REZUM--HAVE YOU HAD THIS DONE???????

Hi Lewy,

Thanks for sharing your REZUM experience. Could you briefly tell us what sort of symptons you had prior to REZUM?

It's interesting that they put you to sleep because several people here had the procedure while awake, and at least in a couple of cases it sounded quite painful. Did they give you any medication to take after the procedure for swelling, etc. ? 

Good luck with your recover and do let us know how things go.

Jim

Sure, just having to constantly having to urinate were the only symptoms I had. I really get tired of having to go 2 or 3 times at night and then not being able to go back to sleep. The only meds I took after the procedure were antibiotics, and only because I had a knee replacement. Like I said I may be lucky, but I have had no pain or problems what so ever.

Good luck Lewy.  I hope you get better in time.  Good luck also on the retro ejaculation.  There is a 5% chance because they distrory the inside of the prostate. An there have been about 8 men that have had retro with this procedure.Most of the time they do four 9 second steames   you had 5 10 second Were hopeing to here back from them to see if there is any change.  I will keep you in my prayers Even if you do It is a good procedure     Ken

It takes about a month to see much in the way of results, most of the improvement comes in weeks 6-12 and the inprovement ends at about 6 months. Feel free to have sex at any time - you won't hurt anything.

Dear Brian,

At what point after your procedure did you begin to notice the dry orgasm?  I am just over 2 months in and experiencing the same issue.  I called my urologist and he stated that it will come back since I may still be inflamed.  

However, after hearing that you had this done 5 months ago concerns me quite a bit, I am now reluctant about this returning to normal.

Did you speak with your urologist? And if yes, what did he say?  What I don't understand that many have not had this issue and had quite a few more steam injections; I only had 3 and I am only 45 years old.

I would of not done it either, but my symptoms were bad leading to bladder stones due to retention and the alpha blockers weren't working.  Like yourself, I have become angry and frustrated.

Brain and Dave.  Did they tell you that there is a 5% chance of Retro ejaculation But I think it more because over the last few weeks on this site there have been 8 men that have had it done and they have retro.  I talked to my urologist that is just starting to do Rezum and he said hat the steam distroys the inside of the prostate which if they get it to close to the ejaculatory duct. it will be distroy that will cause you no ejaculaton.  It may be a easy procdure but it is causing more retro they it suppose to I sent a email to the company a week ago and Im still waiting for them to reply.  I do't think they will because it is distrorying to many men.  They don'y want to take about it.  Ken  

I had it done 11 months ago and am mostly dry. I ejaculate some, but it's delayed and less than it was. Once in awhile, if it's not to long since my last orgasms (2 hours or less) I'll have a decent squirt

Let me know if you here anything from

Company. I'm hoping this can be fixed but my intuition tells me otherwise it's really bothering me I was fine first couple months

How is your other parameters. What is your post void residual and Qmax. Did procedure helped you with other complains. How would you asses postoperative recovery?

I will let you know.  I don't know if it can be fix.  Once the ejaculatory duct are dstroyed it done.  Let pray  things will be change.  Ken

I have some underactive bladder issues that keep me from the ideal results, but here's a quick rundown. The procedure hurt a lot, but it was quick. Given the choice, I'd opt for being twilighted as there is nothing about being awake and alert for that hour that has improved my life in any way. My recovery was initially slow - I couldn't pee at all for over 2 weeks (self cathed which is the way to go whether is 2 days or 2 weeks IMO) and it was about 6 weeks before I was better than when I went in.

Ejaculation is so - so delayed and usually less than before - better if I've had sexwithin a couple of hours. I never measured my flow or retention - neither are a problem. Some times (after a lot of alcohol or sleeping) I have to help things along by pumping with my hand due to my underactive bladder, but I can always get empty. Sometimes, its like I'm 16 again, other times its a bit more work. 

Overall, I'm much better than when I went in and given that about 50% of the time I pee like a normal person, I think they opened up the pathway just fine with this procedure. On that basis, I'd recommend it, but there does seem to be some anecdotal evidence that RE is a bigger problem than they initially published. It seems to me that any urologist knows where the seminal ducts are and sees where they are spraying the steam, so predicting it should be possible.

