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To further muddy the waters on BPH and the factors that may cause or aggravate it:
My own urinary difficulties boil down to difficulty -- and at night, near inability -- to begin the urine stream. My brain is willing but the "let go" message -- for whatever reason - isn't received down below 'til after multiple tries.
Again, this is most serious in the middle of the night. Daytime is not really an issue, insofar as starting a flow. Slow, but adequate and seemingly not worsening. I do take alfuzosin.
But I happen to have a long history of low back issues -- fused lower vertebra a result of years of heavy lifting. Back pain now...and urinary difficulties that -- perhaps -- are not a coincidence.
So now -- at age almost-73, I have decided to re-visit chiropractic, which has helped me in the past.
The other day I am standing in the exam room waiting for the doc for my first overview visit and there is this chart on the wall showing the spine and the various discs and facets and such. Doc wasn't there yet, so I filled the time studying the chart. Next to each disc is a list of the supposed ailments/functions of the nerves in the vicinity of that disk. Well lo and behold -- L4, lumbar disc 4 -- encases nerves supposedly significant to urinary function. And my L-4 has been banged around plenty over the years.
So now that ONLY because chiropractic has helped me in the distant past am I giving it another try with a focus I hope, on that L-4 thingy and how it may be a factor in my urinary difficulties. (I also have serious back pain now...the primary motivator for me to undertake this treatment.)
Wouldn't it be something if a pinched nerve was the source of my problems! (Said problems are not with leakage and such. Quite the opposite, I am not able to urinate without difficulty for a very slow start and a slow stream once started. "I pee in Morse code", as it's been described. So I am actually hoping a lower back nerve has something to do with it and will report here if it does. BTW, my PSA tests have been solid "within your normal" range over the years and the DRE always comes back "not a swollen prostate." At least, I guess, on the outside.
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