Men’s bodies

Filipino men are becoming more and more conscious about their bodies, what with fitness gyms, dietary supplements and all kinds of body stuff, including cosmetics and even “male hygiene wash,” now widely available.

Long before this “beauty” consciousness, our men have traditionally been obsessed with one particular anatomical part, referred to with names like Pedro, Manoy, Totoy and Junior, and lavished with attention, including amazing body modifications like bolitas (little metal or plastic balls inserted under the skin), as well as silicone and Vaseline injections intended to transform Junior into Cobra.

I worry that our body consciousness is about externals even as we neglect the “clockwork,” the internal parts and its intricate mechanisms.

The prostate is a prime example of this neglect. Many men do not even know they have a prostate, which doesn’t have a name in many languages in the Philippines and throughout the world.

It’s located near the urinary bladder, and is always described as the size of a walnut (for Filipinos, maybe we should say a small guava). It’s responsible for the production of seminal fluid and usually just sits there quietly.

But around midlife, aged 40 and above, a growing percentage of men will have problems with an enlarged prostate, a condition with a fancy medical name—benign prostatic hyperplasia or BPH. About half of men in their 60s will have BPH.

It stays benign for most men, but a small percentage will develop prostate cancer over a long period.

As the prostate enlarges and presses on the urinary bladder, men start to feel the “plumbing” problems: frequent urges to urinate but with difficulty getting started, only to get a trickle and finishing with a feeling you’re not finished. The frequent night urination can seriously disrupt sleep and affect work the next day. The plumbing problem worsens, with more and more “accidents” (not making it in time to the toilet), and eventually come the diapers.

In the Philippines, the local term for the condition is balisawsaw, which we blame on changing weather, the heat and even sitting on a “hot seat,” meaning a seat used by someone else right before you.

The plumbing problem is still mild compared with a growing risk, as the BPH worsens, for urinary tract infections (UTI). A serious case of UTI can involve the entire body: excruciating pain all over, fever, chills, and a worsening of the urine problems. Medically it’s called dysuria; in lay people’s terms, it’s like having red ants while urinating.

I’m writing all this from personal experience, having just gone through a very serious UTI that I thought was dengue, and which I hadn’t connected with a BPH problem I’ve had for about three years now. The first bout was three weeks ago; it kept me bedridden for two days, with remaining pains for a few more days. After I thought it was all over, I came down with a second UTI last week.

Friends would comment: “’Di ba sa babae lang yan? (Isn’t that something only in women?)”  Others gave me that look, “Chansy ha…,” their way of suggesting it was sexually transmitted. I would explain that UTIs are sometimes, but not always, sexually transmitted, and besides, with all the work I do it’s been pretty much a monk’s life.

I went to my urologist, Dr. Yul Quanico, to review what had to be done, then we got to talking about public information and education. There’s this continuing unwillingness to go through a simple digital rectal exam to find out if your prostate is enlarged. Digital here doesn’t mean some high-tech tool; it’s the physician’s finger, quick and simple, but complicated for men with, how should I put it, fragile masculinities. I tell friends, come on now, scared of the finger? Be a man.

This Father’s Day weekend, the Philippine Urology Association will have lectures and free checkups, part of a campaign called “Tayo Na MAN.”

Don’t dismiss that balisawsaw, and don’t self-medicate with antibiotics. There are other medicines to deal with the enlarged prostate, and with the urination.

Talk to your urologist as well about other problems, including Pedro’s ups and downs, and all the other questions about men’s bodies, including the dangers of supplements like steroids and creatinine and instant Cobra injections.

One more story to explain the clockwork. Only when I was agonizing with the UTI pains did I remember that about a month ago, I had severe back pains, which I thought simply came from using the backpack. Then I remembered that lower back pain could have been the kidneys. They’re all connected: the urinary tract, the prostate, the urinary bladder, the kidneys.

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