Prostates in older men: why do I need to pee all the time?

We've all had potty-training, but why did my parents never worry about what and how much we consumed when it comes to healthy urination?

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Every two hours, I have an urgent appointment en suite. For three years, I’ve suffered from benign prostatic enlargement (BPH) affecting most older men.

In a previous article I mocked the word “benign” but - according to one reader - embarked on a 1200-word whinge about the unfairness of father nature. With strong email support from fellow-sufferers, I explored the possibility that a new ‘urolift’ procedure to pin the prostate back with stainless steel clips might do the trick. I didn’t fancy the alternatives - having to buy bras after swallowing emasculating pills or likely impotence following radical surgery.

Urologist Tom McNicholas said: “Urolift is the only treatment for BPH that reliably preserves men’s full sexual function”. Hodson thought: “I’ll definitely have some of that”.

Not that I didn’t receive online food for thought. Dr Wendy from Australia tweeted that the article would help women understand why men were always grumpy. Samira Ahmed wrote that she “loved a man who explains prostate trouble with a General Custer analogy”. A Singapore medic recommended cooking the prostate with microwaves.

One osteopath told me to eschew diets involving red meat; a second told me to chew pills containing Saw Palmetto extracted from an Arkansan palm tree. Warren offered to keep my seminal ducts open by kindly sending a month’s supply of anti-microbial peptides.

An interventional radiologist endorsed ‘embolisation to cut off the prostate’s blood supply’. Nurse Terry praised a plumbing implement called “Paul’s Tubing” for safe relief on motorways. A firm called Stressnomore generously despatched an anal stimulator with electric probe to buttress my perineum provided I regularly sat on it.

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A Mr Anonymous thanked me for clearing up a potential mystery in what was happening to him and “why the doctors are doing what they are doing as they haven't been communicative”. (He added that his grandfather suffered the condition for 35 years during which he was humiliated in his job on the GLC Water and Sewage Executive by colleagues who christened him “Walter Works”).

A reader boasted of getting intense Reiki massage from his wife so he could “just about pee over a five-barred gate at the age of 68”. Finally the 82-year-old President of the General Custer Association of Great Britain ticked me off for suggesting that the US Cavalry were ever technically “surrounded” by Chief Crazy Horse at the Battle of the Little Bighorn.

My own doctor, a personal friend, said he wondered why I bothered at all since he found it perfectly normal to urinate every two hours “at our age” and, in his scientific opinion, “doctors only make things worse”. Even so he gave me a referral to the same Professor McNicholas who sank his digits and probes deep into my dilemmas and gave me a mix of statistical readouts and old-fashioned wisdom by which I was both succoured and impressed.

The good news - my prostate does NOT have an obstructive central lobe which would rule out the new stapling process. But with the organ “on the large size of what we we’d ideally like to treat” he suggested alternative interim strategies, including some changes to lifestyle, to make the object less irritated and hopefully smaller. Although I neither drink alcohol nor smoke, for that matter I don’t abuse chilli or snort turmeric, he was frankly horrified by my habit, shared with the late Tony Benn, of drinking tea whenever possible, day and night.

I genuinely had never imagined this to be a relevant issue because in our family, it’s assumed that 1) tea is a benign and holy fluid and 2) you should never trust a person who doesn’t drink it. I had my first cup at the age of three and it’s the only liquid I relish including water. In fact, the good Prof is of the view that ALL tea (including herbals) is a likely urinary irritant which in susceptible people contributes to prostatic inflammation and hence the ominous urge to urinate.

“Cut the quantity”, he said, “and indulge only in the mornings”. Why: “It’s the same with carbonated fluids. All such drinks produce acidic urine causing systemic inflammation - although the science isn’t completely exact”. I heeded and said: “Why should I travel to London and not do what your 30 years of clinical experience recommend?” to which he wearily responded: “You’d be surprised”. He laments the rise of the half-pint mug in place of the quarter-pint cup as a piece of modern idiocy leading remorselessly to increased peeing frequency.

Cycling home, it occurred to me - as if pierced by a catheter - that I had never been taught how to urinate. Potty-training we’ve all endured but why did my parents never worry about what and how much we consumed? I hold more than one university degree but on this subject have never connected inputs with outputs. I’ve even watched my own children monitor THEIR children’s urine colour to ensure all is healthy without thinking – mm – maybe the tea is taking its toll on mine? Warnings about caffeine are legion – but not “Lay off the Chamomile, Peppermint, Echinacea and Red Zinger!”

Since every man who lives long enough will possess a big prostate we’ve naturally focused on size at the price of sense. And yet if your organ is horribly irritated too, like mine, the symptoms only worsen. So for the present, I am following doctor’s orders and getting acquainted with the spa qualities of what the Wessex Water Company apparently supplies to my house through a tube. I now own a dozen redundant teapots.

If you’ve read this far, you may like to know that once my organ is more quiescent, I intend to embrace “Urodynamics”. No it's not the EU's future football team. A woman doctor is to insert a camera into my urethra to make a map - and give me a thumbs up or down for project Urolift. I hope to remain dignified, but you never know...

Phillip Hodson is from the UK Council for Psychotherapy www.philliphodson.co.uk