Prostate,

Hi sorry about spelling I meant to say no natural stuff worked at all.

Hello Pluff mud. I am having to self cath and dislike it...I had turp a month ago but cannot pee enough to empty my bladder. In the middle of the night I cannot pee anything so usually self cath around 3am to try and get what remains of the night with some sleep in.

I am cathing around 4 times every 24 hours but consistently worrying that I am leaving my bladder with stale urnine in for too long (6 hours)....unless I go through a couple of hours of an evening where I pee naturally after a few whiskies with water...not sure if it is the volume I drink, or the alcohol "relaxing" everything....

Any thoughts on your routine with cathing and how are you getting along with it now.?

I worry I will have to do this for the rest of my life....Im 64 years of age.

I have had two utis since starting cathing around 5 months ago. Not sure how as I consider myself hygienic in my routine...but there you are..Im always concerned about the tip of my penis being clean enough now when I place the cath...

What kind of TURP did you have - monopolar, bipolar or Plasma Button? The TURP should have cleared away enough prostate so that you can pee now.

It was bipolar Turp. Yes thats what I thought & it is why I think maybe my bladder is compromised..

When I went for a flow check and was holding a massive amount of urine over 2ltrs..this was four/five months ago, before the turp surgery

Damn, this is one of those HORROR stories I have heard about. Funny some people believe they do not exist, just like my Urolift failure.

Geoff,

So, before the TURP you were holding a "massive amount of urine over 2ltrs" but now even though you can't completely empty your bladder it's better? Just want to make sure that's what you're saying is going on.

Tom

I am at my two year anniversary of self cathing. I am a few years older than you. I have not had a natural void since I started. I usually cath 4 times per day - when I first get up in the morning, around noon, around 6:00 P.M. and right before I go to bed. Occasionally, at other times, I will feel an urge to go, and it is usually an indication that I need to cath, and I will do so. I feel that I empty the bladder when I cath, and ultra sounds at the urologist's office have confirmed that. I always withdraw the catheter slowing, and if more urine starts coming out, I stop and let it drain.

I was retaining 1.5L of urine before I started CIC. I don't measure the volume each time I go, but I can get an approximation from the time it takes to drain my bladder. Luckily, I have not had any UTIs since starting. I definitely feel CIC has improved my quality of life. My bladder became enlarged due to retention. I was only voiding about half a urine sample cup each time I voided. I was getting up multiple times during the night, and I was always worried about the sudden urge to go when away from the house. I don't worry that I may have to do this the rest of my life. However, I do worry that I may become infirm and have difficulty cathing or that my vision may go when I am older making it impossible for me to self cath.

With two UTIs in 5 months, you may be a candidate for hydrophilic catheters. Since I haven't had any UTIs, Medicare will only pay for non-lubricated ones. I don't have a problem with that. I just takes a little more time to complete the process. I am pretty careful about washing my hands and penis before starting the process.

So I'm curious what your urologist says about your inability to empty your bladder after the TURP? I just had a 4-month post-op checkup (had the TURP in February) and my PVR was 0! Pre-TURP is was only 60cc so it wasn't horrible but before I quite often felt I hadn't emptied completely and that was confirmed when I needed to go again 30-45 minutes later. Now I rarely go more often than every 2 hours unless I have been drinking a lot.

I don't think anyone doubts the existence of unsuccessful outcomes from BPH procedures. It's just that some people post "horror stories" that are second-hand and not based on their personal experience. I discount any negative comments on a particular procedure unless the person posting the comment has actually had the procedure.

Lee,

Yes, to me a "horror story" means that the patient is worse off after the procedure than before. There isn't one BPH operation that doesn't end up causing some men issues and occasionally big issues. I read about them all the time here.

In my case, my recent TURP was helpful, but apparently not as successful as yours. My flow is about 50% better, but I am still retaining some urine and am still having insomnia issues. A prior PAE improved flow about 10-20% but only lasted a year.

