Nocturia getting worse - does this sound familiar? Any ideas appreciated!

Tom: I'd like to suggest that you measure the amount of urine that comes out when you self cath before going to bed. If it's a small amount, then I wouldn't expect it to help much. If so, then it could be that the cath is unable to clear your bladder which I believe is possible if a large median lobe creates a valley and the urine sits in the valley below the catheter. Or, it could be that you are producing a lot of urine at night. If this is the case, you might consider compression socks as a way to cajole your body to not store fluid in your legs which then is urinated out at night. In this case you would urinate more liquid during the daytime and less at night (all other things being equal).

OTOH, if the self cathing produces a lot of urine, then it seems likely you should be able to sleep for a fair bit of time before waking up.

rdemyan,

The sleep issue is getting so bad that I will have to try to self cath until I can schedule a procedure - pretty sure now it will be a bipolar TURP. I currently void about 100ml per hour at night - I have measured this for a long time. My rate of flow is 5ml/second during the day and about half that at night. So, it takes me a very long time to clear the bladder. I have considered the compression socks. Good idea. Back to the self cath - I haven't done this in five years, so if I can get through the process successfully it will be interesting to find out how much I am retaining. What I am planning to do is to void naturally until I feel my bladder is empty, then try to self cath and see how much more is left. At the uro's office I voided naturally, then when they ran the ultrasound wand over my bladder the doctor said I was still retaining 200ml - no wonder I feel like I have to pee all the time! I do have a concern about the self cath - that it will irritate the uretha and make it even more difficult to void - maybe impossible without another self cath attempt in the middle of the night.

Tom

@tom86211:What I am planning to do is to void naturally until I feel my bladder is empty, then try to self cath and see how much more is left.

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That is what I do to measure my PVR volumes. Towards the end of my peeing, I tap with my fingers over my bladder for about a minute which may be good for getting out another 20 ml or so. Today at the urologist, he said PVR's less than 150 ml is OK but over 200 ml is not. So far mine are staying around 100 ml give or take 30 ml. He also said that variations in PVR's of 40-50 ml is common.

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If your catheter is well lubed, that should minimize any irritation.

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How are you measuring your flow rates?

Steven,

I have a clear plastic beaker marked in ml that my uro nurse gave me. I can pee in it and count how many seconds it takes, then see the amount of urine in ml. On one Flomax the best I could do was 3ml/second. On two per day, I am up to 5ml/second. So, after about 20 seconds I can pee about 100ml. This is fairly consistent. Then, I always feel there is more urine in my bladder, so I walk around a bit, try to relax the bladder muscles, then I can usually squirt out another 25ml, then do this a few more times before going to bed. I can usually get out 150-175ml before I feel my bladder is empty enough to get to sleep. Then, the whole process starts over again about an hour and a half later. This can take 10-20 minutes to feel like my bladder is not irritating me, so I can get back to sleep. If I don't go through this process I get back in bed, then I can feel the irritation, then it's back up again, over and over again. Last night was the worst. So, this is not getting any better and I have to do something!!

Tom

Tom:

I've only self-cathed twice so I'm not going to say anything about how to do the procedure. However, like most things in life, try to relax and remember to breathe. Don't tense up.

With regards to measuring the volume from the self cath, I did it once to check against my bladder scanner. I found that I had to use a big bucket to make sure I got all the liquid coming out of the catheter since it was difficult to control. I then poured the contents from the big bucket into the graduated beaker.

Good luck.

rdemyan,

A really good idea. Still haven't done the self cath yet. Guess my past experience with the process is creating a fear issue.

Tom

I did it back in November to check my bladder scanner. It was my second time. I have a seat in my shower so I did it disrobed in the shower. The advantage for me was that I could focus on the proper technique without having to worry that I might get urine on my clothes or the floor, etc. Think of ways you can limit what you have to think about while you are performing the self cathing. If you decide to self cath routinely, the advice from others who do that seems to be overwhelmingly that, with time, it is no more difficult than brushing your teeth.