27 Feb DIARY OF A PEEVISH PROSTATE PART 3: THE OPERATION SUCCEEDS

Medically speaking, until you’ve found yourself strapped to a vertical bench in the hospital gown of your nightmares while female nurses insert a two-way catheter plus video attachment into your manhood, I’d suggest you haven’t lived. Especially when the procedure culminates in a perverse form of pelvic waterboarding by one of London’s leading radiologists, Dr Clare Allen… My method of coping was to revert to good old fashioned bravado and journalism: “Tell me, Dr Allen, when you went up to medical school did you imagine you’d spend the rest of your days infibulating naked men?”

Dr Allen, an expert in “Urodynamics”, or the computer-mapping of bladder capacity, responds crisply: “You’re my fifth this morning – I also specialise in all forms of urologic cancer, and I see both women and children. Now then, I am going to auto-inflate your bladder with liquid and I want you to tell me when it becomes uncomfortable. You can watch on that screen across the room”. And so saying, she did.

Of course, true crispness runs deep: “Okay, now I’m going to continue filling and want you to let me know when you’re becoming desperate but at the same time do hold your water!”

Always patient, ever-obedient, I perform as required and am hopping from one foot to another near the end of my tether when Dr Clare pronounces that I am doing rather well. I think of course that she’s confusing my bladder with a well – but she replies that she is the doctor and she’ll make the jokes.

“Now before you empty – and don’t worry the system’s perfectly self-contained – I’m going to test your mental control by repeatedly pouring water from this tumbler into another before your eyes to see whether psychological suggestion produces a difference in outcome”.

“Ah”, I said, “that’s conceivably a mistake. You have now entered the realm of my entire family psychopathology. Having survived an older sibling plus two bossy parents, whole geologic ages could expire before I’d yield. So saying, I held my ground and liquid until her arms grew tired with pouring. Not a flicker; not a drop. Then she conceded I could pee and I watched my bladder empty on television like an office water cooler.

The result was more than a victory: Dr Allen’s research established two facts and confirmed another: 1) I possessed a strong bladder which 2) I could empty completely but 3) it was obstructed by an over-large and irritable prostate.

One week later, my consultant, Prof McNicholas, scanning these returns, concluded that a brief ‘Urolift’ operation to pin the prostate away from the urethra giving it room to ‘breathe’ using five titanium staples was not only possible it was desirable. We had the green light. I packed a small valise.

Never a hospital fan, I negotiated my way to an intensive but limited, three-hour visit at the Hertfordshire centre of medical excellence where the good Professor practises. Once I was checked in, Mr McNicholas enumerated the pre-op checks with such scrupulousness he began to sound like my financial adviser: “As you must be aware”, he said, “results can go down as well as up. Procedures like this always contain elements of unpredictability. Over the next week, the symptoms are probably going to get worse before they get better”. He was particularly emphatic on the subject of “post-surgical urinary urgency”. (And all too accurate – on the drive home, I had to emergency-stop in order to avoid one of those spillages on the M25 the traffic report is always announcing).

For anaesthesia, Prof McNic had promised some “really good stuff that would let him do anything he liked during the operation”. Reader, that sounded both encouraging and a tad Sixties. It may not have been my cleverest rejoinder but just before this sweet sedation, I asked the two anaesthetists why some surgeons and all anaesthetists were hippies. They just grinned. A clear case of pre-operative hysteria on my part which they were very good about, I hope.

An hour later I was awake, refreshed by my legal high. A sympathetic nurse called Lindsay came to my side to teach me how to self-catheterise in case the wounds became obstructive. “You need to grasp your chap in your dominant hand and make him stand up”, she said knowingly. “No, more firmly, like this”, matching actions to words and sounding increasingly like my Satnav: – “Then insert the tube until it’s obvious you’ve reached your destination”. (Much is made of male squeamishness at the very notion of such practices. Let me say I’d rather self-catheterise than visit the dental hygienist. It is actually a doddle).

A cup of tea, a consultant’s debrief and the verdict “all’s good” was illustrated in two easy-to-gather analogies. My prostate, he said, was like Billy Bunter: – “enlarged, obstructive and rather oedematous” – whereas the bladder “rather resembled a gnarled gym instructor: muscular and trabeculated in keeping with years of over-activity”. A humbling business, this.

NOTE: The Urolift procedure meets all current NHS and NICE treatment criteria. However, because it is a relatively new procedure in Britain, it’s my experience there may be bureaucratic delays to do with ‘coding’ in your health area. Should you find your symptoms qualify for a Urolift (and you especially wish to preserve sexual function if a benign prostate enlargement is to be surgically managed) it’s sensible to ask the GP to press your case when negotiating with the hospital authorities.

From a pain perspective, a week of recovery on strong antibiotics plus a few paracetemol was the worst of it. Leaving the clinic, my head felt clear enough to drive but it was obviously prudent to use the tolerant chauffeuse in my life who generously offered. Next day, I felt like what I was – a man held together by five staples walking cautiously with no wish to ride a bike. I’ve possessed neither fallopian tubes nor womb but started to think this is probably what you sense when they quarrel. There were also a few moments of pseudo-cystitis but this was just my apparatus adjusting to its new reality. After three days, all discomfort eased. Even the urgency retreated. And boy did I begin to perk up.

How good is it? Well, a stream now flows where previousIy a brook meandered. I notice my entire torso is free from tension which was obviously triggered by the plumbing conflict. I no longer think twice about car journeys. The tedious but unavoidable and universal process of penny-spending has again returned to a wider world of choice, as though I can be re-trusted with the charge of my own waste-management company. It’s as if Tony Soprano has been demanding protection money since 2011 but finally the pressure is off: he’s been eliminated by a killer urologist in the series finale. As for sex, it is once again in working order with orgasms that DON’T vanish en route. What more could an older man wish for?

PS, the staples do NOT set off airport security alarms, and only heat up by 1.3 degrees centigrade in an MRI scanner, in case you were wondering.