Insomnia continues after bipolar TURP

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On April 5th I had a bipolar TURP and have updated my condition several times here. My frequency/urgency symptoms are improved and my flow is now a bit stronger. Progress is slow, but I am improving, and happy that I did the procedure.

However, one of my issues before the operation was the nocturia - I was getting up 6-7 times per night and it was taking at least 20 and often 30 minutes to clear enough from my bladder so that I was able to get back to sleep. Now, I am able to calm my bladder in 10-15min, and get back to sleep faster. However, I am still getting up 6-7 times per night, and I am only able to sleep about 1.5 hours at stretch before I wake up and head to the bathroom again. I am also experiencing some serious insomnia in the middle of the night - about 3-4am. I just can't seem to get back to sleep right away. Several times this past week I was awake for two hours at a time before dozing off. I am now thinking that this is no longer a retention/prostate issue but is now a bad habit - a form of insomnia. Some here have improved their nocturia issues after various treatments, including TURP and some are now getting up just once per night.

So, my question is, has anyone else had ANY form of treatment, and found that they are still getting up multiple times per night? Did this issue eventually resolve and if so, how long did it take?

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  • Posted

    I had a button Turp 6 months ago and the biggest trouble I had was the frequency issue. I would suggest looking for solutions related to your bladder. Your bladder has trained for sometime now to push against resistance and that resistance has been removed. I looked more to solve this like pumpkin seed extract, and Securi T bladder supplement (via Amazon). These seemed to help until my bladder got under control. Most all the symptoms have since gone away, except for pain in the perinium from time to time (which seem to be motion related.) Best of luck in your recovery.

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  • Posted

    Well it seems to me that the number of times you have to pee in the night is dependent on how much liquid you have stored up from the day and how much you pee each time. If you go to bed with 1 litre left in the body and pee 150cc at a time, then you have to go 6-7 times in the night.

    Actually this was my situation before my Aquablation (which basically does the same job as the Turp). If my bladder only complains when I have 250cc to pee then I only need to get up 3-4 times in the night. My issue is that my maximum bladder capacity seems to be very low (300cc max) so I am doomed to get up many times however well the operation went.

    How much do you pee each time, and how much in total during the night?

    Some say you should not drink after 5pm, but I find this impractical advice.

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    • Posted

      My situation doesn't seem to have much to do with how much liquid I have "stored up" from the day. When I measure the amount of urine total overnight it comes to about 1300ml. This has been consistent since the operation. When I had my Foley catheter in it was still about the same. I always weigh myself in the evening so if I know how much to drink or not to drink before I get to bed. In 2014 I had Foleys in and out for five weeks after radiation to the prostate for prostate cancer and I only got up once per night to empty the leg bag. After my recent TURP I was expecting to sleep better, but no, still got up every hour and a half, even through my bladder was being drained by the Foley. That's why I think this is a bad habit, or possibly my bladder has become super sensitive.

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    • Posted

      1300 ml overnight is too much. I suggest you bring it down and take sleeping pills for a while to train your body into sleeping longer. Another issue is if you still have retention.

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    • Posted

      Surely it has a great deal to do with how much liquid you have stored.

      If you stored half as much, then you would halve the number of visits without doing anything about your bladder sensitivity.

      Of course if your bladder can be trained to be half as sensitive you can then halve again the number of visits.

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    • Posted

      Well, this sounds reasonable but as the night progresses and I have less urine in my system I am still waking up frequently. After the TURP I am definitely better able to empty my bladder and during the day the frequency/urgency issue is much improved, but the nights are still difficult. My bladder feels less irritated at night, but still, no difference in the ups and downs.

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    • Posted

      Hank,

      I am trying to get away from pills if possible. I have a friend who is completely addicted to sleeping pills, so I don't want to go that route, unless I can find some natural relaxing remedy. I tried melatonin for a week and my body just got used to it, and it stopped working, I discontinued it. I just completely stopped my trospium which was supposed to calm my bladder - didn't work.

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  • Posted

    tom i had a TuRp last july and still get up 3-5 times per night.

