Any alternative to Tamsulosin to treat Nocturia due to prostate problem?

Wally that is why all men should look every thing up.  Don't  just take the doctors word.  Some time they do work and you have a good out come but what about the other 35%.  I am 3 week into my Urolife No getting up at night peeing great and no more pills.  The first time I had a dry orgasm I didn't know what happen and my bladder hurt.  No man should let a doctor cut or kaser there prostate.  It may fix one problem but will cause others.  Get all the fact before you have a knife force in you penis and they stary cutting  Take care  Ken

Hey Wally... Apologies for not replying sooner and thank you kindly for responding.

It was very interesting to see you mention excessive thirst. My pre-nocturia fluid intake was something my wife commented on recently. Since retiring from the rat-race and prior to needing to pee frequently, I spent most days leisurely enjoying life in my workshop, primarily woodturning, but tinkering with the occasional motor too... Long story cut short, in spite of wearing a mask while using the lathe and having a great extraction system in place, the shop can be a quite hot, dry, dusty environment, which in turn often leads me reaching for a swig of water. I've no idea if it's significant, but it has to be iced water! The wife remarked my insistence on drinking chilled water points to thirst rather than simply refreshing a dry mouth and throat. (She may be right... She usually is ... I suppose the swigs did add up to a significant amount, but it's something I'd done for years so I'm not sure it has any bearing on my developing the urge to urinate frequently... Although I'll bring it to my urologists attention when I see him, so thank you for mentioning it.

I have read a little about food intolerances such as caffeine, lactose and wheat etc, but since losing my appetite due to the lack of sleep. I'm basically only drinking decaf coffee or water and eating to keep my digestive system ticking over... The wife researched dietary needs and I'm fundamentally force feeding myself a diet of grilled chicken or turkey with a variety of fresh fruit & veg... I only ever enjoyed a few beers (or several - hic!) when my bro visited, having a session in the shop once or twice a week, but him being diagnosed with gallstones 4 months ago saw him advised to abstain from alcohol, I've been on the wagon with him as a gesture of support ever since. I've mostly ruled out any dietary link to my having nocturia.

From what I've learned of the PSA guideline levels urologists follow... Age 40-49 is a 'safe' PSA of 2.7 ~ 50-59 is 3.9 ~ 60-69 is 5.0... Which as you say makes my urologists comment of mine being only "slightly high" at 4.5 aged 53 pretty inaccurate... But having read in depth about the use of PSA to indicate prostate trouble I'm inclined to be very dubious its accuracy, especially as there are so many totally innocent contributing factors that can influence a high reading... I sympathise at reading you were misled into believing you needed a TURP, it's a shameful state of affairs that we can't have complete faith in so called medical professionals.

I'll be sure to remember your account of the effects the procedure had, it may prove to be invaluable advice shortly. Just the thought of ejaculating into my bladder will be reason enough to seek an alternative treatment. Thank you sincerely for providing me with a personal reminder to avoid it and never take everything my urologist tells me at face value.

Regards

BC

Hello BC

Actually,  there IS an important significance in drinking iced water Badly.  It is massively contraindicated for anyone with nocturia.   As is ice cream.

I was warned of the problems cold drinks/foods cause,   by my Prostate Cancer Specialist Nurse.   And I have since unwittingly proved this to myself in one or two incidences of self-indulgence.  Frequency and incontinence worsened. And I'm only talking about a 330ml can of machine dispensed soft drink.

It caused me to rememember that about three decades ago,  I stayed in an Ashram on Fiji for a week.  The Monks do not eat or drink anything that is either hot or cold,  but always as near room temperature as they can get it.  And even though hungry will leave a hot meal for anything up to an hour and a half before consuming it very slowly and sedately.   There are for them,  connotations with both physical well-being and mood/disposition.  And I think they are probably right.

What harm can there be in trying ?

Regards

Dudley

 

 ( I should have mentioned that  'room temp '  in Fiji was warm.  So I think irrespective of geographical location one's food should ideally be,  according to their philosophy,  definitely not cold and not above warm ).

