A word about prostate health and my treatment journey
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DISCLAIMER: This statement lives on my art studio website so that I can link to it from various social media channels. If you’re not interested in this topic, which has nothing to do with art, then please skip to the next thing in your reading queue. HOWEVER, if you are a person who has a prostate gland, regardless of your gender identity, or if you love someone who has a prostate, then I hope you will take a few moments to read my story, which I promise will not be graphic or gory. Also, I am not a medical professional. I’m sharing my experience and making a good faith attempt to get the facts correct, but I am not an authoritative source.
My goal here is to talk to other prostate owners about a topic that we just don’t talk about because, yuck, who talks about that? The subject is what happens in the bathroom, or rather what doesn’t happen. If you find that it seems like it takes a little extra effort to pee and that 10 minutes later you’re ready to go again, that might be a sign that your prostate is enlarged. It could also mean that there is something else blocking the flow of urine out of your body. Painful urination, stopping and starting, weak stream, and bladder pain are among a collection of symptoms collectively referred to as LUTS (lower urinary tract symptoms). They are also causes for concern that you should discuss with a doctor. OK. There. I said it.
I will spare you my own medical history, including all of the details of my urological history. It is sufficient to say that about 7 years ago I had pretty much all of those symptoms. My primary doc referred me to a urologist, and after an exam and some tests he diagnosed me with BPH.
I knew that I wasn’t alone. A web page maintained by the Harvard Medical School states that “By age 60, half of all men will have an enlarged prostate, a condition also known as benign prostatic hyperplasia, or BPH. By age 85, the proportion reaches 90%. (https://www.health.harvard.edu/mens-health/the-growing-problem-of-an-enlarged-prostate-gland, accessed on 2/28/2025). Simply having some degree of prostate enlargement does not mean that you have acute symptoms, but it’s definitely something to keep an eye on.
I had then, and still have, a normal PSA level (Prostate Specific Antigen, a simple blood test to screen for prostate cancer), so there was no reason to suspect prostate cancer. At what age and how often to have a PSA test is driven by a number of factors. The Johns Hopkins website does a great job of laying out a combination of age, family, and health history risk factors that determine if it’s annually, less frequently, or more. (https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/prostate-cancer-age-specific-screening-guidelines#:~:text=For%20most%20men%2C%20every%20two,less%20(or%20more)%20frequently, accessed on 2/28/2025). What you need to know here is that you should get tested and take responsibility for remembering when you should be tested again. Don’t just leave it to your possibly overworked primary care doc. You can be relatively asymptomatic and peeing just fine but still have an elevated PSA. Prostate cancer is a silent killer of men.
Back to my story. I started taking Tamsulosin (Flowmax) after my first urology appointment and it was like turning back the clock. Everything was working again. I took the pills and went in for an annual urology checkup, which wasn’t much more than talking to a nurse practitioner and having a blood test to track PSA. That changed in late 2024. I started having more of those symptoms. During my annual checkup I had a bladder scan (a 30 second ultrasound that measures how much urine is in the bladder). Apparently there was enough that the tech raised her eyebrows. Why was this surprising to me? DENIAL. The more I thought about it, the more I realized that I’d been having problems for 6 months or more. I just didn’t want this to be happening so I pretended it wasn’t. We doubled my dosage of Tamsulosin and that made a slight difference but not much, and certainly not enough.
So more tests, a couple of consultations, and I made the decision to have Aquablation treatment to remove a portion of my prostate. I’m not going to go into all of the details of my particular case. If there are folks who want to hear about the pre-op testing, the hospital experience, and the post-discharge stuff, then maybe we can find some way to have that conversation on some other platform. What I’d like you to know is that it wasn’t as bad as I feared. I did have some post operative issues related to how my body reacts to general anesthesia, but it resolved over a couple of days. According to the surgeon the procedure all went according to plan. I’ve had some discomfort, but nothing that I would call big pain. It’s all been managed with Tylenol. As of this writing it’s been a week since surgery and I think I’m on track to have a good outcome overall.
Part of my recovery is my prostate healing from having about 40% removed. Part of it is my bladder muscles recovering from being strained for months. This last bit is super important. Big or small prostate, unless you’re also dealing with prostate cancer, your bladder is the real issue here. If you ignore these symptoms and injure your bladder muscles it can lead to some really unpleasant things that I expect we’d all like to avoid–things like incontinence and dependance on catheters to empty your bladder. Those symptoms if, left untreated, can be temporary or permanent even after surgery.
Nobody wants to have surgery, but this stuff is a matter of preserving your health and quality of life–and it could be a matter of life and death.
Here’s what I want you to take away from my experience:
Get your PSA level tested.
Go to your doctor or a urologist if you notice any change in your peeing experience. Don’t put it off.
Think objectively about those changes and don’t pretend that it’s no big deal when something is off. Unless you’re a medical professional with expertise in this area, you are not qualified to diagnose or self treat, regardless of how good you are at Googling. Ask me how I know?
Be brave. If surgery ends up being part of your journey then it is very likely not going to be as bad as you imagine. The longer you wait and imagine what it might be like, the worse things get and the more psychological damage you inflict on yourself. I’m squeamish, bashful, and don’t have an especially high tolerance for pain. I got through this. I do not regret my decision to have surgery. You can do it too.
And finally, do what I’m doing. Don’t be afraid to talk to your friends who have prostates. They might be a good source of information or comfort. Perhaps even more importantly, you might be the person who makes them think twice and talk to their own doctors. You could be the one who starts your friend on a path that saves their life!