Tom

Before surgery I was cathing religiously five times a day and measuring everything..it rarely if ever went over 400 mls and I was feeling (to me) normal urges to pee just before cathing. However normal peeing just stopped completely. I guess because my bladder had been drained of the huge amount at the hopsital and that is when they instructed me how to cath.. just normal physics tells me that the pressure in my bladder would have disappeared..that was back in Early April of this year 2019.

I cannot empty my bladder by peeing normally now even after surgery...and have to cath 4/5 times a day. I do pee normally sometimes of an evening but over a period of a few hours and maybe 3/400 mls. I stopped measuring it as I got fed up of peeing into a bottle and just wanted to feel normal by peeing into the toilet basin while standing.

I am going to speak to the urologist later today so will know then. I believe I have left it too long before taking notice of my original symptoms & only went to the hospital after feeling feverish with pain around my midriff at the beginning of this year.

Months ago, I just thought my weak flow was part of normal aging..

In my case, my recent TURP was helpful, but apparently not as successful as yours. My flow is about 50% better, but I am still retaining some urine and am still having insomnia issues.

Tom, per some previous posts of yours, I believe you've determined that your continuing issues, especially the insomnia, are due to previous prostate treatments and are unrelated to your TURP. Someone who has not seen those posts might jump to the conclusion that the TURP didn't work and come away with a misleading impression.

Clearly, everyone is different but extrapolating from my experience, I will opine that, barring other underlying issues, the TURP (and similar procedures that remove prostate tissue) will be successful in most cases and the post-op conditions that many worry about (e.g., incontinence or impotence) are quite rare. Clinical studies support this statement.

I am so sorry to hear about your situation but it does help me feel better. No matter what a person's situation is there is always someone worse off, and eventually we all do not have to worry about anything.

Hi pluff mud,

thank you for your thoughtful reply.

I already use hydrophilic caths and so presume I need to pay more attention to my hygiene regime....The UK national health service pays for them, so I guess i`m lucky..

The thing that bothers me is a psychological one about putting something foreign into myself via my dick....and not being able to see/know excactly what is going on....I am a practical person so am able to do cic but the mind thing keeps me awake at night and I am taking sleeping tabs ...I have to pursuade my Dr to prescribe them for me because of the addictive possibilities etc etc..

Lee,

I totally agree with you. My TURP did work, but the issues I continue to have were present before the operation - insomnia, overactive bladder. And who knows what has happened to my bladder after several years of straining to pee. There is a lot of guessing going on in this field.

Tom

Well mine is a Urolift failure and I am determined to not try and make me worse with some other procedure and then I might have a bad story.

My Urolift made me worse with the flow and now a bad feeling down there, but not a Horror story

Jim,

Very sorry to hear that your Urolift didn't improve your condition. Do you know why? If you can figure out what happened then you can decide what to do next. A PAE is a fairly gentle procedure - I had one in 2017, helped a bit, but only lasted about a year due to a median lobe. Maybe you also have a median lobe issue. Urolift like PAE doesn't work if you have a median lobe. The Urolift people developed a Medlift to deal with this. Trying to decide what to do next is challenging. You have to study all the procedures, figure out which one is available to you, both on your insurance and geographically, then decide who is going to do it. A lot of choices can be time consuming and stressful to figure out how to move forward.

My best to you, Tom

Another question if I may.?

Do you measure or monitor everything you drink and keep it to a limit.? I keep mine to 1 & 1/2 litres most days sometimes a tad more.

I like the idea of cathing four times and not having to do it in the middle of the night, which i do now for fear of overloading my bladder by the time Morning arrives. I usually get up around 6am so if I cathed at 10pm every night I guess it should be doable. What do you think of my approach to things.?

Hi Tom. My urolft was performed perfectly as urethra was completely clear. the problem is not with the procedure but due to bladder having lost elasticity due to pushing urine past constricted urethra. i suspect this will cause poor results irrespective of the prostate procedure.

