Anxious wife

[jennyF]

Hello - my husband has had a few issues going to the loo over the last 2 years. Firstly it started with needing to go in the night once, but now its more like 2 or 3 times. Also he is now complaining that he feels that he has never fully finished - I presume he means emptying his bladder. I have told him repeatedly he really needs to go and see our GP, but he says its just his age - hes 63. Having started doing some research on the internet I am now concerned that it could well be something to do with prostate issues. Please could you advise me what I could say to him to persuade him he really does need to take all these problems seriously. Many thanks - frustrated and anxious wife...

[ieshepherd@yahoo.co.uk]

Hi, perhaps you could suggest a general health check (it seems frequently advised for the over 60's anyway) which would include a blood test. No need to refer to prostate problems. The Doctor would pick up on the urinary problems, and the blood test might give useful information. Be careful about interpreting blood test results. The PSA figure varies a lot and is not always reliable, but it is a useful guide. He is probably inwardly frightened of the result. Obviously tact is called for. Regards.

[Dr Hilary Jones]

I agree about the need for tact. Men hate talking about any part of them below the waist and can be sensitive and embarrassed to admit any kind of age related problem with their bits. It is similar to how women may feel about their breasts or uterus yet they are much more grown up and sensible about addressing any problems. Look, he has already complained about 'incomplete emptying of his bladder' so the likelihood is that his prostate gland is enlarged. He also has nocturia. ! in 3 men over 50 have exactly the same symptoms but it is treatable. Why is he putting up with it? it needs investigation but he might be relieved to know that medication, lifestyle changes and possibly surgery could make his quality of life a whole lot better. Talk it through with him and encourage him to seek advice. Dr Hilary Jones

[Mr Omer Karim]

I agree with the comment from Dr Jones. Urinary symptoms are very common in men. You could download an IPSS questionnaire (http://www.windsorurology.co.uk/Clinica ... naire.aspx) and get your husband to fill it in. If he has moderate to severe symptoms (Total score 8 -35) then he would certainly benefit from a urological consultation and further investigations.
You should reassure him that his symptoms are unlikely to be due to prostate cancer as most men with urinary symptoms at his age have BPH, not prostate cancer.

Also, remind him that this is the month of MOVEMBER. He owes it to himself and his family to get checked up and some treatment could improve the quality of life for both of you.

[Dr Jon Rees]

Hi

You could of course look at this in another way....

The symptoms that he has got are called lower urinary tract symptoms or LUTS and in the majority of men with symptoms as described this will be due to benign enlargement of his prostate. This is really common as men get older and for the vast majority it is harmless. I usually tell my patients that we don't treat the symptoms, we treat the bother that the symptoms cause - both to the man involved and to his partner, who is often fed up of sleep interruption. However, it sounds like he is not too bothered and it may be perfectly fine for him to live with his symptoms as they are unless they cause him annoyance.

Carrying out a PSA test to look for prostate cancer: your husbands symptoms are as I say probably caused by benign enlargement of the prostate. A PSA test for him would really amount to screening for another disease and it is highly controversial - there is no strong evidence to say he definitely should have a PSA test, but there are pros and cons. There are fact sheets available eg on www.patient.co.uk or it can be discussed with your GP.

If he wants, persuade him to post on here and he can discuss it anonymously from the safety of his own home!