Hello this is Ken.  I cannot tress this enough.  Men need to stick together  don't let them talk you into any surgery that cuts away at your prostate.  Remember they get paid accordingly.  The more the surgery it the more they gey paid.  Some urologist don't care your just a number.  I would never have anyone cut away on my prostate.  When you have that done your sex life is shot.  I don't know if you ever had a dry orgasm They hurt like hell.  It's when the sperm does not come out it goes into the bladder.  Make sure you read wallys again.  His doctor was clue less.  You do have some of your sex life back but it mess up the discharge. And it is permanent.  You can never get it back after they cut away at your prostate.  Also alot of bleeding and the down time is longer.    Life is to short not to enjoy it all.  Ken  My irolift is working great off all meds and I sleep all night.  Pee like a horse in the morning    

Hey there Kenneth,

I have been reading your fulsome posts not only with interest but just very recently,  with a growing sense of trepidation for your continued participation on these Sites.

My feeling is that if you do not tone down your language when referring to Medical Professionals,  the Site Moderator is going to bin you.

We don't want to lose you Ken,   because I for one have much enjoyed picturing you as an irate Eli Wallach type with a drooping 'tache and a Tex/Mex accent,  going around town trying to raise a posse of vigilantes,  so to run the Quacks out of Town.  Great stuff.

So keep it coming Ken,  but maybe ... tone it down a bit?

Regards

Dudley

No problem  We all just have to watch and look out for ourselfs  Look everything up  Have a good day  Ken

Hello Dudley

Thank you for sharing the advice regarding chilled drinks having a negative effect on the frequency of urination. It's especially interesting to hear of other sufferers experiences when guidance has been given by a specialist in the medical profession. Taking a moment to think Monks of Fiji and logically about the practice of ingesting anything at either extreme of the temperature spectrum, leaves me suspecting the human digestive system simply wasn't designed for it.

I'll add for clarity's sake... The topic of me preferring to drink iced water arose due to my wife researching possible causes for my frequent bathroom visits. Her search included 'polyuria', the results of which led her to studying the symptoms of 'diabetes insipidus'. My having a history of intracranial surgery to correct burst aneurysms caught her attention and duly raised the topic of my thirst/chilled fluid intake. I should add, 'diabetes insipidus' is not an avenue any of the medical professionals I've consulted thus far appear to be interested in investigating.

In response to your question: "What harm can there be in trying?"... In my humble opinion, absolutely no harm whatsoever. Indeed, when it comes to taking a swig of iced water in my workshop I don't have to try at the moment. The 3 months of disturbed sleep have had a dramatic, negative effect on my lifestyle, the resulting fatigue and inability to concentrate have effectively put an end to my spending evenings 'turning' trees into furniture. The self imposed restriction on fluid intake after 4pm generally sees me nursing a single 500ml bottle of luke warm spring water for six hours before bed. Unfortunately, avoiding chilled beverages has had zero effect on the frequency of my nocturnal bathroom visits, but has served to decrease the volume of each void while adding to my misery over all things bladder related.

Thank you again for your input

Regards

BC

 

Hey there I feel sorry for the way you were taking care off.  That was not right.  Over the last 6 months I had 2 cystoscope done the first one the urologist found a stricture from kidney stone surgury.  That one did not hurt.  The other one he got into my prostate and it did hurt.  Both time the nurse wipe the penis down and then injected the gel and then claped it.  Told me that we have to wait 5 to 10 minutes. The doctor was gentle and not in a rush.  I think the doctor that did you was in a rush to go home and just did it for you to pacifi you.  I hope thing go better for you.  My doctor did a urolife 5 weeks ago and all is well.  I trust my doctors to give me the best treatment for me.  What ever you do may sure you research it.  Happy healing and good luck   Ken    PS  I was only told to take my pants off and I got nothing on my shirt.  Any liquid that came out was on a pad under me... 

Hey again Ken

Thanks for taking the time to respond... Yeah, I paid heed to your earlier advice to spend time researching any proposed treatment and from what I'd seen online of the cystoscopy procedure, it was obvious from the word go that the urologist rushed my procedure. I can only guess he was running late for something important as he seemed a pretty considerate and understanding professional during our initial consultation.

Given a different set of circumstances, as in my not being so sleep deprived that my reaction time is dramatically dulled, I'd have called time the instant it became clear he had no intention of waiting for the gel to take effect before inserting the cystoscope.

