Chioma Umeha
This edition would be addressing what is commonly
referred to as ‘Prostrate problem’ in Nigeria.
The condition directly affects Nigerian men and
indirectly concerns their women counterparts because they often take the
responsibility of caring for the aged with chronic medical conditions.
Following several complains received in the course
of my medical missions in the country, I discovered that ‘Prostrate problem’ is
commonly mismanaged.
It is therefore important to correct certain
deep-rooted and misapplied behavioural practice concerning ‘Prostrate problem.’
Though the explanations provided in this column might not be exhaustive in view
of the scope of the ‘Prostrate problem, it will aim at correcting
misconceptions about the condition.
The Prostate is a gland that surrounds the neck of
the urinary bladder where it opens into the Urethra, and any growth or
enlargement of the Prostate can result in obstruction of urine flow.
It consists of a glandular and a muscular part all
surrounded by a tough capsule which is difficult to penetrate by the regular
medications and antibiotics that can breach other organ barriers.
The muscular part is targeted by medications that
aim to relieve symptoms of Prostate enlargement and it is its contraction that
causes ejaculation of Semen into the Urethra for outward flow during sexual
activity.
Thus without the Prostate, there will not be the
act of ejaculation although the rest of the seminal fluid will still flow
passively into the Urethra.
The glandular part releases Prostatic fluid which
is secreted through ducts that open into the Prostatic Urethra to become a
component of the seminal fluid (semen), which we erroneously commonly call
sperm in Nigeria.
In case you do not know, what is released by a man
during ejaculation is called Semen, not Sperm, but contains about 20 million
Sperm to one milliliter of the Semen released, giving a total of about 60
million Sperm (full name Spermatozoa) in one ejaculation.
The confounding thing here is that only one Sperm
out of the 60 million is needed to fertilize a woman’s egg and produce a baby!!
I often tell guys that they destroy 60 million
Nigerians with one ejaculation when everything is done to avoid pregnancy. But, can you even imagine the population
explosion that could have resulted if not for this? That is on a lighter note.
There are several diseases afflicting the Prostate
which this column would briefly treat, but I will concentrate on the two major
types of Prostate diseases, at least in Nigeria.
These diseases include Prostatitis, Prostatic
calculi or stones in the Prostate, benign enlargement of the Prostate (Benign
Prostatic Hyperplasia commonly called BPH) and Prostate Cancer.
Prostatitis is inflammation of the prostate and is
often the result of Gonorrhoeal Urethritis, or what we just call Gonorrhea in
Nigeria. I am buttressing this terminology because most Nigerians do not know
that one could have arthritis (joint inflammation and pain) due to Gonorrhoea!
Just imagine the incredulity of a Nigerian patient
that consulted me for joint pains and after a series of tests, I told him in
Igbo dialect, ‘Nnaa, my brother, o bukwa Gonorrhoea ji gi’ (translated, my
brother, you have Gonorrhoea). He quickly stormed out of my consulting room and
told me to go back to medical school!
Anyway, prostatitis could present with symptoms of
Urinary Tract Infection (UTI) like increased frequency of urination, burning
with urination, lower abdominal/pelvic pain and occasionally rectal pain and
discharge. If a man has symptoms of UTI not amenable to the routine antibiotics
given, it may be Prostatitis.
Remembering that the Prostatic capsule could be a
barrier to antibiotic penetration, a choice of strong antibiotic in this case
may be in order depending on your doctor’s prescription. In chronic untreated
prostatitis, infertility from the man could arise, but this is quickly
reversible once the prostatitis is treated.
Calculi of the prostate are uncommon in that they
may be incidental findings in men over 60 years old and are usually
asymptomatic, but in debilitating cases may require surgical removal.
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