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March 11, 2009
One problem which becomes increasingly common in old age involves a sex organ, the prostate gland. As you grow older, especially after the age of 50, your prostate gland commonly enlarges. The prostate gland surrounds the urethra, the tube which carries your urine from your bladder to the eye of your penis. If the gland enlarges, you may find that you have to pass urine more often, and when you do, you only make a poor stream. Later, if the prostate grows even larger it may press on the urethra and make it difficult, or impossible, for you to pass urine.
If this should happen you need surgery, so that the enlarged prostate can be removed (prostatectomy). This can be done either through your bladder or by operating through your urethra with a special instrument. Either method is safe and successful, provided your health is good.
Many men worry that if they have to have a prostatectomy they will become impotent. Prostatectomy by today’s surgical techniques does not affect a man’s potency. In some cases, he no longer ejaculates any sperms, instead they go into his bladder, but he still has orgasms. If you need surgery, get your surgeon to explain what he is going to do, and make sure that he knows that you enjoy sex and want to go on enjoying it.
This confirms Professor Curran’s opinion that attempts to convert a homosexual to heterosexuality should only be made rarely, and then only when careful evaluation of the homosexual’s attitudes convinces the therapist that he is sincere in his desire to change. If the homosexual is only trying to change to reduce his guilt, or diminish the fear society has engendered in him, treatment will fail.
A homosexual who has emotional problems is in the same situation as a heterosexual who has emotional problems – both may need skilled counselling or psychiatric help to resolve those problems and to adjust better to their environment.
It is true that a homosexual is likely to be more anxious and insecure and to have a larger amount of ‘self-hatred’ than a heterosexual. This is largely or completely induced by the hostility, insensitivity, and ill-feeling of the society in which he lives and by the stupidity and ignorance of the authorities he may have to face if apprehended by the law.
These attitudes and actions are indefensible when one man in twenty-five is homosexual.
If you do not seek treatment, the symptoms disappear in a few more days, or the disease spreads to involve organs which are adjacent to the urethra, particularly the prostate gland and the bladder, or even the testicles, where it causes an acute inflammation with a painful swelling and the chance of permanent damage which could cause sterility.
In the days before antibiotics were available, the only treatment for gonorrhoea was the use of local antiseptics. These were not very efficient and may have aggravated, rather than cured, the disease. In those days, the symptoms of chronic gonorrhoea commonly developed. The most common, the most painful one, was a narrowing, or stricture, of the posterior urethra. This led to difficulty in passing urine, or to the failure to pass urine at all. The treatment was painful, and consisted of pushing narrow metal or plastic rods along the urethra to try and stretch the narrowed portion. The operation was called dilatation of the urethral stricture, and the sufferer had to submit to this at frequent intervals.
The method described is in direct contrast to that used by earlier therapists who believed that a man with premature ejaculation should not be touched during foreplay, and in intercourse should direct his mind from his sexual performance by thinking about non-erotic matters, Their success rate was low.
The couple are now ready for sex-play and genital stimulation to retrain the man so that he can delay his climax. Masters and Johnson recommend that the woman can best stimulate the man’s penis if she sits, her back against the headboard of the bed, her legs spread out, with her husband lying on his back facing her, his body between her legs, his legs over hers, but the couple should use the position they find most pleasing. Whatever position is chosen it must give the woman a free, gentle, and ready access to the man’s genital area. First, she stimulates his penis to a good erection and then uses the ‘squeeze technique’ suggested in 1969 by Dr James Semans. The idea is that as sexual tension mounts in the man and as he feels his climax approaching, he signals the woman to stop stimulating his penis, and to reduce his need to ejaculate by squeezing his penis firmly, just below the glans. The woman’s thumb presses on the frenulum, and her first and second finger give counter-pressure just below the coronal ridge. If the woman presses firmly in this way for about 3 to 5 seconds, the man loses the urge to ejaculate, provided he has not reached the phase of inevitable ejaculation. Quite quickly he learns to anticipate this, and is able to signal his partner to start the squeeze technique just before the phase is reached. She must press or squeeze firmly, or it will not stop him ejaculating. She will not hurt her partner’s penis; it is much less delicate than many people imagine. This applies equally to stimulating a man’s penis. It can be gripped firmly and masturbated vigorously. If the woman believes she is squeezing or manipulating her man’s penis too hard, all she has to do is to ask him. He will tell her!
In most cultures, pregnancy is still a matter for the woman and her mother or some other female relative. Childbirth is a period for women alone, the man having no part in the process and being expected to keep away. The care of the newborn infant is the woman’s responsibility, although the man is happy to receive the congratulations of his neighbours if the child is a boy!
In recent years, in the English-speaking and Scandinavian nations, particularly among better-informed women, there has been a change. These women want to share their experience of pregnancy with their man. They hope that he will become as informed about pregnancy as they are, and that they will both read about pregnancy and attend pre-natal educational classes so that, together, they can learn about the changes which happen to a woman’s body and her emotions in pregnancy. The women hope that their men will be there to support them emotionally (and sometimes physically) during labour, and will be able to share with them the wondrous moment of the birth of their baby. They hope that their men will participate in the care of the newborn baby and will share in its upbringing. They argue, quite correctly, that as conception was a jointly pleasurable moment, their relationship will become closer and more intense if they can share the process of pregnancy, labour, and parenthood.