I think in part at that point in time, I was just so very grateful to have been given a short notice appointment that might finally pinpoint the root cause of needing to urinate so frequently, I bit my tongue rather than voice my concerns... With the benefit of hindsight and in the comfort of my home, it's easy to see where the procedure fell short of the standard I expected to receive. I can assure you if I should need to place my trust in his hands again, I'll not be so docile or silent.

I'm delighted to hear all is continuing to go well after your urolift and wish you a full and speedy recovery.

Regards

BC

Hello Dudley

The 'detailed account' was a result of me killing time at the keyboard, waiting for my wife to be sound asleep before I retire to bed myself and risk disturbing her with my frequent bathroom visits.

I tend to associate levels of pain with past personal experiences, brain haemorrhages being a 10 on the scale, closely followed by a 9 for pulmonary embolism, with lesser scores for various broken limbs and damaged organs resulting from the joys of motorcycling... The discomfort felt during my cystoscopy merely paled into insignificance, but then again maybe I've just developed a high tolerance for any pain other than headaches, which tend to leave me hibernating in a darkened room.

This cystoscopy was my first (and hopefully my last) I can't make a equal comparison to any other form of anaesthesia I've needed while conscious that compares to gel being forcefully injected into my urethra. But, in all honesty, if I said there was 3 seconds between the urologist removing the syringe and inserting the cystoscope, I'd be exaggerating!... In my humble opinion, it was used purely as a lubricant in much the same manner as a water based gel eases the insertion of a catheter into the same orifice in order to avoid unnecessary pain... A procedure I've had the misfortune to experience numerous times and never yet failed to compliment the nurse for making it a painless experience... Often while attempting to hide my watering eyes

Regards

BC

Wow, just a thought, are you sure it wasn't xylocaine gel ? I have to dilate a distal stricture and find it does work almost ' instantly ', given it might take me five seconds to put one thing down and pick up another.

I have had a scope out down w/o any lube or anaesthetic at all when I had 3 gold aiming seeds placed in my prostate tumour. I assumed my Urologist needed to both not introduce any foreign material and have an absolutely clear view of the sites.

He apologised profusely, more than once. It was galvanising to say the least.

Actually I have found personally, verbal brevity and swift, deftness of procedure, to be markers of a capable and confident Practitioner and not in any way indicators of a lack of care or concern. Yes our feathers get ruffled and our Mummies are not there to stroke us. But that doesn't mean we can't take it. We can. We just have toughen up and prepare ourselves mentally for something that's going to be unpleasant and not get lulled into cosy unreality, in the waiting room.

Just my thoughts BC. I don't think I could cope without being mentally prepared each time for ' to the limit' discomfort and then being appreciative for every degree of easy below that.

Regards

Dudley

Studies are conflicting whether the pain from an injection of lydocaine gel decreases or increases the amount of overall pain in the procedure. So that's probably why some doctor's use it and some don't.

Also, there is quite a difference between a fliexible and rigid cystoscope. The later is preferred for some procedures and at least in my case made the expression "I felt like I was going to hit the ceiling" very real. Also, because of our anatomy and individual sensitivities, experiences will differ greatly. So what is no big deal to one person, can be a very big deal for another.

When considering my second cystoscopy, I was offered the option to be knocked out with the same type of anesthesia I believe they give you for a colonoscopy. Actually, I wasn't "offered" the option but I had to ask, and the answer was, "Sure, if you want, we do that from time to time".

I'm not suggesting that everyone asks their doctor for anesthesia for a cystosopy. However if you have had a very bad experience in the past, or if you are unduly anxious, consider the option.

Jim

 

Hi Jim

Did you mean to reply to me ? I think you might have meant to address your reply to Badly the Cat !? He's the poor chap having the issues.

,

But anyway we are not talking about a skin penetrative injection as such are we ? ? What they do for me at least is a 3ml plastic syringe tip and it's given a squirt in the eye so to speak. Seems to work instantly every time so far for me. I do not really feel the scope until firstly the distal stricture then the stricture adjacent to the Prostate, then the bladder neck where I have had surgery. They warn me and then ease the scope past those areas With gel, it's all pretty much bearable. But I guess we are all different. I think if Badly is or has become hyper-sensitive, he needs to have that notated and then give them verbal reminders. No shame in that.