I asked my doctor about that.  Only doing 3 injection instead of 4 he said that you will not get the full effect of the procedure.  If you do the 2 on the left and one on the upper right of the prostate you may be able to avoided the seminal ducts but he said that the steam will get to them.  So I think this procedure is not as good as they say.  Still waiting for a reply from the company  Ken

Ken,

The top line benefit on the website is: "preserves sexual and urinary functions”. This is probably as far as most will read, and as far as most urologists will go.

However, if you dig further, you will find this in the Q&A “There was a low occurrence rate of decrease ejaculatory volume (6 subjects, 4.4%) and anejaculation (4 subjects, 2.9%).”

That means, according to the manufacturer, over 7% will experience either a dry or diminished ejaculation. And, from what we see here, that figure is very, very conservative. 

BTW they use the term anejaculation, which is similar to retro in that there is no ejaculation. But the difference is that with retro, the semen is ejaculated into the bladder. With anejaculation, there is no semen production at all. Nice.

Jim

Jim  I told think the doctor are telling the patients all they need to.  I read that one and they only say preserves sexaul function.  Most doctors to not consider a male ejaclation a function because we don't need it when we get older because we are not having kids.  I feel it is still important because it is part of my orgasm It feel better with then without  Take care  Ken

Jim  I found one that I printed up  Rezum Therapy ( for BPH )  This was one of the Question....What are the possible risks of Rezum Therapy.  It said during the study prior FDA approvel, Rezum therapy has been shown not to cause adverse effects on sexual funtion or ejaculation.  I think they need to take another look at what is going on  Take care  Ken

Ken,

The numbers I quoted above are from their current web site. I guess either more adverse effects are now being noted and/or the lawyers are telling them to disclose more fully. Skepticism aside on how they arrive at the published numbers, personally the published 7% dry or diminished ejaculate figure is already too high for me. I will stick to steam in my coffee and no where else!

Jim

Me to.  I will stick with my urolift.  There were no nunbers in the one I printed up  Take care  Your doing great just the way you are  Be safe  Ken

They buried the numbers in the Q&A section. No reason to be upfront. 

Jim

Yes they tell you what you want to hear without telling you to much.  Ken

Hello Ken and others,

Very glad to hear that after 2 yrs your urolift is still performing well for you!

     I too had one done the same time as you however mine petered out after about 4-6 mos.    

     This week I consulted with a new primary care physician, who in turn is referring me to a new urologist as well,  says if there is anything new happening in the progress of BPH that he would be well aware of it.   So we will see,   Because what he wont   know is that I am very well aware of whats out there, (to an extent).    Any who, this new primary care doc,  made a suggestion that fenestride for a period of 6 mos may be a good choice, but I would probly  experience RE during this time, but my flow should be significantly increased, and then after the 6 mos get off of it and let my system get back to normal in regards to the RE.

Fortunatly for now I self cath (and use only the compacts so I can take them anywhere i go),    So until some good procedure comes along I guess I will do the "watchful waiting).    I know this is a Reezum site but seeing others score their procedures and not hearing too much good about it, kinda makes me want to steer clear.

I hope I dont get into too much trouble on this thread for being so "wordy"!

  Haha. Lol.  Any thoughts from those with dealings with fenestride would be helpful!

Coop.

Hi Anthony,

From the little I've read about Fenesteride -- never personally tried it -- I'd be cautious, and at a minium do some more reading here and elsewhere about  the sexual side effects, some of which may become permanent.

As long as your self cathing, you don't really need a drug to shrink your prostate, and if you're waiting for a better procedure down the pike, then that procedure should take care of the obstruction. So why chance it with Fenesteride then if you don't have to?

Good luck with your new urologist but I bet if you're up to date here that you will know more of the available procedures than he does. At least that is what I found out a year ago with my urologist, and there have been a couple of new ones since then. Typically, urologists just have knowledge about the procedures they or their medical center offer. You would think they would study all available procedures, like we do here, but that apparently is not the way it works.

Jim

 

Thank you Jim those are good points!     And yes I do follow as much as I can on this site but kind of lose track of all that is being put out there.

I spoke with a dr in Houston, for close to an hour about a month ago in regards to a procedure that he does,    I think he is referred to as Dr. K?

I do not recall the procedure that he performs at this very moment but was kinda considering it,   Funny thing is, is that I dont recall what it is.  But was weighing it agains the PAE,   Which now I feel that PAE is out.

