Bipolar TURP - 2 month post op update

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Many here may recall that I had a bipolar TURP on 4/5/19 and posted detailed updates during the week after the operation.

Prior to that procedure my PVR was about 200ml, and it was becoming extremely difficult to empty my bladder. My sleep was very disturbed and I felt like I had to pee all the time, day and night.

I just got back from my two month checkup and the PVR ultrasound showed my bladder was empty! So, the TURP worked. Very pleased about that. However, my sleep is still disturbed and I am getting up 6-7 times per night. When I do get up I am able to empty my bladder faster and easier than before: in 5-10 minutes with 2 or 3 attempts. Before this was taking 10-30 min and was really a struggle.

My flow is stronger and easier. Back to the sleep issue: I also posted here another discussion suggesting that the nocturia might now just be a had habit. My uro said that I should give this a few more months to let the bladder adjust. I think that's reasonable. He also said that the sensitivity in my bladder might be a side effect of the radiation I had five years ago for prostate cancer. At least, the TURP lab work showed NO cancer, so that treatment worked. The other treatments that don't send prostate tissue to the lab don't test for cancer.

I will be reducing my twice per day Flomax to once per day, and hopefully, can get off this drug eventually.

So, now it's just a matter of getting my bladder to calm down and try to get better sleep. Has anyone here had radiation for prostate cancer that eventually caused bladder irritation that feels like retention?

Tom

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  • Posted

    I was told that sometimes, the frequent trips during the night are because of sleep disturbances (not bladder in origin) that wake you first, leading you to feel you must go pee. A friend of mine who has a younger urologist received this this guidance, and with a light prescription sleep aid got great improvement in his uninterrupted sleep. (A sleep study was performed first.)

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    • Posted

      Glenn,

      I completely agree - I wake up first, then decide I have to go to the bathroom, rather than the other way around. Most normal people can sleep through the night and hold a LOT of urine in their bladder, and it doesn't wake them up. I was like that until a couple of years ago - the good old days! Once, took a trip to Hawaii with little sleep the night before (packing) then finally took a "nap" in my hotel room in Waikiki at 4pm - then woke up and the clock still said 4, but it was 4am! So, I was out for 12 hours. Wonder how much urine was in my bladder when I went to the bathroom? But I can't recall any discomfort - just got up, peed, and felt fine.

      If my sleep pattern doesn't improve (now that I know I can actually empty my bladder) I will ask my doctor if he can prescribe something or refer me to a sleep specialist. I will wait a while and perhaps my sleep pattern will improve on its own, but if not, I am not opposed to a little help. I took Melatonin for a brief time but the effect wore off right away and I had to take more. Then, when I decided to stop it, I really couldn't sleep. So, I'm not going to do that anymore.

      Tom

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    • Posted

      FYI Tom et al,

      I was convinced to have TURP procedure because of nocturia (up 5 or 6 times a night). Had a botched Greenlight that left me highly incontinent (8-10 Depends per day) because external sphincter was damaged with scar tissue. Had a balloon dilation, then a urethrotomy , and finally a bipolar procedure to clear the scar tissue long enough to have an artificial sphincter (AUS) implanted about 20 months ago.

      AUS works well keeping me dry. Yesterday, after church I sat down to watch some soccer, and then realized it had been about 5 hours since I last peed. I checked the flow by collecting in a plastic urinal and timing it. I emptied 525 ml in 15 seconds, for an average flow of 35 ml/sec.

      Given the dark place I was in, living in constantly wet diapers for nearly two years, I am grateful that I found Dr. Ryan Terlecki who did my AUS implant.d

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    • Posted

      Glenn,

      That is quite a story. I normally pee about 150ml - improving after my TURP, but 525 at 35ml/sec!!!! Great to hear of your huge improvement.

      Tom

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  • Posted

    Any idea why it still takes 5-10 minutes to empty your bladder at night? I assume it doesn't take that long during the day.

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    • Posted

      Lee,

      First, I can mostly empty my bladder in about 25 seconds, but there is still some residual urine left. So, I get a little more out a second time, then the same thing a third, and sometimes a fourth time. Then, my bladder feels completely empty and I can get back to sleep. If I don't do this, when I try to get to sleep I can feel a little bladder irritation and have to get back up again to pee a bit more. I can only fall asleep when that little sensation is completely gone. This process used to take up to 30 minutes before the TURP.

