Catheter after 'template' biopsy

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Hi, I am based in the UK so that  may have a baring on the process I describe here. Around early Jan this year I went for a general health check which flagged up a very high PSA (20) for my age (64). A second test was done (17) but I was referred to a urologist. He suggested a template biopsy which is done under a general and involves an overnight stay with catheter removed the next day. I did a TWOC and filled three beakers OK. However, the next day I had urine retention and ended up in A&E (ER in the USA). They had a problem inserting a catheter but got there eventually. I had that in for 2 weeks, went back for the TWOC and it again failed, so yet another put in with difficulty - prostrate blocking the urether - so here I am.

The nurse seemed to suggest that it was not unusual due to the truma of the biopsy and the fact that my prostrate is large - don't know the exact size I should have asked. Oh yes, the result was cancer free! So I am of course pleased but frustrated about the immediate situation.

My question is has anyone else had this type of experience please? I am on Tamsulosin (Flomax) that is meant to help. I started taking this a few days before the biopsy and that relieved the once a night toilet trip although I am aware of various side effects.

Thanks for any info.

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13 Replies

  • Posted

    Hello Ian, I had a PAE done in Lisbon Portugal on February 9, 2017 and I'm 51 years old my psa was 8 and my fusion biopsy showed my postate 162cc. and was taking flowmax. Dr. Pisco is the one who invented this procecedure. RUN FROM THE UROLOGIST !!!!!! side effects from meds and All the other procedures they wnat to do are a temporary fix ( if they work at all ) ...I was getting up 3-5 times a night , never could empty my bladder, had a problem keeping my errection, felt like I needed to crap because of the enlarged postrate, etc... I was scuba diving in Bonaire and don't know if that is what caused more pressure on my BPH but had to go to ER and get a cathater and flew back to states with it. My wife started searching the forum and out of ALL the procedures the PAE was the best with no side effects. BEST DECISION EVER !!!!!! I can empty my bladder, SLEEP 7-8 hrs smile wake up with a hard-on and wife is happy smile ..... GET IN TOUCH WITH HIM ... You will thank me latter. 

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  • Posted

    Once a night seems very lucky! I've had a few similar experiences, but my case will be different to yours - we are all individual. I don't have enlargement and my cancer is minimal. All I can suggest is don't be in any hurry to do or accept anything drastic. Self-catherisation works for many.

    I imagine, once the trauma from your procedure has quietened down - maybe in a few weeks - you will have more idea what needs to happen. The main thing is to get a clear diagnosis - how much is your prostate enlarged and what procedures might help. It's true from what I've read on tis forum over the months and from my own experience that UK urologists do have rather set ways in what they have to offer, so researching what HOLEP, urolift and PAE could do for you would be well worth the effort. Can you pay for private treatment? That would obviously expand your options. Best of luck!

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  • Posted

    Not unusual to experience some or all of the issues you describe Ian and all will come right with time.

    Good that no cancer found and you are only suffering from an enlarged prostate but surprised you have not been prescribed Dutesteride to help reduce prostate size, as without tackling urinary retention which will certainly be part of your life with BPH, you will run the guantlet of UTIs and possibly bladder stone formation.

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  • Posted

    Hi Ian,

    It's likely that you have post operative urinary retention (POUR) which would have been caused by the general anathesia you were given an not primarily due to the trauma of the biopsy and our enlarged prostate as the nurse suggests. The fact that you filled three beakers of urine means that your medical team did not follow best practice by monitoring your bladder volume periodically post operation. This further agravated your condition by stretching the bladder. 

    I assume you still are on a catheter? If so, you might want to learn self catherization (CIC) which will not only enhance your quality of life (no catheter inside you urethra 24/7) but also allow you to exercise your detrussor muscles to an extent. 

    Also, given the amount of time you have had POUR, you might consider getting another consultation in terms of further treatment, preferable from a doctor involved in a medical center not affiliated with where you had your operation. Again, it appears your medical team not only dropped the ball on preventative measures to keep your bladder from stretching, but didn't even offer POUR as a reasonable cause for your symptons.

    Jim

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  • Posted

    Hi, many thanks for those thoughts. I will do some research for sure as the side effects and general downsides from some of the options are frankly frightening!
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  • Posted

    Hi Ian,

    ?         I've been taking Flomax for quite some  time now and a year ago my doc added Finasteride to shrink my prostate. It takes about 8 months for the Finasteride to work (so he said) so I stopped taking it after 9 months because my urolgist told me to.

    ?The Finasteride completly wiped out what little libido I had after being so long on Flomax, so I complained and he put me on  a testosterone course, which means having regular PSAs ( I had another yesterday but won't get the result till next week.) 

    ?On Tuesday 7th March, I am having a Cystoscopy and I am not looking forward to it simply because of the discomfort afterwards. But it should provide an answer to my problems.

    ?Regarding Flomax, if I stop taking it everything blocks up again in just a day or so, so I persevere because it works for me - but we are all different aren't we. But I think we all experience a lack of libido because of it.

    Just one more thing to tell you is that I take a happy pill every night. Mirtazapine  gives me a good nights sleep with maybe one P during the night or early morning and I no longer get stressed out over things.

    I hope that helps.

    Chris.

      

      

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  • Posted

    Good morning Ian.  I am happy that there is no cancer but I have never heard of that kind of biopsy done where you did a catheter and a over night stay.  Been on this site for almost 3 years.  Going to have to lood into them.  In a way to me it seams like it did more harm then good.  Alot of men on here have had the MRI biopsy whish told them everything they needed.  I hope you get better don't rush into any surgery  Good luck Ken

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    • Posted

      Thanks Ken, My situation is somewhat unusual in that an MRI is more tricky to do as I have an implant in my head (cochlear implant). It may be because my PSA was so high that the actual tissue sample was needed, I really don't know. There is different advice between specialists at the same hospital as well so yes I am a bit bewildered and need to take the next steps carefully.

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    • Posted

      Yes take things slow Just read up a little on that one.  There are some side effects from that kind of biospy.  Try to get on something else if you can. Take it easy.  Ken 
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  • Posted

    I think Alfuzosin has fewer side effects.

    I went in to AUR after taking antihistamines 2 1/2 years ago.  I've been catheterizing ever since (w/ very minimal natural voiding: now about 1/50th the volume of the catheter output).  After one year I tried the PAE procedure but, in my case it really didn't help.  I have an enlarged median lobe and this procedure works much better for those who don't.  If you don't have an enlarged median lobe I definitely think it is worth trying.

    In the meantime I would suggest you immediately learn to self cath. (CIC)  I put this off for 2 1/2 months and suffered w/ the Foley (indwelling) catheter.  The CIC method is easy to learn, gives you much more independence, is much less painful and more natural as the catheter is only in for a couple of minutes at a time and the rest of the time your natural system has a chance to "kick in".  The coloplast male compact is by far the best one I've tried.

    Good luck!

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    • Posted

      Hi, thanks for that input. I will ask about the CIC route for sure I don't want any operations in that area!

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    • Posted

      Sure, Ian.  By the way, if they try to put you on a drug like Finasteride (to shrink the prostate), think carefully about it - I thought it was a really nasty drug and it didn't help.

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