Coop.

Hey Buddy....I would not want to take that pill because it going to cause you retro like you say.  Can I ask you how many implants did you have put in.  You may need more.  I had 4 and it works for me.  There was a guy on here Chuck  He had the first one done with 4 it did not work I think it was 6 monts later he had another 4 put in   Now he great.  Check into it   Talk later  Ken

There is a DrK that does FLA  Maybe thats it  Ken

I would STRONGLY advise against taking fenestride. It can make you impotent (one urologist told me about a 20% chance) and not everyone goes back to normal when they stop taking the drug. Rezum or any of the less invasive procedures are safer and more effective IMO.

A couple of thoughts - they've gotten better at some of these procedures and some of the problems they had are less frequent and less severe. The person who started this thread had his Urolift rerdone and has had excellent results. They have learned some things about PAE and the chances of it petering out are greatly reduced from when they first started performing it. The one I find most interesting right now is FLA - not sure if you would be a candidate.

Some thoughts about Rezum. I had it done 11 months ago and while I do ejaculate some, its less than it was and usually delayed enough (10 - 60 seconds after orgasm) that its not part of the sexual experience. I only had to self cath very occassionally (twice in 4 years) but I built my life around the bathroom. I waited for Rezum because I didn't like the side effect profile of greenlight - specifically RE. So I got hosed and ended up with it anyway, but am very glad in retrospect that I did it. My quality of life is dramatically improved, when I go out I don't even look for the bathroom anymore. My recovery took longer than most but and I didn't get full relief because I have an underactive bladder and I would still do it again in a heartbeat. And you are obviously worse off than me because you self cath all the time.

I'd look at all of the non invsive options, including a Urolift redo. It had been so many years since I could pee even semi normally that I had forgotten what it was like not to worry about it. I'm sorry that I ended up with RE and if I had known the odds were higher than they told me (4%) I might have gone with one of the other procdures, but I'm glad I did something that worked. 

My dear friend.  Thank you for your informmation  Alot of men will better themselve with it.  You have to know what is going on to have the best procedure for you.  Most doctor only tell you what they want you to know everything else is suger coated.  PAE has come along way from when they started.  But they do tell you that you will have a smaller amount of ejaculate because the prostate will get smaller and the prostate make most of the liqued In time they will get better.  I think the same is for REZum.  You can have the same thing but there have been many more men on here that have had retro.  I think it it from where they shoot the steam.  If they hit the seminal vessal they will distroy it.  Maybe they can learn how to miss it.  They say retro is about 5% but I think it more like 10%.  But in time things will get better for us men so we will not have to have the old standered procedure.  Good night all and god bless  Ken   

Anthony,

The procedure is FLA. Apparently, Dr. K. is having a sort of trial soon with a discounted rate. I think FLA is very interesting but not much patient data yet. Personally, if I could wait a bit, I'd sit out the trial and then reevaluate the procedure after the data comes in. We do have a member here who already had FLA with excellent results. Maybe you spoke to him already, his name is John.

-- Jim

My friend, I do value your input on this site.  Regarding your comment that finasteride (brand name - Proscar) causes RE, that is probably true ... for some.  I take dutasteride (brand name - Avodart).  Both drugs prevent the conversion of testosterone to dihydrotestosterone.  This conversion happens because of an enzyme called 5-alpha-reductase.  To prevent this chemical conversion, the aforesaid two drugs inhibit it.  Thus, the name; 5-alpha reducase inhibitors.  The essential difference between these two drugs is that finasteride controls for two isoenzymes, while dutasteride controls for three.  Apparently, both drugs have had equal efficacy in clinical trials.  They do shrink the prostate.  They [u]can[/u] cause RE.  However, both drugs have a long, [u]long[/u] half life.  That means that it may not be necessary to take these drugs every day.  At least that is what my urologist told me.  Acting on his advice, I've cut down drastically - down to two pills per week, and in doing so, I may have stumbled upon the goldilocks zone for better ejaculation coupled with the ability to void within normal limits.  I went from what was essentially dry orgasms, to ones that are somewhat more productive.  With that said, I'd advise any guy to run this idea past his health-care professional, rather than "tinkering" with the dosage.  It can be done, but it's best to titrate it down, under the supervision of a health-care professional. 

