The whole area is rich with nerves and valves controlled by those nerves. BPH is not unusual for some level of CA, but yeah some men have BPH and don’t have cancer (Hence ‘benign’) (and some men don’t have BPH and have cancer) So I was unlucky, but I was 'playing the numbers and so was my prostate apparently. So BPH expressly has no cancer, otherwise it would be something like MPH? (Malignant Prostate Hypertrophy)?
PSA does not in itself detect cancer. There are men that have elevated PSA and no cancer, it happens. An MRI is the current ‘recognized method’ of checking on the prostate and determining its size and general condition. I’ve had rectal exams (one that nearly had me seeing stars) and no one ever told me that I had BPH. NO ONE.
Also the PSA test does NOT actually test for cancer. It tests for a blood marker that is emitted by an ‘unhappy’ prostate. Biking really tends to piss off the prostate. The pressure, the repeated ‘trauma’, and the prostate gets irritated. My surgeon said that there is some research that indicates that biking does tend to predispose some men to have BPH, and of that population, a certain number of men then develop prostate cancer BECAUSE they have a large prostate and are cyclists punishing their prostates, or do some other activity known to have unhappy prostates.
During the surgery, it is not uncommon for the nerves to be cut that go to the valve at the bottom of the bladder (and inside the top of the prostate), and also cut the nerves involved in erections and bladder urinary retention. (Not to mention removal of the Vas, (and other procreation necessary plumbing)
In the old days, it was expected that men would be both urinary incontinent AND impotent. With some of today’s robotic alternatives, it’s possible to salvage those nerves, and many men have some level of urinary countenance. My uncle (nearly 90 years old!) had the nuclear fix, and complained to me about the side effects. Yeah, the nuclear/radiation seed treatments had their issues. The seeds ‘migrating’ and being passed in toilets and urinals is kind of minor. (But they also used concentrated radiation in the prostate area, and that had a whole list of problems, but it was ‘killing cancer’, and killing a lot of other things too. I think the surgery was brutal, but the rad treatment seems so over the top, but it wasn’t surgery so there is that. In his time of treatment, they often nuked testosterone production because in the ‘dark ages’, they knew that some indeterminate forms of prostate cancer were sensitive to that hormone, and in men with higher levels of the mighty ‘T’, they could have raging prostate cancer happen. His other option was the normal surgery of the day (through the rectum/anus, and guaranteed urinary, and potentially fecal, incontinence. He is still furious that they ‘injected him with female hormones’, no idea about that, but his treatment team did what was common at that time: ‘Nuke Testosterone’. How things have changed.
ALL of my treatment ‘team’ was really surprised I was not symptomatic for the size of prostate I had. They said that many men find ways to compensate for the blockage, and/or show up in the ER, and their doctors office in a ‘crisis’ not able to void their bladders. My step dad died of a prolonged interval of blocked urethra from, ironically, the prostate surgery he had. (Due to the backup, his kidneys failed and other organs followed, sadly)
On to ‘post-op weirdness’, I was having incidents where my ‘junk’ felt like it was vibrating. (Really, seriously) It’s those irritated nerves reconnecting. Like post op, it’s amazing what I feel and what I don’t) I was given ‘a look’ bu my surgeon after he asked avout those vibrations. I got the idea that he was not impressed. I told him that the vibrations ended shortly after I started riding again. Yeah, the idea that the human male bottom on a bike seat causes erectile dysfunction is a solid yes for me. Eventually I could get past ED, but apparently my surgeon, and researchers, aren’t so sure. ‘Man’ do get it back ‘usually’, but there are no guarantees.
Would I want to give up riding for the ‘vibrations’ to return? Wow, an interesting question there… I’m addicted, like many are, to the endorphins. I need my fix! Maybe the side issue is GET FITTED? Make sure that nerve is happy. Before it was the prostate, now (post-op) it’s that damned nerve.
This is long, sorry, but I’m trying to go through what I have experienced, and hopefully (maybe) will remove some of the apprehension over getting a prostatectomy. (A local friend of a friend had a high PSA and had a bad biopsy, and is scheduled for surgery soon. Yeah, it’s frightening, but dying of prostate caner is no walk in the park. I’m still shocked at the number of people that have died of prostate cancer. It’s largely treatable and caught soon enough is gone. It’s worth getting tested, it’s important to know what the tests are actually testing, and also important to know what tests men should be doing (An MRI, to me is WAY more important to the snap of a rubber glove test)
I think that male cyclists have the possibility for BPH, and that BPH can lead to prostate cancer in unlucky men, and prostate status need to be taken more seriously. Get the PSA (WATCH the trends!, first time elevated, take at least a week off and retest. If still high definitely do the MRI, and followup from there), get an MRI, if indicated, get a biopsy. Life is still worth living, and ride on!!
Yeah to surgery ‘front loading’ the issue of having ‘had’ (hopefully) prostate cancer. (I have to have a PSA done every 3 months for the first 3 years, and every year for the next X-number of years, and then I’m ‘clean’.)
(This post fueled by killer pizza and Ménage à Trois, Silk, soft red blend wine)