Posted , 40 users are following.
I have BPH and have avoided urologist recommendations to do a TURP. I have been intermittently self cathing on an as needed basis for almost 2 years. Prior to this I was urinating 24 times a day, with little actual volume per urination and retaining over a liter in my bladder. Are there negative long term effects to self cathing? Can one choose this option forever?
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alan86734 stephen73997
Posted
Hi, Stephen,
Based on my own experience I fully endorse what the others are saying about Clean Intermittent Catheterization (C.I.C.). I'm coming up to the two year mark and what had been an increasing number of UTIs due to urine retention has fallen back to more than a year since my last UTI episode. Just follow some simple, basic rules and you should be all set. Clean your glans carefully with a suitable antiseptic before each session; if you do use lubricant make sure it does not irritate your urethra; and make sure that your catheter is a comfortable diameter. And you can count on a whole bunch of Forum Contributors who can recount their own experiences.
Good luck, and keep us posted on how you get on!
Warm regards, alan86734.
stephen73997 alan86734
Posted
oldbuzzard stephen73997
Posted
I concur with everything that's been said here. Self Cathing can be done indefinitely and yes, you can do it for as long as you're able. If you were retaining that much and going twice an hour, you probably have issues other than BPH (probably your bladder function). If that's the case, TURP wouldn't have helped all that much.
There are other less invasive procedures with much shorter recovery times than TURP, which is kind of outdated at this point for that reason. You might want to have a complete workup done (scope to measure your prostate and urodynamics to measure bladder function) to see how much of your problem is BPH and how much is something else. Many have rehabbed their bladders over time with cic - stick with it as long as you want/need to. It beats straining, beats retention, beats a foley cath and for many, beats any of the procedures.
stephen73997 oldbuzzard
Posted
Thanks, I am amazed the 2 urologists I have seen most recently advise TURP. They say nothing else works as well. Anyway, I plan to just stay with CIC. I'm 76 y.o., even if I get too old to cath myself, I know a 93 y.o. in assisted living with a foley and it's no problem for him. At 76 with no kidney damage from retention and consistently doing CIC as the urge to go appears, I think I have my sweet spot.
oldbuzzard stephen73997
Posted
I beg to differ on the Foley. I've only had one for a few days, but I found it to be profoundly uncomfortable at best and really painful at worst. And while your doc may be technically correct that TURP works "better", most of the less invasive procedures work more than well enough to provide significant, often life changing relief - meaning the additional incremental improvement isn't worth the risk and long recovery.
Many who self cath without issues have concluded that even the least risky, least invasive of the new procedures aren't worth the potential issues and recovery time. CIC can be an indefinite solution - by all means, stick with it if its working for you. If you can't do it for some reason down the road, you can always do a procedure then and the longer you wait, the better your options will be.
jimjames stephen73997
Posted
Self cathing is the gold standard treatment for the SCI (spinal chord injury) community. Many manage to cath without full use of their hands and arms. There are self cathing aids designed to help facilitate loss of dexterity. If you can put a spoon to your mouth you can probably self cath. Of course anything can happen but I wouldn't worry too much about age as an impediment.
Jim
jwrhn1951 stephen73997
Posted
I've been self cathing for about a year and a half. It took a little time for me to get used to doing it and getting my mind around the idea of possibly having to CIC for the rest of my life.
Sometimes I still get a little bummed that it looks like I am going to be self cathing forever...but I'm the type of guy that wants to have as little contact with the medical profession as possible and I want to keep any treatment as simple as possible. I'm also a bit of a control freak and doing CIC which I know I can make work on my own rather than taking a chance on some procedure that may or may not work and that I have no control over is, for me, the best option.
CIC works for me and a lot of others here, but it's not for everybody, but for me at least the longer I do it the more comfortable I am with the idea doing it forever...
brian34488 stephen73997
Posted
Supertractorman stephen73997
Posted
Hi Stephen, I had a TURP which grew back within 2 years and was self cathing until I could not get it in and had to have Foleys especially when Prostatitis was bad. Now having Prostate removed as have small Cancer as well, and I refused another TURP. After removal it won't grow back then so no more Biopsies and nothing to block urine flow . There is no easy route to clear all problems with the bladder.
David
colin27427 stephen73997
Posted
keith42667 colin27427
Posted
I wonder Colin... did you ask your doctor if he could preserve your bladder neck? Did you ask him to do so? Doesn't an operation like this tear up the urethra? Isn't that a problem or does it just regrow?
frank74205 stephen73997
Posted
Hi Stephen,I had the same problem ,urinating a lot. I started CIC 16 Months ago, because like you they wanted to do Turp. I don't know how old you are or if you have complete urine retention.like i do.I must say I'm glad i started CIC.and 88 years old i think i made a good choice. I must say you need a lot of patience with CIC .take you time ,do it slowly.How old are you, and can you have a natural void?
frank.
dennis47445 stephen73997
Posted
Stephen, I had three turps so far in around 14 years. One of the turps was called "green light laser" The other two were the standard type. If I had to do it all over again, I would just stick to CIC. I think you could do it for many years without any harmful effects. I've been doing CIC for almost two years, and it's the best!
frank74205 stephen73997
Posted
frank
oldbuzzard frank74205
Posted
There are also reasons other than BPH for being unable to void. A full workup with a urologist who performs the newer procedures would allow you to make an informed decision
dennis47445 frank74205
Posted
frank74205 oldbuzzard
Posted
Thanks,
frank,
keith42667 frank74205
Posted
I for one am not familiar with your terminology. What is "diverticula" & "promient detrussor muscle". I know what the detrussor muscles are but not in that context.
jimjames frank74205
Posted
I have all three as well. Do you have a pronounced single diverticulum or many small ones? If the former, do you know the size, it should be on your ultrasound report. The combo doesn't rule out anything except perhaps urolofit (median lobe) but results depend a lot on bladder functionality. Have you had urodynamic testing done? If not, this will help answer your question. Preferably find a urologist that does video urodynamics.
