Does Medication clear obstruction?

Posted , 9 users are following.

I've using the CIC method for the last 6 months and I'm glad I didn't rush into the suggested TURP surgery. I'm heading to a different URO this week and would like some suggestions on what to ask to see if I'm improving. I had a stretched bladder with an obstruction in the lateral lobes, prostate size was 25 cc. PSA test was low so other than asking to check the size of the prostate and maybe the size of the bladder, is there anything else to know? 

I also know that he will ask if I stayed on the generic Flowmax that was prescribed 6 months ago and I didn't stay on it long. My theory was that it's my bladder causing most of the problem and I didn't think the drug would clear the obstruction. From what I read, it relaxes the muscle and I didn't feel anything was changing but I was only on for a month. 

Should I be asking for a different prescription? Is there anything that can help a stretched bladder, other than exercises and time? Or anything that can clear an obstruction, other than surgeries? And does it make sense to do a surgery for the obstruction, if the bladder is stretched? I'm thinking I need to rehab the bladder before fixing the obstruction.

 

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  • Posted

    What is the reason for the CIC ? Because you can't pee or because you can't empty your bladder? What is your PVR, post void residual ? Hank

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    • Posted

      Hank, I'm trying to CIC 4 times a day and keeping my voids under 400. I don't really have any void with out CIC unless I am holding more than 400.

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  • Posted

    Medications like finasteride and dutasteride were proven to shrink the prostates and therefore might reduce the obstruction. However, there are many side effects associated with them. Hank
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  • Posted

    Urologists told me there was nothing I could do about my stretched-out bladder, four years ago.  There was NO voiding possible, and I was holding 900cc and not even feeling it.  Instead of listening to them, starting three years ago, I went on the JimJames Incredible Bladder Shrinking Regimen (Available in our files here on patient.info).  I now have a PVR of anywhere from 250-350cc.  And sometimes as low as 150cc.  

    I'm glad you're doing CIC (I've been doing for most of the past 4 years.).  If you follow the practice Jim James lays out, you too may be able to shrink your bladder. In spite of what the uro-docs will tell you!

     

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  • Posted

    Hi Tom,

    I'm not qualified in the field of medicine so I can only pass on my own experience to deal with a condition that sounds similar to yours.

    I have been practicing C.I.C for over 2 1/2 years to counteract urinary retention as the primary goal, and secondary goals of a stricture in my prostatic urethra plus significant erectile dysfunction. I cath early morning and bedtime using a straight Fr 16 catheter and started with a straight Fr 8 for the early afternoon session.

    I progressively increased the size of this last one until I was passing a Fr 18 straight into the bladder with ease. A few weeks back I took the plunge and substituted the Fr 18 for a Fr 16 identical to the ones I use at the beginning and end. The stricture has gone completely, so I'm eager to see if it stays that way.

    The urinary retention issue is gradually improving, now at a 50/50% ratio natural void and cathed urine. The ED has also resolved to a functional level. A final note: I did not suffer any bleeding other than one occasion when I was up to the Fr 14 and too zealous; the catheter buckled when it encountered the stricture.

    So, there you have it. Take it for what it's worth!

    Warm regards, alan86734.

     

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    • Posted

      That's excellent Alan and I appreciate the feedback. I had just tried to drop down from FR14 to FR12 and I was having some difficulties with the FR12 but I think it was just me getting used to the flexibility in the FR12. I like the idea of slowly going bigger to try to remove the stricture. I will try and get some samples of the 16 and 18 and give it a try in the AM and at Bedtime when I have more time.

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    • Posted

      Hi, Hank. Yes, I should have made this clear up front. It was the result of having a Foley balloon accidentally inflated while it was still in my prostate. This happened 20-odd years ago when I had been rushed up to the ICU. Years later, when I started CIC I realized that my urethra was a little longer than usual and the two nurses were not to blame. Unfortunately the two la dies had move on and I was unable to  set the record straight for them.

      It was because of this that my uro felt that the procedure I followed was worth a try and I had a good chance of success. If it does fail, and I am still here with you all (I'm 89 yo), I'll let you all know,

      The "expansion catheters" I used were all Coloplast Seedicath straight.

      I hope this nswers your questions. Regards alan86734

       

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    • Posted

      Thanks Alan! Did you experience any soreness at the prostate area when you move up on catheter size ? I have 2 years of CIC but I am afraid I am still at where I started, still using Coloplast speedicath 12 straight. A white back I was trying to go up to 14 straight but experienced soreness that lasted for hours afterwards so I went back to 12 straight. Sometimes I even have to use 10 straight when I encountered difficulty with 12 straight.

