Knowing about a patient’s symptoms is important, not only in making the correct diagnosis, but also in deciding if and how the condition should be treated. It is a good idea to think about your symptoms carefully before you see the doctor, as this will help you to answer the questions. It is also important to tell the doctor why you are concerned about your symptoms.
Some men simply want to be reassured that their symptoms are not a sign of something serious, in which case, provided all is well, they may then not want to be offered any treatment. Other men have such uncomfortable symptoms that they are desperate to have them treated.
If you are simply worried and want reassurance, do not be afraid to say this. The doctor will not mind, and it will avoid a misunderstanding that could lead to you getting the wrong advice.
The doctor may use a set of standard questions from a printed list, or may use a computer. In some hospitals you may be given the questionnaire beforehand. If this happens, someone will go through the answers and deal with anything that is not clear. The questions are designed to find out what the problem is, and how severe the symptoms are. The severity is given a number and the numbers for all the questions can then be added up to give a ‘score’ that measures the seriousness of the problem. Questions about your general health are also important, especially if an operation is being considered.
Having an Examination
You will need to have a general examination, including checking blood pressure, and an examination relating to the prostate. Your abdomen will be checked, making sure that your bladder is not enlarged. Your penis and testes will be examined. Sometimes narrowing of the opening in the foreskin – phimosis – can cause similar symptoms to those arising from the prostate, and a simple circumcision operation may be all that is needed.
The final part of the examination is feeling the prostate itself. This can only be done by the doctor putting his finger through your back passage into your rectum. This is called a rectal examination. You have probably heard about it, and many men get worried and anxious about it. Indeed sometimes this is why men do not admit to their prostate symptoms.
It is natural to be apprehensive about this type of examination, and the doctor realises that it is embarrassing and undignified, and will do it as discretely as possible. You should tell the doctor if you have some problem affecting your back passage – such as piles or pain when you open your bowels.
Usually you will be asked to lie on your left side, although some doctors prefer another position. It is important to relax as much as possible. Bending up your knees makes your prostate easier to feel. The doctor wears a thin soft glove on which he puts some jelly to allow the finger to slip in easily.
The examination usually only takes a few seconds, and tells the doctor how big your prostate is, and whether it is enlarged from BPH or another cause. Normally the prostate is not tender, but if prostatitis is suspected you may be asked whether touching the prostate is painful, and very occasionally the prostate may be massaged during the examination to obtain a specimen of fluid from it. The rectum itself may also be examined.