Enlarged prostate.

Great timing---just this afternoon on the local news radio there was a report that these drugs can cause erectile difficulties that can last for years after they are stopped.

It would be interesting to know who funded the studies that concluded the drugs weren't the cause of ED or other side effects. Perhaps their research and conclusions are sound but whenever there is so much money involved, I'm a sceptic. I don't have a lot fo faith in professionals who are often so busy making money they can't keep up with the latest research. In view of all the new and better procedures for BPH, One  would think that procedures like the TURP would have gone the way of the buggy whip.

I agree with what you're saying, but most of the new procedures don't have a long track record

I've been on fernasteride for a year. Honestly I can't tell you when I saw inprovement and can't even verify I have. I also take Flowmax. Here is what I can tell you. Before these drugs when I went pee it almost alwat dribbled on my pants and flow was slow. Yesterday for giggles I did a crude flow test. I have an accurate graduated beaker I pee in sometimes to measure volume. I didn't wait until my bladder got so full there was urgency ( that usually above 400 ML for me ) because I also have retention when I get to that point. Anyway I it took me ~ 13 seconds to pee 300 ml. That is start to finish including the slow flow dribble at the end. When I looked it up online I found thats pretty darn good. I have to assume the drugs have helped. Even night time has gotten better in the past few weeks. Not sure if thats just an anomaly or not. Just a few weeks  ago night time peeing meant wet underwear and dribbles down my leg when I was done.

Unckle,

Might have asked you this before, but when you say that you have retention when you get to above 400ml, could you explain that more?  Is it acute retention where you can't void at all? Is there any pain sensation when you try to void at those times? Is it always when your bladder gets tht full or just sometimes? So what do you do then ? Cath?

-- Jim

 

Hey Jim I don't know if you would call it reterntion. When I get to a point where I really have to go, flow is reduced quite a bit. The last time it happened ( January ) it was pretty close to acute retentiion. No pain just the feeling like I really have to go now but flow is bad. . I never let my bladder get that full. When I feel like I should go I go at the earliest possible moment. That may be different now. I've been planning on trying a real full bladder  in the near furture. No I do not cath, I've thought about but I rarely have trouble peeing.

One more thing When I feel like its time to pee I usually void 300 - 400 ml. I don't know what normal bladder capacity is but when I'm done I feel like I'm empty. No feeling like I have to go again any time soon. I've always been a person that peed when I had the chance. My work schedule when I was young had me driving for 3-4 hrs. So I peed whenever a rest stop was near. 

When I did urodynamics my bladder held 520 ml. But they fill you up til you feel like your going to explode.

OK. Thanks. My situation is a little different.

95% of the time I void normally, but every once in awhile I am unable to void at all (acute urinary retention). It seems to be related to when my bladder is holding 400ml or more. But it's not that simple, because sometimes I have a normal void even at higher volumes.

So my current theory is that it's related both to bladder volume and activity level and/or body position. Most likely to occur therefore if I'm been lying down or sleeping.  Increased activity level may either increase blood flow or somehow redistribute the urine differently. So, for example, even I go into acute urinary retention (maybe once a week), I can usually resolve it without catheters by walking around the room for a few minutes.

If that doesn't work, or if I'm not in the mood to take a walk, then I self cath. Haven't had to self cath for over three months now but then again I haven't been drinking beer lately

It's great you are able not to let your bladder get that full. I've found my kidneys have a will of their own. Sometimes for hours and hours not much activity. And then they will unload all at once at a pace that either doesn't give me much warning or no warning at all. So while I usually feel the urge to void at around 300ml, in those cases it would be higher.

-- Jim

Waffalo,  About how long did it take them from when they starting fill you up until you hit 520ml?

Jim

10 minutes or more I would guess. Seemed like a long time . The Cath they use is very small like IV tubing. They fill it slowly so you can describe the 4 levels of feeling your bladder being filled. They try to fill it very slow so they don't stretch your bladder. All hooked up to a computer to record times, amounts, bladder expansion, etc.

Waffal, Sounds like they did it right. With my urodynamics they filled much too fast so my less than perfect bladder did not have time to react. Finally, I said, "what are you up to". He said, "1000ml" and I said "Stop!". I explained to him that in the real world I feel the urge to void at 400ml. He acknowledged, stopped filling and moved on to another part of the test. 

Did they do video urodynamics or just regular. With video, they are able to watch your bladder filling and emptying real time on ultrasound.

Jim

Hey Jim.  You are always helping others but no one ask you how are you doing.  I know you have been through it all and have stayed away from surgery.  I'm glad you give your special outlook to all of us.  You may help others to stay away from surgery. Not everyone needs it.  They can heal there bladder like you did.  Alot of men do not research and take the doctor word for it. Once it's out there are more problem to deal with. The problem is not all ways the prostate it with the bladder but they get talk into it and they still have the problem.  We must all get the information we need to live a full life.  I hope your doing well so you can keep helping others...Ken    

I got the whole 9 yards. Probes and wires etc etc. Think for a while there I was set up for wifi to. Lol. Took in 520ml . Voided 212ml.

