Had TUIP on Wednesday. Can't get more than 100cc out

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So I had TUIP this past Wednesday (November 9) and my doctor told me I could take my foley out after 24 hours, but I played it safe and waited 48 hours. Considering my bladder neck was cut, and my uro did a urodynamics and determined i'm producing adequate bladder pressure, i'm not sure why i'm having such difficulty getting anything out. The most i've been able to void on my own has been 175 cc and that was after taking a flomax before bed. I still cath'd out 450 cc. Isn't the idea of TUIP to be improved flow? I'm wondering if I made the wrong choice and now have to live with it. Here are my flow results since taking the cath out on Nov 11.

Nov 11. 435pm 50cc out/300cc cath

Nov 11. 645pm 50cc out/450cc cath

Nov 11. 1115pm 50cc out/400cc cath

Nov 12. 630am 175cc out/450cc cath (took a flomax before bed)

Nov 12. less than 50cc out/300cc cath

Nov 12. less than 50cc out/350cc cath

I'm getting the urge to go but it just seems like my bladder is making an initial push and then running out of gas.

Now i'm worried I spent all this money and risking retrograde for nothing, and that i'll wind up cath'ing for the rest of my life.

I'm 40yo with a 29g prostate.

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  • Posted

    Recovering from TURP takes weeks, not three days.  Here's what I think is going on with you.  You most likely have swelling in the perineum area.  Are you a bit sore in sitting ?  If so, that's from  the swelling.  The swelling is compressing the uretha, and that acts as a check on urine flow.  The urine flow happens when the bladder becomes full, and the deltrusor muscle of the bladder contracts to push out urine.  The sphincter relaxes in a normal situation, and the bladder empties.  But if you have a restriction, like an enlarged prostate OR a constriction from a sore perineum from the invasive procedure.  You might want to try applying cold to the area to help reduce swelling.  Just give it time, you'll be fine.  And relax!

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    • Posted

      I didn't have a TURP, I had a TUIP. I do not have any soreness and have not had to use painkillers at all. My prostate isn't enlarged, it's 29g but my uro suspected my bladder neck wasn't opening completely, but now i'm wondering if the problem was an initial surge of pressure from the bladder but then it just suddenly stops pushing, thereby ending flow.

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    • Posted

      I did a bit of searching about TUIP, and you might want to also.  I did find this statement on the Mayo Clinic Site.

      Regarding TUIP,

      ResultsBy Mayo Clinic Staff

      "It might take several weeks for you to experience noticeable improvement in urinary symptoms."

      Since several longitudinal cuts in the prostate and the bladder mouth are made, I would expect some short term swelling in the prostate itself.  That probably is the technical/physical reason that Mayo clinic doctors say it may take several weeks.

      So again, the message is, be patient and expect a good outcome in a week or two.  (And be glad you didn't get left with permanent incontinence from GreenLight laser procedure as I was!)

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    • Posted

      Mmmm. My uro did his residency at the Mayo clinic. He told me he wouldn't cut as deeply into the capsule so as to reduce the likelyhood of retro. From the picture he gave me post-op, it appears he made a unilateral, vs bilateral cut, but I will confirm with him on Thursday when I see him. The photo is actually pretty interesting too...

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    • Posted

      If you have the photo, you can post photos on this site.  Somewhere I posted the results of a second procedure, Gyrus Turp that I had which was (unsuccessfully) an attempt to help my incontinence brought on by the GreenLight procedure.
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  • Posted

    I didn't finish a thought,   But if you have a restriction, like an enlarged prostate OR a constriction from a sore perineum from the invasive procedure, then the bladder will not empty, so that's when retention of urine occurs.  So do  not push hard to try to get more out, as that stress the bladder more.  Careful CIC cathering and applying cold should help you in a few days.

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  • Posted

    Give your prostate and bladder a couple of weeks to adjust...I had a REZUM, a similar procedure, and it took me some time to have a normal void..
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    • Posted

      Do you know if your doctor did deep or more shallow cuts? Bilateral or unilateral? I just had a strong urge to go and nothing but a couple drops of blood came out, so I cath'd 300cc. It has been a long time since I got the urge at 300cc....more like 600cc+.

      In other news, I just got a bill from Precision medical for $1245.00 for compression stockings that my insurance didn't cover when I had bladder stones removed twice last year. Evidently the insurance company denied coverage because I had the procedures done at a surgery center vs. a hospital. Ugghhh insurance...

