“Men are afraid to consult, that Charles III talks about it is very good”

2024-01-23 19:01:51

The news surprised across the Channel and well beyond. King Charles III, 75, is to be hospitalized this week due to benign prostate enlargement, Buckingham Palace announced. “Like thousands of men each year, the king consulted for an enlarged prostate. His Majesty’s condition is benign and he will go to hospital for a corrective procedure,” the palace said in a brief statement.

An announcement which generated an explosion of searches related to this pathology on the Internet: more than 247% in the United Kingdom and more than 217% across the world in recent days. What is benign prostatic hypertrophy? What are the signs and is it serious? “We can live very well with a large prostate,” reassures Professor François Desgrandchamps, urologist, head of the urology department at Saint-Louis hospital in Paris and author of The prostate: are we talking about it? (ed. Hachette), which explains everything you need to know about this little gland.

What is benign prostatic hypertrophy, or prostate adenoma, and is it a serious condition?

This is due to an increase in the volume of the prostate, linked to male aging. The prostate naturally enlarges with age: 50% of men aged 50 have a prostate that is too large, 70% of those over 70, etc. And it’s not a disease to have a large prostate, it’s just a sign of aging, it’s normal. In the vast majority of cases, the prostate is large, but does not bother.

You can live without problems with a large prostate. This is the case of the man who has the largest prostate in the world: it weighs 3.5 kg, it is a benign tumor, and the patient, a Spaniard, still lives with it because it does not bother him at all. daily.

Prostate enlargement is not a serious disease, it is not associated with cancer and is not a precancerous disease.

When does it become problematic to the point of needing to consult?

Illness comes from the moment we are embarrassed. The very first sign is getting up at night but it is not specific. After getting up twice at night, this becomes clearer, but it could be due to something else: we drink too much, we don’t sleep well, but it could be the prostate.

In principle, urination lasts a minute, it is effortless, with a rough and strong flow, and it stops. On average, we urinate six times a day and once a night.

The characteristic sign of a prostate disorder is difficulty urinating: a low flow of urine, you go to the toilet but you have to wait a little before it comes, the stream is weak and interspersed. And when you think it’s over and you get dressed, there are lingering drops. So from the moment urination lasts more than a minute, it is difficult and we urinate more often, it could be the prostate and we must consult.

If King Charles III is hospitalized, is it a priori that he feels this discomfort, or even more?

The first stage is when it starts to affect quality of life, as just described. The next step is when the bladder is chronically blocked, stones can form in the bladder.

For King Charles III, it could be a complicated adenoma, either with catheterization in the bladder or with stone formation in the bladder. We cannot know what its condition is, but in all cases, we are cured of the enlarged prostate, we just have to remove the part which is in growth, and everything is back to normal.

What are the treatments ?

We only operate on one patient in ten. Nine times out of ten, medications and lifestyle changes are enough to cure patients.

Prostate adenoma follows the body size of the man, it is the metabolic syndrome: after the age of 50, men often gain weight, particularly in the stomach area. However, this abdominal fat is toxic, it modifies the body’s hormones and increases the size of the prostate. A parallel has even been scientifically established between waist circumference and prostate size. The men concerned, if they are overweight, are therefore prescribed to practice physical activity to lose a little weight. Walking is very beneficial: if you watch television more than 10 hours per week, you are five times more likely to be treated for a prostate adenoma, linked to aging but also to a sedentary lifestyle.

What risks does King Charles III face by undergoing prostate surgery?

There is no risk, it is not a major operation, it is benign, causes very little bleeding and only requires a short hospitalization of two days.

There is no risk of after-effects of urinary incontinence or erectile dysfunction. Simply, he will no longer be able to have descendants, because prostate adenoma surgery has the only aftereffect of causing retrograde ejaculation: the sperm is produced in the middle of the prostate, and so that it can come out, it The prostate must contract from top to bottom, thus blocking the passage between the inside of the prostate and the bladder. If the prostate is enlarged, the sperm goes directly into the bladder. So after the procedure, he will no longer come out during orgasm. But orgasms and erections are preserved.

Prostate-related problems are taboo for many men. The fact that King Charles III is speaking about it publicly allows free speech…

It is a very good thing ! Before him, there was François Hollande, who made no secret of having had surgery for an enlarged prostate a few years ago.

Very often, what concerns the prostate is pejorative, men feel diminished because for them, it is a question of “old people’s illnesses”, which lead to incontinence and impotence. In practice, it is often women who push them to consult, they are therefore very reluctant, there is a modesty or even a great fear: they are afraid of being operated on, of having cancer and of losing their virility.

So the fact that the king is talking about it is great, because by consulting early, we prevent things from getting worse: one in two men who have prostate problems have erection difficulties, the two are linked. And medications as well as lifestyle improvements can treat both concerns at once. So it’s very good to talk about it!

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