BNI/TUIP experience
Posted , 11 users are following.
Hello,
Had BNI 16 days ago and decided to share my experiences as I found this forum very helpful before the surgery. Maybe this will be helpful for others.
I am 34 years old, for last 10 years my flow has been gradually slowing down when two years ago I also started having significant increase in frequency during the day and also getting up 2-3 times a night. As a result, I became constantly tired and my life became quite miserable.
Went to 3 different urologists, all said that my prostate looks perfectly normal and small (15 ml).
Last one did a bit more extensive diagnostics with flow measurement and cystoscopy. My Qmax was 10.8 ml/s and through cystoscopy and shape of my flow curve he again confirmed that everything is fine with prostate, but I was diagnosed with high/tight bladder neck and a small stricture in bulbar urethra. PVR after voiding variated between tests and was between 50 and 100 ml, which was not ideal, but still OK according to him.
For a year I lived with Tamsulosin, which increased my Qmax to 14-15, however it did not help at all with my frequency during the day or night.
This winter I went for a regular check up. My Qmax was still 14.8, but my PVR raised to 200ml and my doctor now recommended to perform BNI.
I was informed about risks, especially about retro. But since I already have kids without a plan to have more and I felt what it is to have retro with Tamsulosin, I did not feel this is a big issue for me.
Day 1 - very stressful. First surgery in my life. However, I was under general anesthesia, so I just woke up in recovery room with everything already done. First feeling was that I had a lot of pain in the head of my penis, I looked at it and there was blood (not bloody urine) coming out, which was unexpected for me, but doctor explained it that it's due to trauma from resectoscope, gave me some morphine and within 30 minutes I was feeling very well. I hope he did not f**k up and made a stricture in my urethra.
Another surprise was that I did not have any catheter. Seems like doctor decided to see if I can pee on my own and if I can, then just let me go home without catheter.
I got to drink a lot of water and after ~1 hour I tried to pee. Flow was quite bad, but I managed to pee out 250 ml of very bloody urine and after check with ultrasound it seemed that I fully emptied my bladder. I did that again within an hour and had quite similar result, just that my PVR this time was 70ml. Doctor said that it's good enough and I can go home. So I checked in to hospital at 8am and left at 1 pm. Very different compared to experiences I read online.
Day 2 - Living on paracetamol and ibuprofen according to doctors prescription. I got to combine these two and use them for at least for 3-4 days with max dosage. A lot of pain in urethra while peeing even with all the pain killers. Urine is still very bloody.
During the day flow started to reducing from a very thin and slow stream to only a dribble by the end of the day. I called doctors office and he said that I should go to ER if I it's very hard to pee and to see how much PVR I have. If it's above 100ml, then I should get a catheter.
Went to ER. Had 450 ml of urine before, then took around 8 minutes to squeeze out everything I can and after that I had 110 ml. Doctor at ER, said that it's too small margin to 100 ml "limit" to put catheter in, considering that my urethra has been already traumatized. So we decided not to do anything and if it gets worse to come back to ER.
Day 3 - The night was quite ok, got back to thin stream, but in the morning my urine totally stopped.
Back to ER.
However, before getting to doctor I went one last time to the toilet pushed a bit and suddenly a couple of blood clots went out. From that moment urine stream has slightly recovered and I left ER without seeing a doctor. A couple of next urinations had a lot of blood clots in them and after each urination my stream has improved.
Day 4 - 8 Pain in urethra has started subsiding and finally disappeared. Stream has increased and became better than before surgery. Urine become clear without any blood. Frequency is still the same as before surgery. At least not worse...
Day 8 - 12 Sometimes some clots and blood shows up. Stream is not improving anymore. So at the moment it's definitely better than before surgery, but no where near what I had 10 years ago.
Day 12 -13 Some new things. Urine started smelling quite bad and I started to get a very annoying itch in my urethra. No pain or fever, so probably not an infection. However after a couple days smell went away and I was left only with an itch, which is driving crazy.. cause well it's impossible to scratch.
Day 15 Itching is gone also. Urine stream is the same. Frequency during the day seems to be the same, but it has improved during the night. Last 3 nights I only got up once, which has not happened in probably more than 3 years.
Day 16(today) - Reduced flow and split stream. A bit scary.. hopefully just another clot coming out soon.
BTW. 16 days without any sex or masturbation is driving me crazy... My doctor and everything online suggests no sexual activity for at least a month. Anyone knows why and what would happen if I would not follow this recommendation? I understand that sex can put some strain on abdominal area and bladder. But how about masturbation?
1 like, 25 replies
lars40399
Posted
11 weeks after surgery.
Today I visited my regular urologist, who diagnosed me with tight bladder neck and suggested BNI.
Uroflowmetry results were actually quite good. Voided 300 ml with max flow of 22 ml/s, PVR 30 ml. And this is with solifenacin which can actually slow down the flow a bit. It seems that I am voiding properly and maybe my expectations for flow were a bit too unrealistic.
Bladder spasms are almost gone and happens only when bladder is really full. Urologist suggested to continue using solifenacin for a while, since it was very hard for me to hold 300 ml and he though that solifenacin will help to retrain my bladder to be able to hold a bit more.
Currently waking up once a night, which is quite nice. Unless I drink too much in the evening, then it can be more.
Overall everything seems to be better than before surgery, with a hope that frequency will go down even more.
So today I could say that surgery was actually a good idea. Next urological visit in 4 months.