Finally, and as a complete non sequitur, what may have helped me most of all ...was losing 20 lbs.  Still have 20 more to go, but there seems to be a correlation between weight loss and diminishing prostate issues, but that's anecdotal at best.  Just take my opinion for what it's worth.  That said, our adipose tissue - big fancy, schmancy name for fat - does have the ability to harbor all sorts of inflammatory cytokines; many of wich could potentially cause cell hyperplasia / hypertorphy, not only within the prostate, but as a potential carcinogen elsewhere in the body.  After all, the prostate is a hormone-fueld organ.  Hope this helps.

Avodart and Proscar are very similar. Unlikely that switching from one to the other will make any difference.

Good day Alan,

The terminology you use and how your post was put together leads me to believe that you are a Dr.   But I do see where you have a urologist as well.

Anyways I find your post very helpful,  I have recently taken on a new PCP and he was suggesting the use of Adovart for a period of 6 mos. but will ultimately leave that to be decided between me and a new urologist that he is referring me to.    He told me that after 6 mos i would be able to get off of it and the RE should go away.   In reading others posts I am a little reluctant to do so.    In a nutshell I have a couple of things going on,  one is the BPH and the other is I have a low "T" of which I am on 3 pumps daily of Androgel,  my T # is 400-500 while on the Androgel so I know it is helping me in that dept. but I also know it is not doing my BPH any good at all.

Coop

Alan said: Finally, and as a complete non sequitur, what may have helped me most of all ...was losing 20 lbs.  Still have 20 more to go, but there seems to be a correlation between weight loss and diminishing prostate issues, but that's anecdotal at best

------------------------------------

Did you increase your exercise during this time? An alternative explanation is the suggested correlation between exercise and diminishing prostate issues. Of course both could be at play here. 

Jim

Jim

Yes when Dr. K and I spoke he did mention the trial but since I have had a urolift and CIC that I would not qualify, which was fine because I am in the research mode and digging for info. Not looking for a freebie that could be detrimental.    Actually I would love to hear from some who have had the FLA procedure.     I believe the procedure costs approx 20K if it is a cash basis.

Anthony.

 

Hey Ken,

Def apprehensive with taking any new drug,  a lot more men would be on it if it was all that!

I supposedly had 5 devices put in during my Urolift and have not ruled re-visiting the procedure.   Something I am going to run by this new urologist,   I dont even know if he does them.

Just a little side note,  I have noticed that if I lay off of the tamsulosin for a couple of days, then when I self cath it is a little harder to get it through the prostate area,  but when i am taking it, I can immediatly tell the difference,  it seems to be a softer smoother entry past that area.

Anthony.

Anthony,

If it's a silver lining, the trial is not exactly a "freebie". I believe it costs around 14K to participate. It's understandable for a number of reasons that he would not want participants who had previous procedures. John is the only one here who has reported results -- they were excellent -- but he did say there have been several FLA's by Dr. K. since his. Hopefully we will get to hear how they did. 

Jim

Alan that is very good news.  I hope some men try it .  It help you get some of your life back.  It may help them the same it helped you.  Take care  Ken

That may be something to ask Jim  He know alot about CIC  Yes check into seel if more implants would help   should have done the jusb  Did they ever check it see if they are in the smae place or if they moved  Just asking  Take care  Ken

Hi Anthony,

That makes sense because Tamsulosin is a smooth muscle relaxant. Are you using a hydrophillic catheter like Speedicath with a Coude tip? They are very slippery and the coude tip makes it easier to navigate around the prostate. I do CIC  without Tamsulosin and it slides right in without resistance. 

Unless the Tamsulosin significantly decrease your cath frequency, not sure why you're on it because CIC will empty your bladder completely without Tamsulosin's help and side effects. 

Jim

Evening Jim,

What I use is the Coloplast, Speedee Cath "Compact".  i do not use the ones in the package,   The compacts are so convienient, they do have to go in all the way,  as far as they can but I am on the go so much I can carry them in a very concealed manner and use them anywhere in only a minute or two. The tips are straight and not curved.   I did try a sample of the coupe type  but they kinda hurt to use.

