Prostate Gland Problem
I am 72 and I can’t pee very well any more. I have to stand for ages, and then go back again after half an hour. What can I do to speed things up?
The tube from the bladder to the outside in men runs through a golf ball sized gland called the prostate before passing along the penis. The prostate gland is responsible for secreting part of the semen a man ejaculates during sex. There is no female equivalent.
As a man ages, the prostate slowly enlarges, putting pressure on the urethra (the urine carrying tube) so that it is narrowed, and the urine has difficulty in passing. When you go to the toilet, the bladder is usually not emptied completely because of inadequate pressure to keep the narrowed tube open. Therefore the urge to pass urine comes on again after only a short period of time.
The enlargement of the prostate gland is normally benign in older men, but it can be due to a cancer. For this reason it is essential for any man with a poor urinary stream to be checked by a doctor. If a benign enlargement is the cause, a simple operation will set the problem right, and you will rejoin the jet set!
My prostate has been giving trouble, and my surgeon says he is going to remove it—through my penis! How on earth can he do that?
Impossible as it may seem, most (but not all) of the prostate can be removed through the penis.
The prostate secretes a fluid that lubricates the urethra (the tube that carries urine from the bladder to the outside) and nurtures sperm. It sits at the base of the penis behind the pubic bone. The gland is the size and shape of a small egg, but in older men it can enlarge to be two or three times this size. There is no cancer or other disease necessarily present when this enlargement occurs, but because of its position around the opening of the urethra from the bladder, it can constrict the outflow of urine from the bladder when it is enlarged (see diagram).
If the flaccid penis is held straight, it is quite easy (under an anaesthetic) for an instrument to be passed down the urethra to the prostate. This instrument has a sharp edged cup at the end, which is used to scrape away layer after layer of the prostate to remove any blockage that is present. The scrapings are then washed out of the bladder and urethra. In this way, a quite large internal gland can be removed through a very small rube.