Constant need to pee: BPH, or something else (CPPS/CBP)?

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Hi,

I have a constant need to pee and while in the beginning of my current 3 month syndrome I was getting a weak stream, now it seems like I do get small spurts of urine out from 40 to 80 ml and constantly going. it seems like there isn't an obstruction anymore. but i do have hesitation (need to tinkle my peen to get the sphincter to open up) and I do get a double if not triple void.

there is some bph but at 52, not sure if that's the only thing. BPH because MRI measured my prostate at 36ml and ultrasound estimated it in 40's to 50's. cysto by urologist did say some urethral narrowing due to prostate.

but most urologists are saying the constant signal to go is a pelvic floor dysfunction. they are not saying it's prostatitis of any sort (chronic) but I assume it could be that as well?

it seems to have morphed into an OAB situation. Does BPH frequent urination mostly result due to dribbling and not being able to get enough pee out (like nothing)? I can't tell if this is straight up BPH or CPPS?

Thanks,

Cali Mike

0 likes, 11 replies

11 Replies

  • Posted

    It looks like your symptoms are very similar to mine. I had BOO (Bladder outlet obstructions due to BHP; the median lobes) and had the same problems. I had HoLEP a week ago and most problems resolved.

    • Posted

      how painful was holep? how long did you have the cathether in and how uncomfortable was that. i have an extremely sensitive left side urethra (feel like there are extra sensitive nerves on that side) and failed at cath'ing myself but took it super slow and felt how sensitive it was. can't imagine having that signal going on with a foley cathether in me for more than one night (and that with some benzos or something else to relax).

      is the burning pee like when you feel you might have a UTI/urethritis -that sharp pain like after a cysto or is it more intense than that?

      really want to get this over with but afraid of the recovery. heard thulium is a better recovery than holep and just as effective if not more. Also thinking aquablation given my age (52) but recovery there can be nastier i think.

      thanks

  • Posted

    It is bladder outlet obstruction. The ultrasound of the prostate is accurate. How many times do you urinate per day?

  • Posted

    how many times do you urinate a day - a ton. almost constant and at night at least once every hour (wake up between 6 and 9 times to pee into a tupperware toilet next to my bed (no longer sleeping with the wife) --whenever i hit light sleep --good thing is I can get back to sleep and get 5 hours of sleep a night --used to sleep 7 and have 1 awakening at 4 hours on the mark for many years).

    very low quality of life. need to go to the bathroom constantly (every 30 min to 1 hour depending) - sometimes acupuncture + chiro can extend it or maybe I eat the right thing I don't know about

    generally low output volumes (20 to 80ml) unless I consciously try to fill my bladder quickly (maybe I can get to 120ml after holding 60 min) and most importantly.

    Hesitation - that after tinkling my penis for several minutes to get my schincter to open. Worse case there is a neurogenic issue but part of me feels this is BPH. There is just too much obstruction for the shincter to open easily and hopefully that resolves with less pressure in front of it. I have not made it to retention but sometimes I get dribbles out and I've drunken close to a litre and only peed out 200ml all day and get worried how filled my bladder may be. then that night i catch up and pee more.

    • Posted

      Yes, they are all normal. I have 3 ml/sec flow (my own test with stop watch and amount and also from the urocuff test) and one urologist did a urocuff flow dynamics test and said yes you are obstructed based on pressure being exerted to get the pee through. apparently bladder is still working OK (at least it's creating pressure. 71gram prostate. PVR in his office (unaided by alpha blocker) showed PVR of 103ml. other recent PVR's got me to 50 or 60ml but i was on an alpha blocker with those. my issue is the nocturia and needing to wake up every hour. trouble starting stream (have to breathe in and tinkle the little guy against my underwear to get the stream to start).

      does this all go away with a procedure? if someone could give me a high confidence of it I'd probably do it for a good night's rest and to move on from this 3 month ordeal (the insomnia -- bph has been happening several years but never really thought about it)

    • Posted

      Surgery is to open your urinary channel. It is supposed to improve the symptom of the bladder outlet obstruction if the medication finasteride or dutasteride does not work. You need to consult doctor about what procedure is the best for your 40-50 cc prostate.

  • Posted

    Correct more testing seems to suggest BOO (outlet obstruction). maybe a bit of CPPS in there too but that seems to have resolved and acting like straight up advanced BPH.

    • Posted

      as an update to this thread my prostate is 75cc by TRUS, 71cc by T3 MRI and I have a median lobe that creates a ball valve type IPP presentation in addition to a narrow urethra, somehow i'm able to pee 90ml now (up from 50ml when this began) without flomax or supplements. i still have to wait a long time and I'm getting very high frequency during the day (with the urge to void as my bladder is filling up (either to 90ml and i'm going to empty) or a bit above 90ml and voiding to near empty. My recent PVR after drinking about 16 to 20 oz of water got down to 37ml so below 50ml.

      It seems given my big prostate, the ball valve that I should get the procedure but I'm certainly not retaining. hopefully the OAB-like high frequency goes away. I have aquablation scheduled for dec 28th. will be a happy new year indeed!

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