Jim
jimjames keith42667
Posted
Keith,
A diverticulum is like a pouch off the bladder. "Diverticula" is plural so Frank may have more than one pouch. These pouches are often formed over years of bladder outlet obstruction but sometimes you can be born with them. I'm guessing that what they mean by "prominent detrussor muscle" is a thickend/trabeculated bladder wall and muscle. This is also caused by years of bladder outlet obstruction. Both are relatively common, with bph, with bladder wall thickening more common. Neither in itself or in combination means a surgery or procedure will not work but does suggest further testing is required for bladder functionality. That would be urodynamic testing.
Jim
frank74205 jimjames
Posted
Jim, They told me a i don't need another urodynamics test. The one i had done showed i have activty meaning the obstruction { enlarged bladder }is the reason i cannot have a NV. I then asked what guarantee do i have if i do this Turp,or laser. They said there is no gaurantee in medicne.
Leaves me felling not good about this?
frank,
oldbuzzard frank74205
Posted
If an enlarged prostate is a significant percentage of your problem, then yes, Rezum could well help and maybe a lot. If your doc thinks you have enough bladder function that without the obstruction of the prostate you could void at least semi-normally it might be worth looking into. Many docs are using temporary stents on Rezum patients (who are able to void prior to the procedure) so they don't have to self cath afterword. You might ask your doc to try one before deciding to see if opening up your urethra will allow you to void. If that experiment works, I'd say it would be worth seriously considering Rezum. If not, I'd want to discuss why Rezum would work when I temporary stent didn't.
jimjames oldbuzzard
Posted
OB,
You're talking about the Spanner temp stent. I've talked about it here before and to Frank. I agree that it's worth a try, but the Spanner does not completely mimic a prostate reduction surgery, because unlike a true stent, it keeps the internal sphincter open as it's anchored in the bladder with a baloon like a Foley. The Spanner web site talks a lot about the trial by stent concept, but when I mentioned it to Jersey Doc (he does both Rezum and Spanner) he said he uses it mostly as a Foley alternative after Rezum and only secondarily for diagnostic purposes. He inferred it was not as accurate diagnostically as claimed. Personally, I think an evolution in stent technology might help a lot of men, either temporarily or permanently, but doesn't seem like we are there yet.
Jim
jimjames frank74205
Posted
I believe you told us last year that based on urodynamics they gave you a 50-50 chance of TURP working and only a small chance of the less invasive procedures working. Is this a different doctor? Why don't you ask JerseyDoc again what your chances of Rezum working are given you've been in complete retention for x amount of time. I believe he already said not great, but can't hurt to ask him again. There is also a new procedure coming around called Aquablation, but I'd hold off on it until more patient data.
Jim
oldbuzzard jimjames
Posted
Hi JJ,
It sounds like the Spanner temp stent test might yield false negatives, but not false positives. So if it works, something like Rezum would probably help. If not, the test hasn't proven much one way or the other.
jimjames oldbuzzard
Posted
I would think it would yield false negatives since the internal sphincter is held open. In that case, a positive spanner is inconclusive and a negative spanner suggests a surgery will not help. Problem is can't seem to find anything online about this type of trial by stent except on the Spanner web site!
Jim
jimjames oldbuzzard
Posted
What might work would be incorporating a temporary stent that doesn't protrude into the bladder with urodynamic testing but that doesn't exist as I know. Truth is the money is spent more on the equipment and less on the diagnostic part.
frank74205 jimjames
Posted
frank,
jimjames frank74205
Posted
There should be a symbol of an evelope to the right of his name. Click on it and it choose the private messsage option. Or maybe just wait till he's posting and answer one of his posts.
Jim
johnny90372 jimjames
Posted
Hey Jim James, can I ask a question/When you sign a consent form in the hospital for a procedure. Where does the consent form end up at the hospital.?Edit
When you sign a consent form in the hospital for a procedure. And the procedure is in a few weeks. Where does the consent form end up at the hospital. What officer department would the consent form end up. What it be the records department? This is before the surgery has happened and after the consent signed was signed. It's an that in between.
If I wanted to track down the consent form I signed and cancel it or notify the office that has it to avoid it, howlin where would I do that in the hospital?
jimjames johnny90372
Posted
It's probably is in the records department but it may also be in the computer. I would make sure it's updated in both. Also, whenever I have a procedure involving anesthesia in a hospital, I ask the speak to the doctor performing the procedure before they put me under. The first thing I say, is that we're going to do such and such, right? Or, in your case, we[re not going to do such and such, right? Mistakes are made all the time.
Jim
frank74205 jimjames
Posted
THANKS
FRANK,
jimjames frank74205
Posted
fred43679 jimjames
Posted
jimjames fred43679
Posted
I personally have never used a Foley, but a lot of folks in this forum have used it post or pre op, or just to carry through a bout of acute urinary retention (AUR). Sometimes that makes more sense than CIC, if it's only going to be for a short while, but anything longer than a week or two, I think most men would prefer CIC although some might not. But if you have a question on a 30cc balooon catheter, ask away here and if no response, you might start a separate thread on it.
Jim
Jim