Dr Phil Hammond, GP, lecturer and presenter of BBC2's Trust Me, I'm a Doctor

Hello, is that the telephone advice service?

Yes. How may I help you?

I'm having difficulty passing water.

Can I have your name please?

Alfred Jones.

Are you a man or a woman?

A man.

Hang on, I'll just find the right flow chart. 'Is the blood coming from the front passage or the back passage?'

Eh?

Sorry, wrong page. Here we are. Is it water or urine you're having trouble passing?

What's the difference?

Well, if it's water, you need a plumber.

It's urine.

Fine. And how long has this been going on for?

Well, my flow's not been so good for a while now and I do tend to dribble a bit. But I just can't seem to get started at all now.

Could you try for me now?

Try what?

Try to have a pee.

Um, OK. I'll be back in a minute.

No, don't go. I want to hear what sound you make.

This is the telephone advice line, isn't it?

Of course. Who did you think it was – some sort of pervert who gets off on the sound of you straining?

Well, you can't be too sure.

I need to hear you to make a diagnosis.

Oh, right. Mhmhmhmhmhmhmh. Jesus.

And again, closer to the phone?

Mhmhmhmhmhmhmh. Jesus.

I think it's your prostate.

How can you be sure?

Have you got any gloves?

What sort of gloves?

Washing-up gloves are fine. And you'll need some lard or lubricant. But first, could you percuss for suprapubic dullness?

Eh?

If you press on your belly, does it make you want to pee?

Ahh. Yes. But I can't. Please help.

Have you got any pasta?

What sort?

The long flexible stuff with a hole in the middle. You'll need to cook it until it's al dente, then slip it up the old man, round the kink in the prostate and up into the bladder.

I can't do that.

Yes you can. Retract the foreskin and stretch the penis perpendicular to the body to eliminate any urethral folds that may lead to false passage.

Steady gentle pressure should be used to advance the pasta – sorry catheter – and any significant obstruction encountered should prompt withdrawal and re-insertion.

Insert the pasta to the hilt and wait till urine emerges before blowing in the end to create a balloon. Remember to reposition the foreskin to prevent massive oedema of the glans.

Have you got that Mr Jones?

Mr Jones? Are you there? Ungrateful sod.

 

Guidelines in Practice, March 2000, Volume 3
© 2000 MGP Ltd
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