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Hi all, I'm new to the forum and wanted to share my story. I am also in a dark place as I feel like I don't know where to turn or what the right decision is to make.
I'm approaching 40 years old and was recently diagnosed with a number of lower urinary tract symptoms. A CT scan revealed I have a abnormally elongated urinary bladder with a trabeculated wall. A flexible cystoscopy was performed and it was noted my prostrate was mildly occulsive, and showed a high bladder neck with non-occlusive lateral prostatic lobes there was a spasm at the bladder neck, which was somewhat high.
In addition to the above, I also had a urodynamics test done and this revealed a poorly compliant bladder (pressure of 27cmH20 at an end-fill volume of 229ml) and extremely high voiding pressure (100cmH20). The maximum flow was reduced at 9.9ml/second and had a post-void residual of 700ml.
My options have been the following:
- Perform clean-intermittent self-catheterisation (to preserve bladder function).
- try medication (tamsulosin) to try to improve urinary flow and bladder emptying (with the level of obstruction it's unlikely to provide a good and safe long-term solution).
- Bladder neck incision (this would be the most definitive way to improve his bladder
emptying and reduce his voiding pressure over time back towards a normal level).
My concerns are:
I have gone from twice daily to 4 x daily with ISC and I'm not a fan of doing this long term.
The side effects of Tamsulosin have put me off this method so I have not attempted to take this.
BNI only seems to be the most appropriate form of fixing this long term and I'm aware of this risks with retro-grade ejaculations. I'm not entirely fussed about that option, i'd just rather be able to flow and empty bladder properly and live a life where I'm happy again. I've had a serious bout of depression since the diagnosis in December last year and struggling to come to terms with ISC long term.
To give some context, my NV is anywhere from 50-200mls and PVP is anywhere from 400-600. On Average it's around the 100ml - 500ml mark.
Any thoughts would be most welcome, thank you!
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