The Joy of Maleness

If you are a male, especially an older male, you may have recently become more acquainted with your prostate, probably a lot more acquainted with it than you would like.

One of the “joys” of this new relationship may be a prostate biopsy procedure. Count yourself very fortunate if you have not reached that point. The first is you get to partake of this manly entitlement because your urologist suspects you just might have prostate cancer based on a sudden or significant rise in your PSA count. The second reason to rejoice is the avoidance of the procedure itself.

About that procedure…

Several years ago my urologist ordered a prostate biopsy. The experience is a major event in your life. For a male, probably something akin to giving birth but not taking nearly as long and perhaps not as painful.

It begins with a purging. They will be violating you rectally and do not wish for you to soil them or their torture examination table. That requires a good flushing of the system. Whatever it is that they give you to take, it is very effective. You might want to hold onto the toilet or be prepared to utter the words, “Houston, we have liftoff!” I passed everything I had eaten in the last week and some things I had only thought about eating!

In a badly weakened state, I reported for my exam. My doctor introduced me to the ultrasound operator, who would be his “eyes” during this expedition up my rectum, and he fancied himself a comedian, keeping a running dialog of one liners all during the procedure.

So, I was instructed to drop my pants and lay down on the torture examination table on my side in a fetal position, which, by the way, is well chosen for this procedure however you look at it. Then the violating begins.

First the ultrasound tech/comedian shoves a device up your know where, prefaced by the encouraging request, “Now, Mr. Casteix, just relax your sphincter muscle.”

Yea, right! How in the world do you order THAT muscle to RELAX? Especially considering he is preparing to insert a device that felt like it was about the size of a baseball bat, the big end! I never actually saw it, but my sphincter muscle must have, because it clamped shut like an oyster avoiding the shucker’s knife.

“Now, Mr. Casteix, I need you to relax your sphincter muscle, please.”

Pleading didn’t help one bit! But reluctant oysters and sphincter muscles can be overcome—with brute force.

And he is in!

That is followed by the encouraging words directed to my urologist, “Hum, rather large prostate.”

“Indeed,” came his informed reply.

I’m thinking, Oh, joy!

Then the urologist gets in the game and inserts his torture device after more requests to relax my sphincter muscle. At this point, it is now stretched way beyond relaxed, and I wonder if it will ever return to its natural state, and am I doomed to be forever incontinent after this?

There must be a camera on that thing, because I then get a congratulatory remark from the urologist, “Nice, Mr. Casteix. It is really clean inside. You did a good job!” And I am thinking, It was none of my doing! After THAT laxative, he is lucky there is even an “inside” left there for him to comment on its cleanliness!

That was only the beginning. Then comes the violent assault on your prostate. I never actually saw it, but it felt like whatever it is the urologist shoves up there must have resembled the head of the alien from the movie of the same name.

He took nine tissue samples with it–NINE! What was that like? The alien head shoots out its telescoping jaw device and punches through your colon wall and into your prostate. There it opens up and bites huge chunks of flesh out of your prostate. In between periodic urgings to relax my sphincter muscle, I am thinking, He might actually be removing my prostate a piece at a time!

Having extracted most of my prostate, they remove the alien head and the baseball bat/ultrasound from me. The ultrasound tech/comedian gets cute then. “My girlfriend doesn’t know what I do for a living.”

And I am thinking, That might be a good thing for the both of them.

He continued, “I will be slipping down the back stairs. If you should see me downstairs, just pretend you don’t know me, OK?”

And I am thinking, Not a problem!

I was warned I might see a little blood in my urine and stool for a few days. Understated! During the next few days, I considered the possibility I might need a transfusion!

Thankfully, the results came back negative. Recently my PSAs went up a point and the urologist suggested another biopsy. Not a chance, and I refused, suggesting we wait and do another blood sample in a few months. We did and the PSAs went down! Whew!

So, gentlemen, welcome to old age. You do need to keep tabs on your prostate, but understand that all kind of things can temporarily drive up your PSA count. Get a biopsy when your urologist says you need one but hold his feet to the fire on it.