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    • Posted

      I had a TURP in February. Was getting up typically 2 times per night as long as I watched my post-dinner fluid intake. I generally drink 8-12 oz during dinner at 6 (could be water, beer or water plus wine) and try not consume more than 4-6 oz the rest of the evening. That pretty much guaranteed 2 nighttime bathroom trips pre-TURP but now results in only 1 more than 50% of the time. (I am currently on a 6 day streak of only getting up just once!)

      My daytime frequency has also improved as has my bladder capacity. Pre-TURP I generally got a pretty strong urge with only 4-5 oz in my bladder. Now if I wait until the urge is strong, I can void 10-12 oz. Overall I am extremely satisfied with the outcome.

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  • Posted

    I had a Rezum at the end of November 2018. I am now getting up to pee 1 to 2 times per night. In the evening, I limit what I drink for 2 hours before I go to bed and right before I go to bed, I self-cath to completely empty. I have been dealing with insomnia for years and BPH made it worse.

    .

    Before the Rezum, I had AUR and had to self-cath for 10 months. Before that, I had severe (IPSS 29) BPH and I was getting up about 5-6 times per night and not getting much sleep.

    .

    I have avoided medication for insomnia. If you Google "sleep hygiene" there is lots of information on how to improve your sleep habits. My recommendation is to limit what you drink 2 hours before you go to bed and self-cath right before going to bed. Also stay off the computer before going to bed.

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    • Posted

      Steven,

      I have tried to self cath but it's too painful for me - completely unable to to it. No need now anyway as I feel I am able to clear my bladder sufficiently well to get to sleep. My IPSS score was about 30 and it's certainly still high, but I do feel a lot of improvement being about 5+ weeks post TURP. It's not my bladder that is now waking me up, but I just can't seem to sleep more than 1.5 hours no matter what I do.

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    • Posted

      Tom,

      .

      I reread your original post. So the problem is getting over the sleep pattern resulting from however long you had nocturia from BPH.

      .

      I never had that problem. Once the BPH was fixed (either by the Rezum or before with a Foley), my sleep pattern was fine. When I was self-cathing, my overnight self-cath would take a while as I needed to wake up enough first and it would then take a while to fall back a sleep.

      .

      As I said, I have been dealing with insomnia for years. In 2008 and 2009, I worked with a sleep disorder doctor. It was well worth it.

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    • Posted

      Steven,

      Yes, exactly. My BPH issues are improving after my bipolar TURP, but the sleep pattern hasn't changed much. It takes less time to empty my bladder when I am up, so I am able to get back to sleep faster than before, but I just can't seem to sleep more than 1.5 hrs at a stretch, no matter what I do. In a few weeks I have an appointment with my urologist to test my PVR and if I am still retaining urine then that is a possible reason for my continued sleep issues. If my PVR is improved then there is something else going on. Can't self cath and don't want to get hooked on sleeping pills, so will try pumpkin seed products next (just got off Amazon doing the research). I was taking trospium and that was supposed to help, but appeared to do nothing for me. Getting a decent night's sleep is a very, very big deal. This issue has to be resolved one way or the other. I will look into an appointment with a sleep disorder doctor if I can't get this under control.

      Tom

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    • Posted

      Tom,

      .

      I hear you on "Getting a decent night's sleep is a very, very big deal" as I have been there before.

      .

      After my Rezum, my BPH issues have improved significantly. My PVR's from self-cathing are still averaging about 130 ml, but that is most likely due to bladder damage as when I was in AUR in January 2018, they took 2 liters of pee out which means a badly stretched-out bladder. Hopefully, the bladdder will improve over time.

      .

      I don't know about any pumpkin seed products for helping sleep. Saw Palmetto was total crap for treating BPH. When I was working with the sleep disorder doctor 10 years ago, she recommended very low doses ( 1/2 mg) of melatonin 2 hours before going to bed combined with practicing good sleep hygiene. This meant splitting 1 mg melatonin pills in half.

      .

      Steve

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    • Posted

      Steven,

      I also split 1mg melatonin tablets in half before my TURP and took the tablet about an hour before bed. However, my system quickly adjusted and I was right back to where I started from. Then, when I stopped I had trouble sleeping, so I really didn't like the effect. I am trying to get off pills, if possible. Just ordered a pumpkin seed product from Amazon. Will try it and hope it works. If not, am only out about $10.

      Tom

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