      I don't see how people can use such large size. One fellow on this forum even uses size 30, LoL. Hank

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    • Posted

      Hank, absolutely no pain throughout the entire process. But, you must keep in mind that I am one of those weird types who takes catheterization and cystocopies without analgesics or numbing agents of any sort; just oodles of lubricant. No, please do not jump to conclusions: I do not enjoy pain! but this way I retain maximum feedback which, in turn, allows me to control both sphincters. Perhaps I have an unfair advantage here because I have taught natural childbirth (Grantly Dick-Read method).

      Psychoprofilaxis does work for most women and I applied the same technique to myself each time I dislocated my left shoulder (27 times in all). And that's a long mariner's story of itself!

      Warm regards, alan86734.

       

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    • Posted

      Do you still have retention ? If you can get a 18fr straight through easily, you must not have much of an obstruction anymore. Perhaps bladder problem ? Hank
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    • Posted

      I have a neurogenic bladder. The nerve signal to void - the urge - disappears too soon. In other words sends the "all done" signal which closes the bladder sphincter way too early, trapping urine. This is due to some form of nerve damage and, sure enough, I remembered only recently that some 65 years ago there were two occasions when I was handling mercury. I had put on gloves but the "protective gear" in those days was laughable by today's standards.

      Moral of the story: take great care of what you touch!

      Warm regards, aan86734.

       

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    • Posted

      Hank,   I remember the fellow who used size 30, he said it stretched the urethra and prostate so that is was easier to urinate for a few days after that. 

      The Coloplast Speedicath is too stiff.  If you want to go up in size, try the Bard red rubber, The are very flexable, so will bend through the sphincter without irritating it.  Use plenty of lube though.

      Thomas

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    • Posted

      Thanks for sharing Alan. What do think of many people here with problem of getting signal late, way past the full bladder state? Is that also neurogenic? Or just plain old BPH ? Hank
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    • Posted

      Hank, I don't know why our signal recognition gets messed up when our bladders get super-stretched.  What I do know, is that when I started "listening" for other signals, I noted new sensations, that my bladder was full.  Very different form the old signals, but reliable in my case, 95+% of the time.  It's bio-feedback retraining at its best...

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    • Posted

      Cartoon, l usually get my signals late, not until my bladder is full, at least 400ml, sometimes even more. But I am also on Doxazosin. Are you taking any meds currently, or just CIC ? Hank
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    • Posted

      Well, I was there, too, for a long time.  I think it took close to 2 years, to get down to the lower volumes, to trigger the signals.  And as mentioned, they are different, more subtle messages than the old signals were.  I was on 2 meds until my Uro-lift (Dec 2015), and quit gladly after the procedure, when the doc said it was ok.  Intuition told me I shouldn't, but I disliked the side-effects and quit anyway.  The prostate resumed growing (I'm guessing) and closed off the urethra a few months later.  

      I'm no longer on those meds, but I'm transgender (male outside/female inside) , and began hormone replacement therapy in February.  Either the estrogen or the testosterone blocker have reduced the internal resistance I was experiencing over the past two years.  Often, I could barely force the catheter (FR 16s) in.  Now, that's never a problem, and as mentioned, my PVR is as low as 150cc!  Not applicable solution for anyone who's male/male, however!  :-D 

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    • Posted

      Hi, Hank, as I stated at the beginning of this thread, I am not qualified in the field of medicine. I cannot answer your question "plain old BPH?" Personally I would think there is a strong possibility of more than one factor playing a role. In my own case my urinary retention is gradually diminishing, which is good.

      I also fully endorse Thomas's comment. "The Coloplast Speedicath is too stiff". Did he insert it slow enough to allow it to warm up to body temperature? The Red Rubber are quite soft and flexible and the 100% pure silicone devices even more so. The only problem with the last two is that you can run into the "Wet Noodle Syndrome". I believe that this gorgeous term can be credited to Cartoonman who has contributed to this thread.

      I cannot stress enough: test different versions of catheter, whether from the same manufacturer or otherwise. I changed from the Speedicath to the Cure straight Hydrophilic HM16, Fr..16. Even though both are hydrophilic the superiority of the Cure was incredible; it was as though the bladder sucked the catheter in, although this would normally be an impossibility!.

      So, experiment carefully and gently. Warm regards, alan86734.