I use the tamsulosin because even tho its minimal it still helps some,  with it I void natrually about 100-125.  Without it I am lucky to fill a urine sample cup.

I cath about 4 times a day,   Upside is that when i cath before i go to bed i sleep through the whole night and when I wake up  I dont feel like I have to go,  until after a couple cups of coffee.    So thats where I stand.

Thanks for your questions.  Good to talk about it,

Anthony.

I'm 58 and had the REZUM done 2 months ago.  It has taken me a while to get back on the right track.  I have had no problems with dry orgasm. I stopped taking flomax because of having dry orgasms. Now after having this prcedure done I have more seamon coming out now than when I was in my 20's.  I do notice it keeps coming after sex so there is a lot after wards.  Last night I got to sleep the entire night and only got up once!!! That was such a improvement in my life!!

 

Anthony2858, I'm not a doctor, and I apologize if I came off that way.  Like every other guy on here, I just try to stay informed on matters of health.  I could be mistaken, but it sounds as though that six-month trial period is being implemented to rule out other possible causative factors for your BPH.  As I understand it, it's considered a "maintenance" medication, intended for long-term use.  Common sense tells us that if a drug company invests billions in their latest pipeline, then they'll want the customer to consume it as much as possible ... AND AS OFTEN AS POSSIBLE.  In his book, "Overdosed America," author John Abramson, MD makes this point clear.  Like I already said, the half-life for finasteride or dutasteride is incredibly long.  You'll probably will have to take it every day, and it can take up to two months before it becomes totally effective.  Thereafter, you may want to do your homework on tapering the dose.

You mentioned you're reluctant.  I get it.  That said, Avodart is now a widely-prescribed drug, and since becoming generic (dutasteride), it has also dropped in price significantly.  Like you, I also use testosterone (cypionate).  Take my opinion for what it's worth, but according to the head of urology at Harvard, it's a good thing.  It's also a myth that it causes prostate cancer and, truth be told, it may prevent it.  More research is needed.  If you think about what you're doing, anthony2858, it's actually a pretty conservative approach - one that can buy you quite a bit of time.  One final note, you may want to discuss the idea of daily Cialis (5.0 mg) with your new PCP.  It's helped me significantly.  My only complaint is that it's prohibitively expensive.  That said, it's supposed to go generic in the forthcoming year.  Hope this helps.

Jim, some of the conventional wisdom surrounding BPH is spot on.  For example, when I do cut out dairy, my symptoms abate.  Same with exercise.  I'm 65 years old.  One piece of conventional wisdom, and it's one I don't buy, is that we need 450 minutes of exercise per week for optimal fitness,  In fact, this figure is beginning to be debunked in study after study.  I try to exercise for four hours per week, and when I do, the benefits are noticeable. Granted, if I can do more, I notice more benefits.

I'm just a believer that health care ... is self care.  It's taken me a while to lose weight, and it's only my opinion, but this has probably helped me as much as anything.  I'm also a big believer in Michael Pollan's seven-word edict:  EAT FOOD.  NOT TOO MUCH. MOSTLY PLANTS.  It's important that if we're going to eat animal flesh, and I do, that we maintain the right ratio of Omega 3s to Omega 6s which is 1:1, ideally.  If an anti-inflammatory, say, salmon is heart healthy, it's probably prostate healthy as well.  If too much sugar wreaks havoc with the vasculature endothelia, then what is it doing in the prostate?

Takeaway:  Our overall health is based on a constellation of things we do (and don't do).  Not a believer in a singular, magic bullet, inclusive of a scalpel or a pill, though they definitely have their place. Take care, my friend.

Just an aside, were it not for some of my brothers-in-suffering on this site, I would have lost hope a long time ago.

Alan are you taking the cialis instead of Flowmax for your BPH symtoms? Did you take flowmax before? If so had do they compare when it come to BPH symtom relief?

Thanks Tim

Leon  I'm so happen for you.  Keep it up,  There has been alot of retro on  this site forom that procedure.  Take care  Ken

Alan,

Thank you for your input!  Got to admit this is the first time that I have heard about using testosterone being a good thing,  also have not heard that it may cause prost. Cancer.    All I have heard is that it works against BPH due to it swelling, putting pressure on or strengthening the prostate making it even more difficult to pass urine..

