I can remember exactly where I was when my chronic prostatitis kicked in.
I was 24 and, during a few pints at my local, the sensation of a nail being hammered through the tip of my penis came on very suddenly. By the time I’d made it home to bed, I was passing water into an empty bottle every three seconds.
A week later I was with a urologist on Harley Street undergoing a barrage of tests: blood/urine tests, a bladder ultrasound, a urine flow test, and a digital rectal examination. With everything else coming back normal, aside from a tender prostate, the prognosis was chronic prostatitis.
Prostatitis affects men of any age but it’s most common in younger and middle-aged men, typically between 30 and 50. Up to half of all men may be affected by it at some stage in their lives. Though prostatitis accounts for a quarter of all urology consultations in Britain, it is a complicated and thus poorly understood disease. Because it has a range of common urological symptoms each person can be affected completely differently.
Basically, because of a combination of stress, strain and/or infection, the prostate — a walnut-sized organ at the bottom of the bladder — becomes inflamed, putting pressure on the urethra, bladder and pelvic floor. The result can be devastating.
For the last four years I’ve had a split V-shaped stream, several days of complete retention, nerve spasms in the rectum and the urge to urinate every ten minutes. The most frustrating of my symptoms were the bouts of weak erections — all down to constricted vessels and reduced blood flow.
The psychological impact of chronic prostatitis has been deemed worse than that associated with congestive heart failure or diabetes. Online, there are forums of 30-year-old men contemplating suicide due to the constant gnawing pain. Two months after that initial visit to the urologist, I sat down to write my own rather grandiose goodbye note.
The Harley Street urologist prescribed Flomatrax and yoga. Flomax – an alpha-blocker that relaxes the muscles in the prostate and bladder neck – didn’t improve the situation. I haven’t yet tried yoga.
He also explained that prostatitis is common in the army in those regiments that change the tracks on tanks. All the strain in that area when bending up and down can cause the gland to become infected or inflamed.
Another urologist suggested I have a cystoscopy under local anaesthetic to see if there were any obstructions or scarring. Everything was ‘unremarkable’, but it took five minutes of a thick fibre optic tube being twisted up the urethra to find that out.
Consequently, like many other sufferers, I have developed a pattern of coping strategies. ‘No, I can’t crash on the couch because I’d be super uncomfortable,’ or, ‘Can we switch? I’d prefer the aisle seat.’ I worry about a future of constantly interrupted road trips, agonising long-haul flights and stop-start sex with future girlfriends. There’s only so long a date believes you’re still brushing your teeth.
I’m comfortable discussing my condition, but more guarded about the methods for dealing with it.
The internet is awash with those suggesting their own remedies. Some sufferers shove crushed Valium tablets up their back passage in the hope of relaxing the prostate. Others believe using a drumstick to drain the prostate and massage the surrounding area will help.
Some even advise a 21-day broccoli diet detox, and in recent years Botox injections in the perineum is suggested to stun nerves. A particularly common one is the use of frozen coconut oil suppositories. Aside from paralysing my pelvic floor with Botox, I’ve tried them all.
Other less hands-on remedies involved taking mixtures of sleeping tablets and anti-anxiety medication — Xanax, clonazepam, diazepam, zolpidem — in the hope of getting a few hours of uninterrupted sleep.
While working in Guangzhou, China, I saw a urologist whose approach was to give me prostate massages three times a week for two months.
They were highly effective, numbing the area for a good few hours after each session — which often involved at least 10 other out-patients crowded around the bed vying for his attention. He prescribed huge bags of bitter Chinese tea which did little other than to stink out my kitchen.
Aside from sessions of switching between incredibly hot and cold sitz baths, forgoing the weekend curry and double espressos, there’s little else that can help.
With every GP, urologist and physiotherapist I’ve visited stuck twiddling their thumbs, I’ve had to learn a kind of subdued acceptance.
The best thing for me is creating my own distractions: having a routine, people to talk to, and exhausting workout sessions.
At the moment, I’m waiting to have an endoscopy for further investigation. But, like many other sufferers, I may be told that it’s all in my head.