EVERY man has a 50 per cent chance of developing benign prostatic hyperplasia (BPH). Many men have symptoms of it. Some men are driven demented by it. Few talk seriously, even to good friends, about it. Rarely is it discussed in public. That's why it was all the more surprising when 400 men and a sprinkling of women crammed into the Dodder Suite at the RDS in Dublin last Monday to attend an event billed as "For Men Who Can't Make It Through The Night" and devoted to that very subject.
BHP can lead to the "waterworks" misbehaving in any one of these ways: difficulty starting the flow, interrupted flow, weaker flow, a sense of incomplete emptying of the bladder, dribbling and increased urgency and frequency.
Many men have to interrupt their sleep, avoid going to theatres or give up a recreation of choice because of BPH. Even one of its symptoms can prove detrimental to the quality of life of the men themselves and even affect their families.
Many men are more likely to know where their wife's cervix is than their own prostate. The chestnut sized prostate is located between the urethra (the tube taking urine through the penis) and the bladder. It makes the fluid of the semen in which sperm swim. As men grow older, the prostate grows bigger. This can constrict the flow of urine, like a weight compressed against a hosepipe.
"You've no idea what it's like to live with him," the wife of a 68 year old chronic sufferer told Alan Alive. "He'd hardly have returned to bed when he'd be getting out again to go back to the toilet". The couple now sleep in separate rooms and no longer stay over at someone else's house because of the sufferer's embarrassment at having to go to the toilet "practically all night".
A 54 year old man who contacted Man Alive says that if he has lunch and goes to the cinema he "can't last throughout the movie". Atypically, he has suffered from symptoms since he was in his twenties. He needs to go to the toilet three or four times before going to bed: "If I'm lucky I get two and a half hours sleep - and I've had this since I was 22 years old."
He keeps a two litre milk container by his bed and has to pack it in his suitcase if he's travelling. (He says it's no way to try to impress a woman, having to get out of bed five times - to say nothing of the plastic bag in the briefcase.) He takes a critical view of the claims of surgeons and pharmaceutical companies: "There are people who have gone under the knife or use medication who still suffer."
Another man in his late 60s began to have symptoms of BPH five years ago: "Sometimes you re piddling all night. Then sometimes you can't go. You want to but can't. Or you think you're finished, go back to bed and you re up again in five minutes. Yeah, I've mentioned it to my friends - good friends, but never in detail."
A 61 year old talks about how if and when it does come up among friends it would be only as a laugh and a joke. "Nobody's prepared to say it's a problem for them. Men are very secretive. They keep themselves to themselves and do nothing about it. They never talk about their own problems - they talk about their wife's problems or joke about `the old prostate on the go again'."
Why doesn't he talk seriously about it himself?
"You'd feel you'd be setting yourself up for the butt of a joke. They're always talking about their nose, eye or some old sports injury but not about the prostate."
So sought after was the information given at Monday's talk that an estimated 60 people were turned away when the venue filled to capacity. Dr Cormac Macnamara, President of the European Union of General Practitioners, who chaired the meeting, which was sponsored by Abbott Laboratories Irl Ltd, said it was sheer luck prostates weren't impaled on railings in the attempt to get in.
Dr Macnamara was gratified by the willingness of the assembled men to publicly ask candid questions about BPH and expressed the hope the meeting would engender an "awakening" about men's health.
He advises sufferers to visit their GP: it's important not to leave it until the symptoms get worse. If symptoms are ignored, the cure can be less effective.
Dr Macnamara says GPs will probably ask you to fill in a score card which provides objective criteria for gauging the severity of symptoms. A digital rectal examination is usually necessary - dread of this is insufficient reason not to go through with it. A rectal examination will allow the doctor to check whether the problem is BPH or a cancer. Other tests can include blood tests, urine tests, a urine flow test (where you urinate into a high tech toilet which measures the rate of flow) and ultra sound scans.
Dr Macnamara explains the options for treatment. The first is "watchful waiting". Often this can be the most effective treatment. A second option is to use drugs. Alphablockers "relax the prostate's grip on the bladder". Hormone inhibitors could also be used. The third option is surgery, and "some men have no option other than the surgical strategy, like men with a complete blockage."