Self Catherization. An alternative to Turp, Greenlight, HoLEP...?

Hi Alex,

Yes, CIC should be the gold standard of watchful waiting, or at least a step routinely offered when drugs don't work and prior to surgery. Don't think that will happen because of the culture and economics of how urologists practice today. The surgeries and procedures pay their kids's tuition, CIC just helps the patient.

Jim

Great advice, and I wish I'd had it before I got driven into a quick GreenLight and then TURP by my urologists fearful pitch about all the bad things that might happen to be if I didn't.  A year later, I regret having gone down that path, and think I will live with the bad consequences of it for the rest of my life.  I'm not saying TURP isn't necessary for some, and it can have a good outcome for some.  Just go down that road very slowly.

Hi Michael,

Teriffic you had a good result with PAE!  Just keep an eye on your PVR with periodic bladder scans at your urologist's to make sure things stay good. Please keep us updated now and then. PS Did Bagla say anything about keeping the clips in vs removing them? I assume they may become even looser as your prostate shrinks from PAE.

Jim

I just posted it to Neal.  Dr Bagla suggested i might have it removed if it's easy. My urologist who did the failed urolift said it could be removed but if I'm not cathing I might not bother. Really wish I never did the urolift. Haven't made up my mind about the clip. All this has made me wary of elective procedures.

I read that that there is a shift away from TURP toward in-office procedures. I'm sure part of the reason is that urologists were looking for a less invasive option, however I've also read that part of the reason is that because of current insurance reimbursement guidelines, urologists will make more money from in office procedures. So start looking for lots more UROLIFTS and REZUMS as the "TURP only" corner urologist now becomes the "urolift, rezum" urologist with TURP being offered if the others don't work. Just hope they understand that all these procedures have consequences and don't start promoting them like an alternative to Tamsulosin!

Jim

Jim

My urologist is starting to do the REZUM procedure.  It's another option.  He told me yesterday that not many of the patients are going for Turp or Laser because of the side effects.  He said that alot of his newer patients are between 40 and 50.  Your getting younger men having problem.  He is also good in explaining everthing.  He will not force you to do anything you are not happy with.  Ken

Ken,

Your uro sounds like a good guy who doesn't push, but I don't have to tell you the influence uro's have in directing their patient's therapies. It may be the side effects of the TURPs and GLs that cause younger men to pause, but I don't think you can minimize the influence of the uro. And now that more and more uros are being trained in Urololift and Rezum, I think you will see patients steered toward these procedures earlier and earlier in the "watch n' wait" process with probably less screening than for TURP, with a little bit of a "whatcha gotta lose" attitude. Well, we've seen some success stories here but also some who wished they never had these procedures. 

Jim

 is and does happen.  Thats is why I say get the information.  And don't be forced into anything.  Take care  Ken

Hi Michael,

Thanks for the heads up. Hopefully Neal will see this to respond but if not, maybe you should address this to him as he is the one who was given the info.

-- Jim

Jim

Neals told me the same thing. It reallt freaked my wife and myself out. We spoke to our doctor who performed the PAE along with 2 other radiologists and also another Urologist. This is false information.

Hi John,

Never read or heard of that myself. Hopefully, it's just left over fromthe tamsulosi and will resolve soon. Regrding the self catng, do y ou keep track of your volumes. If you want to keep your bladder from stretching, it's a good idea to try and keep total bladder volumer under 400ml. Total bladder volume would the amount of your natural void plus the amount  you cath right afterwards. If it's over 400ml, then increase cath frequency.

Jim

Hi John, I was on Rapaflo, but it took more than six weeks for me to get over the retro. It's most likely a matter of time. Best wishes, Fred

John, I'm kind of like you.  I had prostate problems for around 14 years.  Had two turps, and one greenlight Therapy.  My last problem, I couldn't urinate and so I went in for a turp.  After recuperating from the turp in the hospital, I could

nt urinate on my own.  Had to wear a catheter for about a month afterwards.  Went back in to see my urologist, to remove the catheter.  Still couldn't urinate.  That's when I decided to do CIC.  Best thing I ever did for my bladder and prostate.  Now, I can empty my bladder completely and not being worried about where the next restroom is.  Like you, I wish that I had done CIC, long ago!!!  I've been doing CIC for a little over a year.

Dennis, Was your prostate so very enlarged that Turp didn't work?Wow ,you had all those surgeries, and still had retention. I have been doing CIC 1 year now, they wanted to do Turp ,however they said they didn't know if i could get out of retention's i refused and have been doing CIC .Do you have a bladder issue? Perhaps thats the reason turp was not right?

Thanks for all that info Dennis , I would sure like to have a natural void again, however at 88 i'm lucky to be alive.

thanks

frank,

Actually I did the greenlight first, because I read that it was less invasive.  After two years following the greenlight, my prostate, started to close up again so I did the turp.  The turp, was better in my estimation. I could urinate better after the turp, than after the greenlight.  After several years, my prostate started to close up again but with medication {doxasosin} it was manageable till I had full retention.  That's when I did my second turp.  After my second turp, I couldn't go on my own.  I had to wear a catheter till I decided which way to go.  Should I wear a catheter all the time, or do CIC.  Just the thought of inserting the catheter on a daily basis, made me nervous.  I finally got the courage to do CIC, and it turned out to be the best thing I did in years!

