A Question of Health: Trouble going

I'm a 39-year-old man, and I have noticed a problem that seems to be becoming more frequent. After I go for a wee, and zip up, I seem to have an embarrassing pee-stain on the front of my trousers more often than I ever used to.

I'm a 39-year-old man, and I have noticed a problem that seems to be becoming more frequent. After I go for a wee, and zip up, I seem to have an embarrassing pee-stain on the front of my trousers more often than I ever used to.

Might this be anything to do with a potential prostate problem? Or should I just shake my penis more vigorously before putting it away? I think I give it quite a good shaking, but worry that if I seem to be conducting too much shaking/wringing in public loos I will get arrested.

The urethra, which is the tube that runs the length of the penis, sometimes retains a small quantity of urine after urination. Shaking the penis, even quite vigorously, is quite a good way of removing a few drops from the end of the penis, but it is not very effective at completely emptying the urethra.

The best way to do this is gently to squeeze the penis, starting at the base and gradually working your way up to the end. This pushes the retained urine out, and will probably solve the problem. If this doesn't work, you might want to ask your doctor to examine your prostate gland to see if it is enlarged, but that is not likely to be the cause of the problem in someone of your age. The usual symptoms of prostate enlargement are a weak urinary stream, difficulty in starting urination, and needing to go to the loo very frequently. Dribbling at the end of urination can also be a symptom of prostate problems.

SORE ANKLE JOINTS

I find that my ankle joints become very stiff during the night. If I wake and need to visit the bathroom, which is down a flight of stairs, my ankles are quite sore. Similarly, the trip downstairs in the morning is very difficult and uncomfortable.

Last year I was diagnosed with breast cancer and I have spoken to my oncologist about this problem but she does not seem unduly concerned. I have started to take cod-liver oil as a food supplement. Do you have any other suggestions? My general health is good and I am reasonably fit and very strong. I go horse-riding each week as well as regularly walking quite long distances.

The symptom of early morning joint stiffness is traditionally associated with types of arthritis that cause inflammation within the joints. People who develop rheumatoid arthritis, for example, find that they are stiff first thing in the morning. The stiffness is relieved as the joints get moving, usually within half an hour or so.

I agree with your oncologist that this is not likely to be a symptom that is associated with your breast cancer. Some people swear by cod-liver oil for joint problems, but I think they sometimes have the fanciful idea that the oil gets into the joints and lubricates them. In fact, research has shown that the omega-3 fatty acids contained in cod-liver oil seem to prevent joint damage, rather than simply lubricating the joint surfaces. Ankle pain can be related to being overweight, and you should make sure your weight is not making the problem worse.

It might be worth having a blood test to look for evidence of rheumatoid arthritis. You would be unlucky to have both breast cancer and rheumatoid arthritis, but it is not impossible. If you have developed this type of arthritis, there are drugs that can slow down its progress. Have a look at the website of the Arthritis Research Campaign at www.arc.org.uk. It contains useful information sheets, including one called "Exercise and Arthritis".