Suzanna Hopwood: A patient perspective

The experience I am going to describe concerns the successful diagnosis and treatment of a seriously annoying and not necessarily straightforward urological problem.

The problem first surfaced several years ago when I was diagnosed with a prostate problem. The diagnosis was seemingly straightforward. An examination and a scan identified a slightly enlarged prostate but nothing sinister. The treatment was equally straightforward; a couple of different pills (Mirabegron, Finasteride and Tamsulosin)

A follow up appointment with the consultant at his clinic. This was quite an amusing experience in itself because it entailed my sitting waiting to be called together with a large body of mainly older men, many from diverse ethnicities and cultural backgrounds. They may have found this surprising assuming they were aware (I suspect unlikely) of the incidence of prostate issues among women assigned female at birth. I was thus discharged. All well and good. No beats missed on this occasion.

Things proceeded straightforwardly for the next few years my simply taking my medication. However they took a different turn about 12 months ago when I began to experience what I have subsequently learnt is “urge incontinence”. I will spare the details but it became a complete nuisance; not a very good look to suddenly experience an uncontrollable flow of urine in the theatre, the cinema or indeed anywhere!

After some months of this enough was enough, so my GP referred me back to the clinic for a cytoscopy investigation. This confirmed that my bladder and prostate contained nothing sinister. The next step was a urodynamics test to determine the capacity and functioning of my bladder. As a result I was diagnosed with an overactive bladder.

The two investigations were very professionally done not least with great deal of humour. I felt very comfortable The senior consultant who conducted the cytoscopy (referred to as “ The Boss” by the nurses who clearly adored him) did not miss a beat likewise the two specialist nurses who conducted the urodynamics test.

The result of all this was a very clear explanation of the potential treatments with escalating levels of intervention. Fortunately the proposed initial treatment is a daily Solifenacin pill which so far has transformed my life,restored my general good humour and enables me to dispense with pads!

From start to finish all the clinicians and staff involved were exemplary in the way they engaged with me. This was especially true in the early stages when I suspect a woman with prostate related urological issues is not encountered every day.

The wider significance is that the cohort of trans and gender variant/diverse women experiencing and likely to experience prostate issues is large and will continue to grow. Clinicians and clinic staff need to respond to this diversity without missing a beat. And in my case no one missed a beat.

You can read more about trans women and prostate cancer, including my story, at Prostate Cancer UK.