Difficulty Urinating when bladder gets full, particularly at night
Posted , 5 users are following.
I just had a median lobe only TURP 3 weeks ago hoping that it would fix the issue that I have where I can barely go when my bladder gets full. My Dr. thought this was due to my median lobe, and removing the median lobe with TURP would hopefully solve my issue while preserving ejaculation function. This happens mostly at night, an hour or two after I go to sleep. I have started setting an alarm an hour after I got to bed to wake me up so that I can go to the bathroom before my bladder gets too full. I even have to set a second alarm another hour later as even after going once I can still have an issue with my bladder getting too full. It’s happened twice since the surgery. Last night, I stopped drinking water three hours before going to bed. I haven’t had any alcohol for weeks. I did have coffee in the morning and a green tea about 6 hours before bed. I went four times in that three hour window, including once right before I went to sleep. An hour later my alarm wakes me up and I can barely go. It’s a weak stream and took a couple minutes to mostly empty my bladder. I then wake up another hour later and I can barely go again. This time I can’t even start a stream. I lay back down again and then about 2 minutes later I get up and I have a decent stream that seems to empty my bladder. I then get up a couple more times on my own with a decent stream and no issue starting it. I went into complete AUR about 9 months ago at night which makes me constantly worried about it happening again. I have the problem during the day as well if I can’t get to a bathroom, mostly commonly on an airplane or stuck in a meeting. I was hoping the median lobe was the issue as during the day my flow used to start and stop. That does’t happen anymore since the procedure, and my stream during the day seems better. My PVRs since the surgery have been 25 and 50ml so it seems like I am emptying my bladder. My PVRs before surgery were around 150ml. I wanted to do an aquablation instead of the median lobe only TURP, but it’s still not offered yet in the Portland area and UHC doesn’t cover it yet(without appealing). I don’t even know if a more complete TURP or aquablation would fix this issue. I am following up with my doctor who did the TURP next week, but I already messaged him and he thinks it has to do with not relaxing my external sphincter. Maybe that is the case, but I seem to relax it fine during the day. Has anyone had this problem, and was it resolved by a complete TURP, aquablation or something else? I have described this issue to a number of urologists and none of them seem to know what is the cause. My prostate was measured as 56cc on MRI and 90 on ultrasound, so it’s big. The median lobe TURP only removed 4cc which seems like very little.
0 likes, 2 replies
pi_ not_too_shabby
Posted
Hope it's gotten better since you posted.
When my bladder is too full, it's much harder for me to get a stream started - typically there'd be a little splash, but then a long pause to get the rest going. It is definitely worse in the middle of the night. About a year ago I started to wake sometimes unable to void anything at all, not even the initial little splash, for many long minutes. (Eventually, maybe with some combination of straining and relaxing, I'd get through it.) My understanding is that from years of straining against obstruction, bladder muscles are either thickened, or bladder is stretched/floppy, but either way results in this type of symptom. If it's distended it just can't contract.
It doesn't actually feel like my bladder is fuller than it is during the day. So there could be something more to it - as your urologist is suggesting, a "clenching" at night.
During toilet training the brain learned how to hold it in, even at night, and maybe that's going haywire in the middle of the night, holding it in even when you don't want to. Like people who sometimes don't fully wake up, but maybe their mind wakes while they're still briefly paralyzed in bed till their bodies wake up too.
I started using Cialis 5 mg daily a year ago and it eliminated the night-time disturbing total freezes. It's relaxing something, whether it is overcoming obstruction or relaxing some middle-of-the-night clenching - I don't know.
But, I'm going to stop the Cialis due to gradually increasing side-effects, and then I don't know what I'm going to do.
Good luck - I hope you've gotten a better understanding of what's happening and that it's gotten better.
not_too_shabby pi_
Edited
Thanks for posting. I can't say things are better as I have been hesitant to really put my bladder to the test. I have been setting an alarm to wake up about an hour after I go to bed to get up and pee. Usually that is sufficient to keep my bladder from getting too full during the night. I'm still uncertain whether a more complete resection of my prostate would help resolve this issue. Keep us posted on what you decide to do. I just saw United Healthcare covers aquablation now, so I'm kicking myself for not waiting a few more months and getting aquablation.