My big question is if my bladder has been jeopardized from years of retention, and a certain amount of pressure is required to push urine through the prostate by the bladder, at what point do I stop focusing on opening my prostate and start focusing on strengthing my bladder?   And how is that achieved?

When I cath,   realize the urine initially has to flow through a very small opening and then flood on through a larger opening before actually exiting out the end of the cath.    Keep in mind the cath i use is a "telescopic" type cath. ( compact type).   My point is that when the urine is actually flowing it appears to have fair pressure, (which would be diminished from the flow going from the small opening to the larger opening.   Basically what I am saying is that it appears,  to me anyways, that i still have relatively good pressure from my bladder,, but to listen to a uro, they say my bladder is "shot"!   so do I turn to my bladder or my prostate?

I congratulate you if you can translate what I just said!  HAHA!    

FACT IS I KNOW SOMETHING HAS TO BE DONE,  BUT UNTIL THEN I WILL JUST DO IT MYSELF.

 talk soon friend!

Hi Anthony,

I'll be interested in hearing what Alan says about the relationship between testosterone, retention, and the easy/difficulty of passing urine. I've thought about testosterone myself, however after achieving a fine balance of finally being able to void without self catherization (CIC) I'm concerned that even a little prostate growth/swelling would upset the balance.

As to how to turn a "shot" (atonic) bladder into an elastic/functioning one, I can briefly relate my own story. Three years ago I was in near acute retention and I showed up at my urologists office carrying close to 2 liters of urine which was backing up into my kidneys (hydronephrosis). After three years of self cathereization, starting at 6x/day, I have rehabilitated my bladder to the extent that today I only have to cath maybe once every couple of weeks, I have decent natural voids for my age (250-350ml) and my PVR is often under 50ml. I owe it all to CIC. The trick, if you want to call it that, is to keep your total bladder volume to 400ml or under as much of the time as possible. If it's over, just increase the frequency of CIC. My prostate certainly hasn't gotten smaller in the last three years (never had a procedure) so it's the rehabilitated bladder that has made the difference in that my detrussor's are now strong enough to push through whatever obstruction I have. Of course your experience may differ as you have a different bladder and different obstruction. 

So, to your question -- do you turn to your bladder or prostate -- I was offered a TURP but decided to pass because of the side effects. I therefore turned to my bladder via CIC. Should things change, I would probably go back to CIC at this point as I still don't feel the newer procedures are ready for prime time. But some appear to be coming close.

Jim

 

Thank you Jim,

 I completly concur with you!  I CIC approx 4 times daily and when I see that it may go over I start thinking I better call and get my next shipment early.

I have heard,  through this site that keeping your bladder down as much as possible can help re-train your bladder,   But when I run that by my uro he will say "not happening".    Which is why I am now being referred to my 3rd uro.  And if he starts talking a bunch of crap I will walk right in front of his face.    But I dont want to insult what he actually knows....  this site is my friend and so are all of those who help me make educated decision!

I will be asking questions about Cialais, but ultimately,  like you said,   The "trick". (If there is one). Is to keep cathing to keep my bladder content low!!

Thanks!    This input is better than any doctors for sure!

Jim,

I meant to ask you something that I have heard from others on this site.   Why would you feel like you need to cath only once every couple of weeks?

I feel that if you feel that once every couple of weeks would tell you that you still have problems and they are not just a frequent problem but once they start they are just going to get worse.   So how do you decide that once every couple of weeks you need to do this, instead of never having to?

I saw a post a few days ago where someone said they had to cath only twice a year.  ???   How is that?   How could someone feel like they only need to cath that far apart and not feel like they need to get back on a regular basis of self cathing?   I just don't get h0w   Only one or two times a year does anything??   Baffled by that

Anthony said: I have heard,  through this site that keeping your bladder down as much as possible can help re-train your bladder,   But when I run that by my uro he will say "not happening".  

---------------------------------

Three years ago my uro, big honcho major teaching hospital, told me I would never be able to void again without a surgery or without catheters. He was wrong. 

Don't waste your breath trying to convince a uro but rather do your homework and take control of your own body. This doesn't meaning doing anything reckless but CIC, for example, is as safe (actually much safer) than any surgery and will protect both your bladder and kidneys just as well. 