      Tom

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    • Posted

      Have you tried a bladder spasm medication? Feeling the urge when the bladder is almost empty sounds like a spasm. Btw, as my uro suggested, I have been able to discontinue my bladder spasm meds after my TURP.

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    • Posted

      Hi, Tom & Lee,

      Together the pair of you have given me the insight that enabled me to take a giant leap forward. I am also dealing with urinary retention and owe much to JimJames and Cartoonman in particular, and several others now consigned to memory.

      The routine I was following was:

      natural void, measure it, catheter assisted void, measure it, add the two quantities to arrive at a total bladder content. Improvements were slow, just as JimJames had warned, but I never got beyond a 50/50 ratio of NV to RTV.

      Then you guys posted your short thread which inspired my changes a follows:

      natural void, measure it, natural void, measure it, ...and repeat this cycle 4 or 5 times before, catheter assisted void, measure it, add these quantities to arrive at a total bladder content. And, viola! The ratio has gone below the former 50/50. I will give this another week or so before reporting back.

      Thanks, guys, teamwork in action once again. Warm regards, alan86734.

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    • Posted

      Lee,

      I was taking trospium for a while and it didn't seem to be doing much to help. I discontinued it because one of the side effects is sleep disturbance. However, I am now off that med but there is still no improvement in my sleep. If, as my uro mentioned, my bladder sensitivity is a side effect of the radiation I received five years ago that cured my prostate cancer, then I have a different issue.

      Looking back five years, if I had gone for a RRP and had my prostate removed, I might now be in a situation of permanent incontinence. So, I decided that the radiation was a better choice. If I had known at the time that five years in the future my sleep would be ruined due to bladder irritation I might have made a different choice.

      Once you get a diagnosis of prostate cancer and have to move forward with treatment, there are no easy choices. Any decision you make can and will have life long consequences. Same with BPH treatments, which is why we are here sharing our stories.

      Tom

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    • Posted

      Alan,

      .

      Thanks for the post on multiple voiding. I am curious what your urodynamics and cystoscopy results were?

      .

      I had a Rezum on November 29, 2018. The Rezum cleared the blockage but I am still having retention with PVR's of 125 to 150 ml. Before the Rezum, I flunked the detrusor muscle part of my urodyamic tests and my cystoscopy showed moderate bladder wall trabeculation. I did the Rezum anyway knowing that it might not work,

      .

      The post-Rezum progressed as I expected and I started to open up at 4 weeks. When I pee, the stream volume is big but it only lasts for a short time and then stops. The overall volume is usually 100 to 150 ml but sometimes it can be less. I then do a "suprapubic tap" over my bladder for 200 taps and it starts up again and then stops.

      .

      The start up is usually at 40 or 50 taps but I continue for 200 taps and I usually get a 2nd peeing episode and then maybe a 3rd one. I wait a few minutes and then repeat this for another 25 to 50 ml total . I have been doing this 3 times before self-cathing for my PVR's which I am doing 2 times a day and not 4 or 5 like before my Rezum.

      .

      The Rezum obviously cleared the blockage but the urodyamics tests and my cystoscopy showed obvious bladder damage. I am curious from this thread what others are doing to improve their damaged bladders' ability to get more pee out other then self-cathing.

      .

      Steve

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  • Posted

    Hi Tom.Hope your recovery is getting better. I would like to know if you had Chronic total complete urine retention before the Turp surgery?

    Thanks,

    frank,

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    • Posted

      Frank,

      I was not in total retention but was moving rapidly in that direction. After I got on the surgery schedule I had two weeks to wait for the operation but I wasn't sure I would make it. When I got to the hospital they asked me to pee and I went into the bathroom and was barely able to get any urine out. I had a TURP scheduled several months before but "chickened out". That was a mistake. The entire experience was much, much easier than I was expecting.

      Tom

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  • Posted

    Hi Tom.Hope your recovery is getting better. I would like to know if you had Chronic total complete urine retention before the Turp surgery?

    Thanks,

    frank,

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  • Posted

    Hi Tom.Hope your recovery is getting better. I would like to know if you had Chronic total complete urine retention before the Turp surgery?

    Thanks,

    frank,

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