Geoffrey

I don't monitor my fluid intake. I probably get most of my fluid intake in the morning and at lunch. I will drink 2 - 3 cups of coffee in the morning. I don't drink many sweetened drinks - usually just water or unsweetened iced tea. I will have a beer with dinner 2 or 3 times a week. If I am thirsty before I go to bed, I will drink a half cup of water. The length of my overnight interval is about the same as yours. I figure that when I was younger, I didn't get up in the middle of the night, so how can I be overloading my bladder now. I find the volume of urine will occasionally increase between cathing intervals, and it doesn't necessarily have anything to do with fluid intake. I also occasionally will awaken early in the morning with the slight urge to urinate. At those times, I do get up and empty my bladder.

Thanks pluff,

yes I have noticed there doesnt appear to be pattern to the amounts voided, day to day, compared to intake (ignoring the water perspired or breathed out of course)..our body works things out for its own reasons doesnt it. I guess it is all about averaging things out. Personally I have a feeling if our bladder is on occasions holding more than 400 mls it will be ok and it gives it a work out..?? You mentioed about when we were young.. Im sure we all woke up at times with our bladder crying out to be emptied..

I fill a 1 & 1/2 litre bottle with water every morning and use that for coffees, teas, or just to drink on its own. I try to finish it off by 6pm most days. Sometimes I will drink more if thirsty but usually I find it is enough to keep me hydrated without my urine going dark orange..

Thanks for the info. I wish I did not have had the Urolift donesince I have found out taking some of the medicines like Flomax (Tamsulosin) and Rapaflo every other day can works and not have some of the side effects like RE. I would have tried harder to make the drugs work for me before doing any procedure if I had know that. My doctor never suggested to take the drugs every other day and I guess he does not know about a study on this. Hopefully he can remove the Urethra clips but I suspect he will not do that unless I have a TURP. Als, I am not sure if my insurance will pay for just removing the clips.

Jim,

For a few years I took Flomax every other day and just came up with this on my own. It was never suggested to me either. Worked fine. After a PAE in 2017 I increased Flomax to 2 per day, then backed off to none. However, after a year I was back to 1 per day, then 2, then I had a bipolar TURP. Still on 2 but plan to cut back, and hopefully back to none. From just experimenting on myself it seems that Flomax stays in your system for almost 5 days, so taking it every other day does work.

Tom

Thanks, I just do not understand why Urologists do not recommend the Alternate Days when a patient like me does not like it because of RE. FYI and others, this is what I found on the health.harvard.edu site on this issue:

Alternate days

Investigators asked 140 men with BPH to take 0.4 mg of tamsulosin (Flomax) daily for three months. If the men responded to tamsulosin, they were randomized to one of three groups. One group continued taking the medication daily, the second took the same dose every other day, and the third stopped taking the drug. Men taking tamsulosin every other day did just as well as those taking it daily, and experienced fewer side effects such as ejaculation problems.

Jim,

Thanks for this information. This is exactly what I found out experimenting on myself. What I have learned from my own experience and from this forum is that urology covers a very wide range of topics and urologists have limited knowledge and abilities. One will tell you one thing and another will tell you something else. So, basically, you have to do your own research and work in partnership with your urologist rather than assume that they have complete knowledge.

Tom

I agree and my Urologist will find out I have become educated on the Web. Hell, doctors hate it when patients become educated about their profession, especially on the Web. I will continue to research the bes options for me, drugs and BPH procedures available.

Its not "better".. I am having to self cath. I`m fed up with things. I am now waiting to have a urodynamics test to check my bladder. Which they say will have to be in a couple of months time to allow my turp surgery to heal properly first..weak bladder muscles might be the reason my turp op was not a success, but I also still have a 2cm piece of prostate tissue near the sphincter muscle, (which was spotted on a scan) that was not reamed out. Im hoping and praying that might be the reason for my weak stream, but I just do not know.......it is the waiting that I dislike..