MEN - MY CHILDHOOD; MY MANHOOD; MY PROSTATE.. Part 1.. MUST READ!!

Ladies and Gentlemen

I am here to speak with you on Prostate. The topic is misleading. Is prostate strictly for men? Yes, ONLY men have prostate and ONLY men over 40years but the healthcare enlightenment is for everyone. There is no woman who does not know a man 40 years and above – father, uncle, brother, son, friend, neighbor, colleague …

Essentially what I will be doing today is health promotion. Responsible health promotion must provide three things:

1. Information
2. Reassurance
3. A plan of action.

Let me start with a background on prostate health.
Everyone has a pair of kidneys. The job of the kidney is to remove waste. It is the LAWMA (waste management company) of your body. Everyday your blood passes through the kidney several times to be filtered. As the blood is filtered, urine is formed and stored in a temporary storage tank called the urinary bladder.

If there were to be no urinary bladder, as a man walks on the road, urine will be dropping.
Now think of the plumbing work in your house. Think of the urinary bladder as the overhead storage tank. From the storage tank, a good plumber will run pipes to other parts of the house, including the kitchen. God in His wisdom ran pipes from our urinary bladder to the tip of the penis. The pipe is called the urethra. Just below the bladder and surrounding the urethra is a little organ called the prostate gland.

The prostate gland is the size of a walnut and weighs about 20grams. Its job is to make the seminal fluid which is stored in the seminal vesicle. During sexual intercourse, seminal fluid comes down the urethra and mixes with the sperms produced in the testicles to form the semen. So semen technically is not sperm. It is sperm + seminal fluid. The seminal fluid lubricates the sperm.

After age 40, for reasons that may be hormonal, the prostate gland begins to enlarge. From 20 grams it may grow to almost 100 grams. As it enlarges, it squeezes the urethra and the man begins to notice changes in the way he urinate.

If you have a son under 10, if he has a little mischief like we all did at that age, when he comes out to urinate, he can target the ceiling and the jet will hit target. Call his father to do same, wahala dey. His urine stream is weak, cannot travel a long distance and sometimes may come straight down on his legs. So he may need to stand in awkward position to urinate.

Not many men will be worried their urine stream cannot hit the ceiling. Toilets are on the floor and not on the ceiling. But other symptoms begin to show.

TERMINAL DRIPPLING:
The man begins to notice that after urinating and repacking, urine still drops on his pants. This is the reason why after an older man urinates, he has to ring bell. A younger man simply delivers to the last drop and walks away. Just see an older man coming from the bathroom. Sometimes he may clutch the newspaper closely to hide the urine stains, particularly on plain colored trousers.

HESISTANCY
At this point you wait longer for the urine flow to start. There are 2 valves that must open for you to urinate – the internal and external sphincters. Both open but because of obstructions in the urethra, you wait long for the flow to start.

INCOMPLETE EMPTYING
You have this feeling immediately after urinating that there is still something left.

As all these things happen, the bladder begins to work harder to compensate for the obstruction in the urethra. The frequency of urination goes up. Urgency sets in. sometimes you have to practically run into the toilet. Nocturia also becomes common. You wake up more than 2 times at night to urinate. Your wife begins to complain.

Men being men may not talk to anyone even at this point. Then the more serious complications start.
Stored urine gets infected and there may be burning sensation when urinating.

Stored urine forms crystals. Crystals come together to form stone either in the bladder or in the kidney. Stones may block the urethra.
Chronic urinary retention sets in. The bladder stores more and more urine. The size of the bladder is 40 - 60 cl. A bottle of coke is 50cl. As the bladder stores more urine it can enlarge up to 300cl. An overfilled bladder may leak and this leads to wetting / urinary incontinence. Also the volume may put pressure on the kidney and may lead to kidney damage.
What may likely bring the man to hospital is acute urinary retention. He wakes up one day and he is not able to pass urine.

Everything I have described above is associated with prostate enlargement, technically called benign prostate hyperplasia....... To be continued in part 2....

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