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Acute urinary retention.... Need advice on options please.

Posted , 19 users are following.

aliL
aliL

Hello all,

My husband had a crisis on Saturday night with acute urinary retention, absolutely nothing coming out and left at the mercy of Aand E for several hours in agony. Now home with a catheter, awaiting test results ( PSa etc) and an appt. with a urologist. I am terrified it is cancer but trying not to think about that to much so now throwing myself into researching BPH and our options so we are well informed at our appt. I don't want to accept surgery or strong drugs forever if there are other options. 

I would bery very much appreciate any advice from you lovely gents on supporting my husband and any success with alternatives to avoid surgery ( saw palmetto, pumpkin oil etc) . 

Maybe be I should mention he is 54 ,in very good health generally but has a ' slow' flow in the mornings for a few years . I am 4 months pregnant with our first long awaited child and need someone to give me a kick up the bum to start thinking positive!!

many thanks in advance for any advice

Ali

0 likes, 134 replies

134 Replies

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  • derek76
    derek76 aliL

    Posted

    PC is the least likely thing for it to be. As you did not mention pain it is less likely to be prostatitis and probably BPH. Many of your replies have been from Americans who have different options from us in the UK but the advice to avoid TURP is universal. If you go to the NICE web site (moderator does not like links) it has write ups on all of the options.

    High PSA is also not a thing to worry about. Mine went from 5.0 to 9.8 over the years when I was refusing TURP and waiting for something better in the way of a aser procedure. Now I would want PAE as the first choice over Holep.  

  • stinger212
    stinger212 aliL

    Posted

    Hi AliL.

    Not a doctor but all of us been there and done that, as many of the fine gents that have given you their honest opinion will attest. My guess is that PCa is not causing urine retention plus BPH tends to elevate PSA as stated in many medical journals. Your URO can do other tests for PCa.

    My solution after emergency room Foley was to self- catherize and do a PAE, less than a week ago. Still self - catherizing and waiting for the PAE to kick in. As stated by my partners in this blog, CIC gives you the freedom to do what you want, eliminates bladder distention/infections and takes 1-2 minutes to get CIC done at home or away. Would agree with other statements here: TURP IS THE VERY LAST RESORT WHEN ALL ELSE FAILS!!

    My spouse, like others am sure, is very supportive and just wants me to live a more normal life. Bottom line: though no doctors here, you have received the best and most honest recommendations from men that have dealt/dealing with BPH. You and your husband just need to decide on what to do once ur research on BPH medical procedures is exhausted.

    Wish you Godspeed with the new Baby !!! Hope this long response helps. And follow up in the UK Med system for non-invasive treatment. Cheers

  • ES28567
    ES28567 aliL

    Posted

    Hey Ali,

    Sorry you and your husband are going through this. I am 56 and my first PSA came back 18.5! The first thing he needs to do (if the PSA comes back high) is a minimum 30 day round of antibiotics because infection in the prostate can influence the PSA score. If the score is still high (as in my case) DO NOT agree to a biopsy until a 3t MRI is performed. If no areas of concern are found then have a PCA3 test (urine) performed. This is considered by many more accurate than the PSA which by itself is not a good reason to jump on the biopsy table.

    If either the MRI or PCA3 test indicate concern for cancer, (which was my situation), then and only then have a biopsy. I am not a doctor. These were just the steps I found logical for me to follow.

    It is very common for men to have an enlarged prostate without it being cancer.

    If a biopsy is warranted I would be happy to share my experience (as are others on this site) the logic I used to determine the number of cores I allowed/restricted the urologist to, and how to minimize the effects of the experience.

  • MK51151
    MK51151 aliL

    Posted

    Same acute urinary retention happened to me on beginning oh April of this year. I went to ER and was catheterized but instead oh lieving catheter in me I dcided to do CIC self intermittent catheterization and ER doc gave me prescription for catheters. I am using speedi cath type of catheters and it is easy and pain free to do it. Prior to retention I had high PVR up to 450 ml. I am scheduled for TURP on June 1. I am also on tamsulosin twice a day and still have hard time urinating. I can gat some of urine but still stays lot in my bladder. I am 51 years old. I want to fix this problem and that is why I decided to go with TURP. I hope to have good outcome for good number of years. I am also in good shape and very active. Your husband problem is most likely caused by enlarged prostate that is pressing on his urethra and causing retention. So he is not alone here with this problem. I hope he will find solution that will work for him.
    • jimjames
      jimjames MK51151

      Posted

      Since CIC seems to be working so well, why the rush for a TURP? I also had a hard time urinating after only two months of CIC, but after the second year my bladder has rehabilitated itself to the extent that I can sometimes go for days without CIC and can empty naturally down to below 50cc without any drugs like Tamsulosin. Before CIC, my PVR was similar to yours. I know you're in a rush to fix things, but newer procedures are available and more in the works, procedures much less invasive than TURP and procedures that won't leave you with retro ejaculation. Also, why the Tamsulosin if you're doing CIC. CIC empties your bladder completely so no reason for pharmaceutical help. Consider letting CIC buy you time for something better than TURP.