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  • Posted

    Maybe you just need more time. Was the 29 g prostate before or after TUIP? 
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    • Posted

      OK read more about TUIP . Seems its only an incision with no tissue removal. I find it ironic how Tpanative's prostate is only 29g yet he is having trouble urinating. Other guys have massive prostates with only a bit of trouble. 

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  • Posted

    My understanding is that "high pressure" on your urodynamics doesn't necessarily mean that your bladder isn't flaccid (stretched), it just means you probably have an obstruction, ie your prostate. You should talk to your doc about the recovery period from TUIP and when you should expect normal emptying as your residuals are quite high. Meanwhile, you might want to discuss self cathing (CIC) with the doc so your bladder does not continue to stretch.

    Jim

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    • Posted

      I have been self-cathing for several months, four to five times a day. I had bladder stone surgery in January of 2015 at age 39 and the doctor explained that it would have taken quite a while to get as big as it was (1.5" in diameter), so I was retaining well before then.

      After the surgery in January 2015 I was passing pieces and seemed to have adequate stream, however, that deterioated and in December 2015 I had a second procedure to remove four stone pieces that did not pass.

      I am certainly concerned that my bladder was stretched out too much and I never realized it, causing permanent damage. I guess time will tell if it recovers fully.

      With a 29g prostate, my doctors only real explanation was a tight bladder neck that developed over time.

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    • Posted

      Sorry, misread your initial post. It's only been a few days since your operation so maybe you just need time to heal. Do you know what your retention was prior to the procedure and stones? Bladders take time to stretch. You also might consider throwing in another cath or so each day to keep your bladder volumes a little bit more down.

      Jim

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    • Posted

      Well if there is any good news in this I am getting the urge to go between 350-450cc. This morning I got out 200cc on my own which is the most but I also still have 500cc that I cath'd out, so the urge was pretty strong.

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    • Posted

      Hi Jim

      I was reading the intial post from Tpanative with interest regarding the amount he is passing naturally v Cathing.

      IS there a general consensus as to what is an acceptable amount to void naturally? Or does it vary massively from person to person?

      Following on from that is it ok do you think to have frequency as long as you are  fully voiding each time?

      I know you are the expert in CIC so though you might know?

      thanks

      Jeremy

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    • Posted

      You reported mostly 50 cc per trip yesterday, so haveing a 200 one is good progress.  Keeps us informed, we want to hear how this book ends.
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    • Posted

      Hi Tpanative,

      Again, it's so soon after the procedure I would just be patient and give it a little time. Normal that you would void more with higher total bladder volume but encouraging that you are able to void easily with 700cc in your bladder. Some of us lock up with the amount. That said, I'd still consider throwing in another cath or two a day so your total bladder volume is 400cc or under. Sounds like things will end up fine but as long as your self cathing anyway, why not get those bladder volumes down.

      Jim

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    • Posted

      200cc was when I first woke up and had taken a flomax before bed. I still had 500cc in me when I cath'd. This correlates to my experience before my surgery when I took a flomax before bed, so the larger bladder neck opening doesn't seem to be making a difference. One would think any swelling would be less today and here are my numbers so far today.

      200cc out/500 cc cath 10am

      50cc out/300cc cath 4pm

      50cc out/400cc cath 730pm

      <50cc out/350cc cath 840pm

      I am getting the urge in the 350cc range so my bladder seems to be responding to my brain but it seems to run out of gas by 50cc (or when there is a lot of pressure built up at 700 in the a.m. with the aid of a flomax).

      I'm not terribly optimistic that this procedure worked for me.

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    • Posted

      Hi Jeremy,

      It's case by case. Tpanative is just recovering from a procedure so the only really important thing for him is to make sure his bladder is emptying completely regardless of the percentage of natural versus catherized voids. As he recovers hopefully things will naturally switch over to more of a percentage of natural void until it's all natural void. 

      As to other cases, it can vary quite a bit depending on the overall condition of both bladder and prostate. When I started CIC, my cath volume was almost higher than my natural void volume. Later that shifted to where my natural void volume was consistently higher. Today, most of the time I don't cath so there is no cath volume. But all along the journey, and to this day, I try and keep my total volume bladder below 400cc and make sure I empty my bladder fairly completely either via cathing or natural void. That way my both my kidneys and bladder are protected.

      Jim

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    • Posted

      CORRECTION: Meant to say in second sentence, second paragrapth...

      ".....my cath volume was almost *always* higher....

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