meant. It was marvellous! Steadily, day by day, the situation eased. Within three months I was regularly spending more than three hours in between visits to the loo, and I had rediscovered the joys of a lifetime’s love of wandering city streets, picnicking in urban churchyards, going to plays and concerts and having an uninterrupted night’s sleep.
Old habits die hard. I am only slowly getting out of the habit of making sure I have a pee before I go out and checking to see if there are loos or pubs nearby. But the day I went for a pint and a half of Old Empire IPA in the Reading Wetherspoons I whooped with joy as I took the 45 minute walk back to my daughter’s house without the slightest flicker of wanting to pee. Twelve months on and my family and friends are getting tired of hearing my accounts of my astonishing new, tiny prostate, now reduced to about the size of a pea (pun intended). Yes, I have let slip the urinary leash and can lead a normal life again. Whether by TURP or by laser, welcome to a whole new life, your Majesty.
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There is unfortunately always a risk with any surgical procedure.
Which is why I grabbed the opportunity with both hands to have experimental high dose precisely targeted radiotherapy for a cancerous prostate. It was 100% successful for me and the rest of the guinea pigs and has gone on to become mainstream so I am told.,
I wonder how many of those 2,556 funded toilets (sounds a really small number) are actually open and in reasonable condition. So many are locked or disgusting.
Go on line and buy yourself a R.A.D.A.R. key. This then lets you unlock, and use most disabled toilets around the country. There’s also an app that gives the locations. Some you might have to pay for but most are free.
I agree with the encouraging tones of this article, and would say that men should have the courage to deal with this condition. It can be very helpful in so many ways – including improving sexual confidence, since you feel ‘comfortable’ at last.
However, all is not necessarily rosy in the garden. To quote Robin Williams, I could ‘pee like a racehorse’ after the inflammation had gone down. But as likely as not, your bladder will have been stretched by being over-full during your period of prior urinary retention, and this ultimately affects flow. The urethra gradually shrinks back a bit after being extended by the passage of the instruments – this reduces flow. And worst of all – after a year I got worse and worse until I could only pass a thimbleful at a time. I nearly ‘managed’ myself into the grave – a catheter could not be inserted – even with the help of a metal rod. They have to push ever larger sharpened plastic expanders into you, in order to cut a pathway into the bladder. (yes – agony, but without it, you die)The cause? scar tissue caused by catheter use, and possibly the operation itself. Stenosis of the bladder neck can almost completely close the bladder. The cure is a simple incision of the bladder neck under general anaesthetic. Subsequently, you wet yourself when you pass wind… but… it’s strangely reassuring, and much better than the alternative!
What do you do as an encore..?
I don’t suppose his surgery will do much for ‘liberating’ us.
I’ve had enlarged prostate issues since my late 40’s and it was causing me big problems in my 50’s, I took medication for quite a while but in the end it the problem was too bad to be solved that way.
I wasn’t keen on having TURPS or HOLEP laser treatment as they can have some side effects I really didn’t want to get.
Luckily I have private medical insurance, and after some research for the technique least likely to cause side effects I tried an experimental arterial embolism technique. As my prostate had a median lobe sticking into the bladder this wasn’t the best one to use, as they couldn’t target that area due to the possibiity of affecting bladder function, but it did work for a couple of years. This technique does work well for a lot of people with minimal side effects but in my case I wasn’t an ideal subject for the treatment, but it was worth a try.
However it didn’t work 100% and the problem reoccurred a couple of years later (As it was the median lobe in the bladder causing issues). Luckily in the meantime a new technique had been developed, called Rezum which uses steam injections in your prostate. This has far fewer side effects than Turps and Laser treatment, and it can target the median lobe, but it is invasive and it was pretty uncomfortable afterwards as I had to wear a catheter for a week.
Following this though my condition has much improved. It isn’t perfect as I do have good and bad days, but I can normally get through a 2 hour plus film without feeling the need to go to the loo and I’m not getting up multiple times in the night – often I can sleep through without needing the loo at all.
So in my experience it’s well worth getting looked at and treated. It’s made a huge difference to my quality of life.
A yoga teacher told me yoga was very good for mens prostate issues. Worth considering going to a yoga class?
Bloody hell! Reading this stuff is quite an eye opener.
25 years ago, when I was 50, a dentist client of mine in his early 50s enquired whether I’d ever had a PSA check, to which I replied, “no”. Having had a ‘scare’ himself, requiring surgery, he advised I have the check performed as a precaution. Following his advice, I had a biennial PSA check until 2019, when the Cv-19 malarkey interfered with my regimen.
I resumed my check ups this week, prompted by an increase in frequency of loo visits, particularly, nocturnal. Turns out all is well, and my doc’ (in his 60s) was very sympathetic and knowledgeable about the subject, due to first hand experience.
My point is, though not a fan of King ‘Brian’ fair play to him for bringing his problem to the attention of millions of ordinary blokes who know little if anything about possible prostate problems. Getting the subject aired can only be a good thing for potentially thousands of men. (It’s extremely rare in women).
Having had a cancerous prostate removed fairly recently via the robotic technique, access to a PSA test at times proved problematic but I persisted. Sadly there appears to be some resistance to accessing this test, although I found out in my case that this was more about who was going to pay for it, rather than the value of it. I, probably like many men of my age actually had no symptoms, and an elevated PSA was picked up via an offer of a test (pre-Well Man). This prompted monitoring, palpation, scans, biopsy and finally removal. The journey was at times met with resistance and I had to be persistent but, being able to speak ‘medic’ helped. An enlarged prostate is pretty much inevitable, and whilst cancer is not, every man of a certain age should seek a test and not be put off.
We are in Spain Felix and pay an annual fee of €300 to a private doctor to give us, as a family, 24 hour access to consultations. Thus a PSA check is but a doctor’s prescription and €25 away, in the adjoining Farmacia (tuesdays and thursdays). The results are back within 24 hours. The State system offers a similar service free of charge, but involves queueing. Plus, I’m a believer in the ‘belt and braces’ approach.
As an aside to the important Prostrate chat, Arnold Ridley, mentioned in the article in his guises as Pvt Godfrey, was quite the battle hero. In real life severely injured during hand to hand fighting in a German Trench on the Somme WW1. He was peppered with shrapnel in his legs,virtually lost the use of his left hand and sustained a bayonet to the groin. He was invalided out of the Army, and turned to acting and writing plays, the most famous of which was ‘The Ghost Train’. It is quite amazing how many ordinary people were in the most horrific life and death situations, and just came home and lived their lives. Suggest that you take a look at Donald Pleasance, and Lee Marvin, if this sort of stuff interests you.
“…having passed his allotted three score years and 10…”
Good job he didn’t get it done on the NHS or he’d be waiting another three score years and 10.
The ONLY thing that works for a Benign Enlarged Prostate with ZERO side effects, ZERO Medication, HIGH Success, & Carried out whilst you are AWAKE is a Procedure called PAE , Prostrate Artery Embolisation. by Dr Hacking ( radiology ) Southampton Hospital. UROLOGISTS will NOT tell you about it nor will eh doctors.