      Jim

  • derek76
    derek76 aliL

    Posted

    Some NICE and NHS Links for your information. Once on the NICE site you can search out more on specific treatments.

    https://www.nice.org.uk/guidance/IPG475/chapter/1-recommendations ;

    https://www.nice.org.uk/guidance/GID-MT265/documents/final-scope ;

    https://www.nice.org.uk/news/press-and-media/nice-recommends-new-device-which-avoids-surgery-for-enlarged-prostate-glands

    http://www.lyntonsurgical.co.uk/Papers/NICE_Guidelines_on_LUTS.pdf ;

    From this site:

    https://patient.info/doctor/benign-prostatic-hyperplasia

     

     

  • aliL
    aliL

    Posted

    Thankyou so much for all your replies. I am overwhelmed to get so much helpful advice and appreciate each and every one of your repliessmile

    you have all given us so much info and we now feel confident that with self catheterising we can buy some time to come back here and make the right decisions with your help. I can't thank you enough smile

    can an I please give you a bit more info... The night of the ' crisis' my husband had been out for a works do and had five pints. He also took an antihistamine before the meal ( allergy to red meat) . I have since discovered a link between antihistamine and urinary retention.... Has anyone experienced this and do you know how long it took things to settle?

    Also, when I had my IVF we underwent a lot of screening. I tested positive for Chlamydia to my horror but was assured that this can lay somewhat dormant for years. Neither of us have ever had any STI symptoms and have been married for 23 years so it's been doing its damage for a long time. The consultant told us that my husband would benefit from a course of antibiotics once every 2 years to keep this infection at bay.... If he didn't he would suffer with prostate trouble in later life. I'm assuming she's meaning chronic prostatitis? No symptoms apart from slow flow, kidney ache and poor sperm quality...does prostatitis cause the prostate to enlarge or urinary retention?

    one more question .....hubby has a tap on his catheter rather than a bag to try and regain bladder control. However he says when he passes urine it flows fine but then stops very suddenly! No gradual slowing.... Does this sound ok? He's worried it's leaving some in the bladder.

    thankyou all once again for your valuable advice ... You are all so knowledgable and I  am very grateful to you all for helping me ,

    Ali smile

    • oldbuzzard
      oldbuzzard aliL

      Posted

      Normally when you cath it just stops, it doesn't slow down, so that's normal. MAybe the anitbiotics will give his some relief right now/
    • aliL
      aliL oldbuzzard

      Posted

      Thankyou OldBuzzard...... That will make him feel bettersmile
    • derek76
      derek76 aliL

      Posted

      When you have BPH never take an antihistamine as it will probably cause retention but it should not last for longer than it is in your system.  Cold cure remedies, codeine and too much alcohol are other possible causes. Some people take a couple of codeine or an antihistamine at night to cause temporary retention and so not need to go to the toilet during the night!

      I had BPH for ten years with my prostate growing from 35 grams to 75 grams. I had retention of up to 600 mls at times but my flow never stopped. After having PVP in 2005 my prostate regrew over the next eight years to 135 grams. I still had retention of up to 450 mls but could always pass some. During that time I had several bouts of prostatitis but could still always pass urine.

      After having Thulium/Holmium laser surgery in May 2013 I was still getting prostatitis until January of last year but since then I have been clear and zero retention and PSA down from 7.8 to 0.74. 

    • jimjames
      jimjames aliL

      Posted

      Yes, some drugs can make retention worst. Antihistamines are one of them. That said, if you self cath it doesn't matter if you take antiistamines because you will empty completely anyway. Sounds OK regarding the flow stopping with the catheter and tap. However, if you really want to make sure he's still not retaining have your doc do a bladder scan right after he empties. Most urologists at least in the U.S. have a bladder scan unit right in the office.

      Jim

    • arlington
      arlington jimjames

      Posted

      For me, it definitely does matter whether I take antihistamines, drink alcohol, caffeine, etc. - even while on self cath:

      1. it increase the extremely uncomfortable urgency as well as the frequency w/ little result

      2.  it causes me to have to cath much more - which is  not a good thing

       

    • jimjames
      jimjames arlington

      Posted

      Understood. I guess what I meant to say is that when you self cath there is no concern about retention (acute or chronic) because you always empty completely. As to the uncomfortable urgency and frequency, I never noticed that with either alcohol or caffeine but we are all different. In fact, at one point I felt that coffee helped me empty better naturally by stimulating the detrusor muscles, but it was by no means a controlled experiment. Antihistamines and certain pain killers however, did make it more difficult for me to urinate naturally which I am able to do more and more of the time now without the need for self cath.

      Jim

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