So, if you start seeing results from CIC, as several here including myself have, listen to what your body is telling you, not your uro. 

That said, unfortunately you need them to write prescriptions and order tests, etc, so unless you happen to find the rare open mind uro, you gotta listen to what they say and be nice. But hold your guns!

Jim

Forgot you asked about daily cialis. I've taken both tamosulin and daily 5mg cialis and found daily cialis a little better in terms of voiding and also better in terms of side effects (no retro and a little sexual boost). That said, neither helped enough to get me off catheters at the time I took them, so I figured as long as I had to self cath anyway, why put more meds into my system. However, if it makes your CIC easier -- I didn't see a difference there -- then I'd say try the dalil cialis and see how it compares.

Jim

Anthony,

I wish I had a definitive answer on why I only cath maybe every couple of weeks, but I'll tell you what's going on as I see it.

Most of the time I void without catheters, without pain, with decent volumes (250-400ml), and with low PVRs (often under 50ml). In other words I void like a normal person, and in fact better than I have since my 30's. 

However, every once in awhile it is painful to initiate a void and at that point I try a couple of things which I have found are helpful. One is walking around for a few minutes, another is some deep knee bends and/or some yoga poses. If this doesn't work, then I've found leaning back in a chair and voiding into a container sometimes does. If that doesn't work I self cath.  Or, if I'm not in a patient mood, or in a hurry, I skip the walking around, etc, and just self cath as soon as I have a problem with the natural void. That's actually the quickest of the lot since it only takes about a minute.

Again, not 100% certain on why 90% of the time I void naturally with low PVRS and the rest of the time I have either near acute retention or full acute retention. However, it almost always is associated with a very full bladder (400ml) and inactivity prior, such as lying down. I also think it might sometimes be associated with very mild episodes of prostatitis from sex which might inflame/swell the prostate therefore adding a little more obstruction. 

I was considering doing video urodynamics to see if that could pinpoint the problem (there would be a real time video of my bladder during voiding) however I would have to time the urodynamics so as to recreate the issue which isn't as easy as it seems plus I don't think much could be done anyway since it isn't even close to being inconvenient enough at this point to warrant surgery or a procedure.

FWIW I have heard of others having similar issues with voiding and similar remedies such as walking around which I guess just sort of loosens things up.

Jim

Just to add to the last reply, I think the physics at work is that while my bladder has been significantly rehabilitated, it's still not strong enough to push through whatever obstruction I have when the bladder is very full which I would think would involve more detrussor strength then if it were not as full. The walking around and exercises maybe sends blood to the detrussors and/or moves the urine around in the bladder making the void easier. 

I would work on the prostate and the bladder. Any obstruction will challenge a weak bladder, so opening up as much as possible is in your best interest. I have an underactive (which I guess is a form of weak bladder) and had Rezum done and it helped a lot. In fact, the prostate masked my bladder issues until it was relieved. And how well it works seems to vary too, but not the way Jimjames' does. A full bladder empties better than a less full one for me. Sleep and alcohol seem to impact it negatively but I can't trace anything else. About 70% of the time its fine, the other 30% I have to sort of help it by pumping.. But I can always get empty and am not (at least haven't been) at any danger of retention since Rezum. And I was a very occasional self cather - once after minor surgery and one other time in 4 years prior to Rezum. But I built my life around the bathroom and am much better now.

So if you have an enlarged prostate and a weak bladder, if you can open up the blockage, a 50% rehab of your bladder might be enough to get you functioning pretty normally. Despite what any doc says, there is no dnager in trying as its hard to know how much you can rehab it until you try.

Good morning Anthont.  What all these men are telling you it true.  Make sure you fix the bladder and you should be able to pee better.  There are less invasive procedure that will open you up Urolift or rezum both will do that.  Alot of times urologist if they can't find a problem they assume it's the prostate.  An they start cutting away.  These men that have they done find out it is not the prostate it's there bladder that was giving them the problem.  So they have a procedure that did not need to be done.  Work on your bladder before you get talked into anything.  You can fix your bladder many men on here have.  Jum is one of the best guys on here.  He fix his bladder without getting a turp done like the doctor wanted.  Take care  Ken

Good afternoon Alan.  Just checking on you.  How is everthing going with your meds.  I hope your better then your last post and that was good.  Take care  Ken