Sounds like you got maybe only "8 yards" without the video, but still probably a better job than they did with me. As to your 308ml retention (520-212), there's a decent chance that's an overestimate.

"Real world" retention is measured by walking into your uro's office under normal fluid intake, waiting for a normal urge to urinate, urinating, and then having your doc measure your residual with a scanner. (If you self cath this can be done at home). 

The problem with urodynamic and other "test" measurements of PVR (post void residual) is that they often they either hydrate you up too much to speed the test along, or in my case, they fill you up too fast.

-- Jim

 

Hi Ken,

Thanks for asking!  The short answer is doing pretty well. No urgency, no dribbling, and usually up only once at night, sometimes two. IPSS score is 7-8 (mild) compared to over 30 (severe) prior to self cathing. around 95% of the time my voids are painless and fairly complete (200-400ml) and I empty down to under 50ml at least once a day.

The other 5% of the time I still have these acute retention episodes where I can't void which seem to be associated both with the amount of fluid in my bladder and/or activity level and/or postural issues. In most cases, I can literally walk off these episodes by walking around the room for a few minues. If that doesn't work, or if I'm too lazy to walk, I self cath. The last time I had to self cath was over 3 months ago.

I'm curious to see how things hold up with no CIC as I still have an obstructive prostate that contributed to my atonic bladder in the first place. Hopefully, now that my bladder is stronger from CIC rehab, it will be able to push through the obstruction for some time without stretching again. Especially with improved bathroom habits, such as not "holding it in" and not "rushing" it, two things that I, and many did for far too long, and no doubt contributed to my LUTS/BPH/bladder problems. 

Since I'm not self cathing for such long periods, there is not way to check my PVR other than to go to a uro, but I'm inbetween uro's at the moment. So recently I bought a bladder scanner so I can check things out myself without having to call the doctor. The other advantage of the home scanner is that I can check my retention at different times of the day, under normal fluid loads, with no one trying to water me up and rushing me because the nurse or doctor is waiting with the scanner! In other words, more accurate results. 

Meanwhile, I watching with interest the emergence of the newer, less invasive procedures such as PAE, Urolift, iTind, REZUM and now FLA. I am an optimist by nature by a skeptic by medical experience, so I still don't think we have all the answers we need on the newer procedures. Fortunately, I don't need to make any decision today, and no doubt the future will provide all of us with more data and probably even newer procedures. 

How are you holding up these days?

Jim

They did video. And did one that they had me drink 24 onces before coming in. Void there, measure residual with scanner. Also did ultrasound at special imaging center with full bladder and empty. Scanned bladder, kidneys, prostate.

Well, you did get the "whole 9 yards" then! I didn't know enough when I had my urodynamics three years ago so I only got maybe 5-6 yards. However, just purchased my own scanner recently, so I can now take my own videos

Jim

Jim  I will tex you later I got cut off again  Ken

Jim,

You self cath? You mean you insert your own catheter?

I cringe just thinking of that. You're a far braver and tougher man than I. I'm considering canceling my urodynamic study just over fear of a catheter.

I don't know why I have such an irrational level of anxiety over this but I do. I admire your courage.

I'm kind of embarrassed to admit how fearful I am. 😔

Hi Michael,

I am sure I was more fearful than you before I started, but really had no choice at that point. First time I self cathed I practically passed out in front of the nurse and had to lean against a wall. Anxiety was an understatement of what I felt heading home with a box of catheters the nurse gave me. 

Flash forward a few weeks and both my mind and body adjusted. Today, I can honestly say that self cathing is about as traumatic as brushing my teeth, just takes a little less time. 

It is amazing how the mind and body steps up to the plate when motivated. Don't cancel your urodynamic study, you can handle it and it will make you stronger. That said, ask your doc if it's OK to take a small sedative dose -- something like Valium -- just to take the edge off the procedure. 

Jim

The urodynamics Cath is very very small. After they fill you up, you pee around it. My urodynamics test was the first time I was ever cathed. It was really not to bad at all. My uro also scoped me after the urodynamics test. That was not to bad either. I looked it up on YouTube before. Watching it scared me. It was not bad . One good thing, the nurse who did it was cute. Lol.

Michael...... Don't worry your not alone.  There are alot of men that do not like catheters but we have to do what we feel is right.  Jim 6 years ago was told he needed a TURP and he started to do CIC.  His problem was not his prostate but his bladder.  He fixed it and did not have to have the TURP. Doctors if they can't find out whats wrong.  They assume that it the prostate and they after they do the surgery they find out it the bladder or something else.  You can't get it back.  That is why you have to have all the test you need to make the right pick.  I hate catheters that why if I have a surgery they put it in when I'm a sleep.  If I have to do it my self I would if it ment saving my prostate.  Talk with you doctor and maybe he can give you something to relax.  Take care  Ken

I am glad they put that 3 way Foley garden hose in when I was asleep. Can't even imagine what that would be like.

Yes when it came out it was like a sucking cup.  It kept going back it.  What a relief when it was out  Ken