Regards

Dudley

They will not put you to sleep for a cystoscopy. I had 2 within 6 months. Had it done in the urologist office.  When the nurse put the gel in he put a clamp on my penis for 5 or 10 minutes.  The gel will only help with the pain or discomfort in the penis urethra.  Once it get lower the gel is not in there.  When the doctor tryed to go through the prostate that is when I felt the pain...But he was a nice guy and not in a rush.  Just be ready for it the next time.  It may be a diffrent experience  Ken  

Hi Dudley,

No, sorry, not specifically addressed to you. More of a general reply as some have described good experiences and 'Badly the Cat' not so good. (Anyway, still can't get used to the structure here where you can reply either to the whole thread or a person! Different from every other forum I've been in )

But no, I was not talking about skin penetration. The study I believe was referring to the injection of a  numbing gel into the urethra. The point being that at least one study found no benefit (actually the opposite) and that may be why some doctors don't use it.

But the main point, as you mention, is that we are all different, and what may be not a big deal to one person may be painful and traumatic to another. I fell into the latter camp with my cystoscopy. Also, if you search through the forum here for other posts on the topic, I think you will see that "Badly the Cat" and myself, while not in the majority, are not alone.

Jim

Hi Ken,

You said, "They will not put you to sleep for a cystoscopy"

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I asked two different urologists if they could put me to sleep and both said it would be no problem. If I remember correctly, one said he would do it in the hospital, and I believe the other had the  necessary equiptment in his office. I'm in the U.S. so maybe it works a little different. That said, a quick "google" found this article here which suggests that it is also offered in the UK

http://www.nhs.uk/Conditions/Cystoscopy/Pages/How-is-it-performed.aspx

Also, here is another thread where someone was put to sleep, although not sure if they were from the UK.

https://patient.info/forums/discuss/browse/cystoscopy-415?page=0#group-discussions

The main point is that while most people seem to do fine with the procedures, some, like myself, found it extremely painful. Whether it's a difference in anatomy, in the condition of the urethra, size of prostate, or type of cystoscope (flexible versus rigid) there can be marked differences in how it is tolerated.

Jim

 

Hi Jim,

Commiserations !

Dudley

Thanks Dudley, but it was about six years ago and pretty much forgotten unless something (like this thread ) calld it to my attention. Now that I've been self-cathing for a couple of years, chances are I (my urethra ) will be more receptive next time so I will probaby forgo the option of being knocked out unless for some reason they insist on the rigid cystoscope which supposedly is quite different from the flexible one that most of you have experienced.

Jim

I had a rigid one in 1983 that they knocked me out for. Done by a marvellous lady called Miss Waterfall on her final day before retiring to go to do good works in India.

I've had three flexible ones in the past eight years and all were straight forward and pain free and all done by the same Guy. Gel in, scope in and all over within two minutes. A friend who has bladder cancer has about three a year plus laser treatment and goes straight back to work.

 

On size of prostate. Mine was 120 grams at the time and I was being treated for prostatitis when I was due for heart valve replacement.

I phoned the hospital who said no problem to do my operation under the circumsrances.

When I came round from the operation completely alert and pain free and asking for details about it I asked if I had a catheter in. The nurse said that they could not get it past my prostate in the theatre and had to use a suprapubic one.

I spent the next few days dragging an ECG monitor, my urine bag and another bag draining fluid from my lung around when taking exercise.  

Hey Jim  What I said that most of the time they do not.  But I know I have seen a few done on the internet that the men were put to sleep.  I had 2 done in the urologist office  Only thing they used was the gel in the penis.  The first one did not hurt Because I don't think he went into the prostate.  He found a stricture but the 2nd one he went past the stricture and into fhe prostate and that hurt.  I could not wait to have him pull the camera out..  It was the size of a lemon.  I live in Orlando fl.  Ken

I feel for you.  I saw that procedure done.  I wonder why they could not get the catheter in.  The tool they use has to go thru the prostate and into the bladder to see where the suprapubic is to be placed. Why one went in and the other could not.   Hope your better now  Ken