Plan to update this discussion only at the next uro visit in 4 months or if something significant happens before..
dan30039 lars40399
Posted
First hand experience with BNI two years on:
Proceed with caution
Erectile disfunction, irritation, constant tearing sensation, loss of your male soul
Only to be performed as last option
Don't listen to doctors claiming minimally invasive etc this surgery slices into you prostrate in two locations. Imagine your erectile supportive muscles being disconnected. You will lose an incredible amount of feeling and won't feel like the man you were before.
Research how men who have had a radical prostectemy feel - lost, impotent, empty. This is the effect of cutting into a man's prostate. The urological community only treats the prostate as a problem and does not acknowledge any of it's function. You will have complications and nobody will listen, they will just quote you the textbook phrase 'Gold standard treatment.' These people are either misinformed or just influenced by money
This surgery is damaging
If you are no longer sexually active and have major problems voiding go ahead. For all else be warned and do not trust the 'professionals.' The industry is tainted. Get at least three opinions and remember my words
lars40399 dan30039
Posted
Hi Dan,
If you were answering to me, then I think you are a bit late. My thread here is my experience after the surgery. So I couldn't really opt out.
Sorry to hear that your results were not good. I guess I was one of the lucky ones, since I got all the benefits without any side effects that I can notice.
valentin65337 lars40399
Posted
Hello Lars.I also have a very tight bladder neck....life is a hell atm.Your symptoms are very similar with mine.You said you had a constant urge....i have this also , is 24 / 7 some days is low ( but i always feel i am not fully empty ) sometimes is very strong for hours......even if i pee in 30 sec in back.For me this constant urge is more in urethra , not in bladder.You had same symptoms before surgery ( a constant desire to urinate / pressure in urethra ) ? ty
lars40399 valentin65337
Posted
Hi Valentin,
Yes. This was one of the most debilitating symptoms I had. I could say that it used to come and go.. so I could feel constant 24/7 urge to pee for 3-4 weeks and then it disappears for a couple of months and comes back later. Similar as it was for you, sometimes it was quite low, and sometimes it was quite intense.
I found out that coffee and alcohol were exacerbating this feeling, so I was trying to reduce consumption of those. In addition check reverse Kegels exercise.. it actually helped me a lot to reduce the feeling. Might help you to..
Just to be clear... my feeling was mostly in the bladder and rarely in the urethra.. maybe at the most intense moments it was radiating a bit into urethra, but most of the time it was bladder.
lars40399
Posted
As promised new update after urologist visit.
6 months has passed after surgery, I would say all of the surgery after-effects have disappeared. No more bladder spasms, no more itching or weird feeling in urethra.
My stream is still strong. Today I urinated 260 ml with max flow of 17 ml/s. PVR was 30 ml. Only 260ml because I came to urologist a bit unprepared, not because I cannot hold more.
My frequency during the day is great. I go to toilet only once or twice a day. Occasionally I measure urinated volume in the measurement cup and can hold up to 400 ml.
Nocturnia is also almost gone. I might get up once a night if I drink more in the evening, but most of the nights I do not wake up to pee.. I would say that it is the biggest improvement for my quality of life compared to 2-3 or even 4 times a night before surgery.
And as I mentioned before, no changes in my erection or ejaculation happened, so I did not get the most common side effect - "retro".
So I can confirm that this surgery was a great idea for me.
Maybe to be totally honest. My bladder and urination is not the same as it was when I was 20. I still can see that my flow is not as good (especially that it's not as wide) as it once was and I used to walk around without a need to urinate the whole day. I am sure I was able to hold much more urine when I was younger.
But as I mentioned above my quality of life has been greatly improved by this surgery and that happened without facing any consequences.
Jams777 lars40399
Posted
lars
Glad to here you are doing alright , I'm in the 5 month of my TUIP procedure I happy to say it was a good decision I visit the uro back on Oct. the uroflow was : 409 cc voided with max flow rate 22 postvoid residuls 50 ml. I also feel than now takes me a longer time to feel the urge to urinate and when I go is with strong flow and i feel like I am voiding about 300 ml . My problem was at night I was feeling the need to still get up and go , this is because I m a heavy coffee and diet coke drinker my uro suggested no caffeine after 1pm and that fix the problem now I don't wake up until I hear the alarm clock. Like you I cant say I'm back to normal like when I was in my twenties but this has change my life for the better also I m happy to say I did not get negative side effects .I have no problems with erection and do not have retrograde ejaculation. I am glad you posted your experience with TUIP , there is a lot of negativity about this procedure and many are afraid to go for it, I guess this also depends on the uro , again I'm extremely happy with my results, my uro also gave me good feedback and now I will just visit him only for the annual check up
Thanks
Jams
Scott557 lars40399
Posted
i too had TUIP 8 weeks ago. still have frequency on myrbetriq. sensation of urine getting stuck in urethra. Burning pains post void which im told is muscle related. at what month did most feel symptoms got better. thanks for reply
Jams777 Scott557
Posted
Hello Scott;
I'm 10 months after my Tuip procedure i felt progress about 5 month but for me is key to keep caffeine and bladder irritants to a minimum that works for me sometime its sucks because I like to drink beer on the weekends but i know I pay the price getting up at night if I drink at night. Your sensation of urine being stuck in urethra could be the bladder pressing the urethra its bladder spasm i had that sensation again I try to keep bladder irritants to a minimum I love coffee but only drink one cup in the morning I'm also a fan a diet coke but i don't drink any after 1 pm with dinner i have high pH water . One of the most important things is too relax I try to exercise the most i can to relieve stress. In all honesty when I take easy its like i never had a urinary issue and I feel normal in that regard.
I hope this help you and I hope you will improve
Best regards
Jams