       

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    • Posted

      Hi Alan, I might be wrong here but I think the main reason for your diminishing retention might be your success in increasing the catheter size, therefore in a way reducing the obstruction. I am planning to work on this idea. Hank
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    • Posted

      Actually, this is an interesting idea.  And doesn't build on the iTind idea, that by applying pressure from INSIDE the urethra, you can apply "push-back" to that pushy old prostate?  I wonder whether over time, this really would stretch/increase the size of the channel.  Stay in touch if you try this.  I'm thinking of ordering a few FR18s myself!  :-)

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    • Posted

      Absolutely! I'm using Fr 16s for all three sessions. The catheter is a comfortable fit and, as a quick test, I can plug the catheter and force (most times) an external flow of urine, I cannot do this with the Fr.-18.

      Since my stricture was termed "anastomotic", meaning man-made versus occurring naturally, my uro was confident that there was a good chance for success.

      I had to postpone a urologist appointment for this week due to a positive lab culture for Hafnia Alvei, rare in humans but essential for some cheeses. Lab technician's lunch maybe?! This was followed a few days later by a C-diff bacteruria. This was serious and they came round and quarantined my room. Additionally, all my appointments were postponed until early November.

      So, we're on hold for the time being. I have an excellent update to this train of events but not relevant to this thread so off-subject here

      What really delights me is that you and most of the other contributors are looking for the signal at different levels of bladder fill. Way to go, guys!

      Cycle through "urge"  no, not convenient, "clamp down", urge diminishes, go into wait state, then cycle repeats after another "fill" command.

      Warm regards, alan86734.

       

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    • Posted

      There is a fellow on this forum who utilized this idea, though I doubted it that he knew about iTind. He kept increasing the sizes until he got to 30fr straight. From that on, he only self caths one a week.

      If I can get up to 16, I'll be happy. Hank

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    • Posted

      OH...MY...GAWD!  FR THIRTY????   WHOA!  And... OTOH, maybe worth trying it.  Do you remember which brave soul it was?  I would like to hear particulars, very much!
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    • Posted

      Hank,   I looked for the posts from the person who used 30fr catheters but couldn't find them.  They must have been on one of the catheterization discussions.  That's one of the problems of this forum, it's difficult to find posts from the past.  I also remember him mentioning the rubber hose he used.  If I remember correctly he was in his 80s.

      Thomas

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    • Posted

      Hi, Thomas. I'm also looking but as I recall i PM'd with him. If he logs in only sporadically it will be difficult to contact him. He is in total bliss and wants to be left alone?

      I'll continue with my search and keep you all informed if successful

      Warm regards,  alan86734.

       

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    • Posted

      Hi, Thomas. I found our Fr-30 user! He is fred43679, well known to many of us, but I had encountered some problems when I replied to him I got an answer from Frank.

      I have responded to him a few minutes ago.

      Warm regards, alan86734.

       

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    • Posted

      Good evening Alan and Tom.  I think it does help but you have work up to it.  When I first found out I had a stricture was in 2015.  I was told by my Urologist that I should not have anything over a 14 Fr coude catheter.  Well over the year I have had no trouble with catheter.  When I went in for a Urolift repair My doctor put in a 18 Fr. I was p****d that I got a 18 Fr because of what I was told  by my doctor.  He came and saw me in the hospital He told me that the instruments for the Urolist is a little bigger and being I was open more he put in a 18 Fr.  I had no problem then.  The next time I was peeing blood and having bladder spasm I had to go for emergency surgery to fine out where I was bleeding  I must of p**s him off because I told him I did not want my prostate cut or anything remove  It took him 30 minutes to sign the paper.  I had the surgery and I had bleed clogs on my prostate he burn them and then he put in a 28 Fr 3 way catheter in  for a flush. I was glad I was asleep when he.  put that in.  Sorry I had to go through the whole sorry.  You see the catheter were going up in size.  I just had a scope in the doctor office 2 weeks ago and he told me my stricture was fine and prostate was wide open.  So if you go up in size little by little you can open the stricture and the Urethra.  I hope this helps  Have a great day  Ken
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    • Posted

      Ken, thank you for your kind words. One of your comments rings very true. If you allow your bladder to empty too rapidly it is likely to cause bladder spasms.

      Warm regards, alan86734.

       

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    • Posted

      Hi, Ken,

      I worked up to it and it took me almost a year, as I recall. My stricture was just shy of the bladder sphincter so I had to go very gently at first since most of the catheter was in normal urethra and very prone to buckling. However, my goal was eventually achieved. Now I wait with baited breath, how long will the remedy last?

      Regards, alan86734.

       

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    • Posted

      Very happy for you  I am glad that it works.  I know from what I want through I have no problem now with the stricture.  We have to do what we can.  Take care  Ken
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