Wednesday, 9 October 2024

Men's things - XXI

Piss on the boil

As I prepare for my last session of hypofractionated radiotherapy for prostate cancer, I seem to be made more aware of what until now was an invisible and unheralded presence and function of the prostate gland.

With regards to the side effects of radiotherapy and apart from the fatigue that to various degrees has impacted my capabilities, the bowel issues have been quite manageable, whether constipation is preferred to diarrhoea is beside the point, the former offers less of an embarrassment.

It is the bladder and urinary functions that have given me more discomfort. Surely the prostate gland has not turned into a kettle, boiling the piss just as it begins to traverse the urethra, but that is how it feels, a hot to stinging sensation that you feel both happy and concerned to have, each need to ease oneself announced at the cacophony of all organs at play.

Changes in symptoms and perceptions

The International Prostate Symptom Score (IPSS) which I filled in twice in July with two weeks between assessments about my personal perception of how easy urination is, has precluded me from consideration for brachytherapy, however, with an enlarged prostate, it was never in the running. [MedScape: IPSS Calculator]

After 19 blasts of radioactivity, the prostate has had a bashing and a bit more inflammation with bladder outlet obstruction, when I spoke to the radiographers yesterday, during the pre-radiotherapy scan they noticed my bladder retained fluid, despite having just been to the toilet. It was not completely emptying but that should improve with time. My Incomplete Emptying score has increased.

The Frequency of needing to urinate had increased over the last week, along with the Urgency and Intermittency, and every time, I am Straining to start, then a Weak Stream follows. Having made accommodations for Nocturia, the number of times I get up to pee at night does contribute to insomnia. How my prepubescent and adolescent bedwetting days have long gone. [Blog - Childhood: Atọ̀ọlé]

It would get better

If I were to add up the IPSS score this morning, it would be severely symptomatic of benign prostate hypertrophy. However, we are beyond that, as malignant adenocarcinoma of the prostate has been diagnosed and treated, along with the dreaded onset of erectile dysfunction (ED), something we rarely discuss about masculinity and performance. Still, with time, even if mild forms of ED remain, all is not lost compared to what a prostatectomy might have offered. [The NHS: Benign prostate enlargement]

The Quality of Life due to Urinary Symptoms I assessed as mostly satisfied before treatment just over two months ago, I will raise the discomfort to be mixed, though I reckon things will improve and there are palliative measures to help the bowel, bladder, and sexual functions. My treatment is successful with checks and monitoring over the next few months and years.

This blog could easily have been classified under Men’s things as it could have received a Photons on the Prostate heading; I have plumbed for the former.

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Blog - Men's things - XX

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