Getting back to your question, My prostate was huge, around 141 grams.  Really big for an enlarged prostate.

AFter the turp, they removed 39 grams.  I was still having trouble urinating, but much better.

If I could do it over again, I would choose just to do CIC, like you.  No surgeries etc.  Like you I"ve been doing CIC for a little over a year.

I wonder what a urologist would do, surgery or CIC, if it were his condition?

By the way, I'm 68 years old. Yes, you are fortunate to be alive, and coordinated enough to CIC.  You must be in really good health. My dad, lived to 88, however I really doubt if he could have had the dexterity to do CIC.  Hope you make it to 100 and more!

You asked me if I had bladder issues.  I believe I have.  Because my bladder could not empty for many years, it became flacid and so no tone in the bladder wall to contract and squeeze the urine out of the bladder.  I hope that it will eventually change, like in the case of JimJames.

Take care,

Dennis

Dennis  you went through a lot.  I could never let my father go through that.  To have 4 surgery's and they don't work.  thank God for CIC  Ken

Dennis,I guess these urologists are all in this for doing surgery ,thats where  the big bucks are. I'm sorry to hear the problems your going through. I guess your URO never told you about the possiblity that maybe the surgery won't work. 

Your prostate was 141 grams,how big is that in inches?I guess our prostates keep growing.

I hope your feeling better about CIC,it's really not that bad. I Don't know what i would do if mine keeps growing at almost 88 i think i'm to old for surgery?

frank,

Good luck with your bladder retraining..! It's amazing what jimjames has done in that regard.

CIC is great if you have at least a medium size 'holding tank' [bladder] as a small bladder would make this much more difficult due to frequency.

You might try having the DNA sequencing done on your semen and urine to determine if you have any unkown pathogens. An infection alone can inhibit urine flow, even in a young guy. 

Also, you could consider having a semi-permanent stent placed. This will give you full control of urination as the lower part of the stent is placed above your urine controlling shincter in the prostate. You will have full retro from this. And just like CIC there's a risk of infection. I believe I have read that these stents can be placed for a year or two at a time. No ED from a stent either.

Having a stent placed is just an idea to explore, I have no idea if this might help enable rehabilition of your bladder as jimjames has already proven that CIC can do.

All the best to you sir as you have suffered greatly.

Cheers

If I had done CIC from the beginning, perhaps, I would be in a better place.  My bladder would probably have gotten it strength back and my empty bladder would have been much healthier for the rest of the body. Too late now.  I'll continue to do CIC. 

I hope to  reach 88 someday. I like CIC.  It's the best feeling when the bladder is completely empty!  As for the big bucks, I guess it depends on the urologist. Eventually he'll have to become "thick-skinned" in order to make a very good living by not telling the entire truth,  After a while, they would be able to get some sleep at night. I think the human mind, is able to justify just about anything.

yes, it was not the best thing to go through.  It was 3 not 4 surgeries. 

Thanks for all the replies. I've only just realised there were replies. 

Thanks Jim for the tip on measuring bladder volume. I'll try this.

Again, I would repeat to anyone who has doubts about self-cathing, that, for me, I find it an effective and relatively convenient way to deal with problems caused by an enlarged prostate. I've found that emptying my bladder with a catheter gives me six to eight hours free of having to think about going to the loo. This means I can usually get a night's uninterrupted sleep, which is a relief after having spent years getting up between 2-5 times a night. I can also drink coffee and alcohol (in moderation) without concern. The main drawback is risk of infection; but I've also found that having the ability to completely empty my bladder is also an advantage when seeing off infections. I no longer take tamsulosin; but to go back to my original question, I've still got some retrograde ejaculation. It's better than it was, but not back to what it should be. But I'm not too worried.

John 

Sorry..  I know it was 2 two many  Take care  Ken

I thought I answered your question about retro from your first post awhile back. CIC isn't going to cause retro. It sounds like it's better than when you were on tamsulosin, but not as good as before. That's completely normal and can have to do with age and/or an enlarged prostate. My ejaculate isn't as strong as it was ten years ago, and I have had dry or partially dry orgasms occasionally as well. It's possible that a prostate reduction procedure could increase your ejaculate but also possible that it wouldn't. 

Jim

JIm,I have a question,i should ask my URO but i feel your answer is just as good if not better. {question}

Since I started doing CIC 1 year ago I stoped all medicine Dutusteride,flomax. I feel better since i stoped this medicine. Do you think i should be taken this medicine again?

Thanks Jim

frank,

John, I agree with you CIC is better than surgery. At 87 refused surgery. I have a question John? Can you do a natural void? I cannot--I have to CIC every 31/2  to 4 hours.Ican hold it for 5 hours i don't know if thats a good thing. If you can get 6 to 8 hours rest thats great. Tell me your secret? Do you still take medicine?

Thanks John,

frank

Hello Frank

Sometimes, in between CIC, I can void a small amount, but it will be enough to keep me going for another hour or two before having to use a catheter. Other times, I can't void anything at all – not a drop – and it's straight to the catheter. 

I don't take medicine. I used to take tamsulosin along with the CIC because I thought it boosted those small amounts voided in between using a catheter. However, sometimes the tamsulosin had no impact on improving my stream, so I haven't been taking it at all for four-five months and rely just on CIC.

I don't really have a secret. I drink normal amounts – four/five glasses of water/juice a day – but do find, occasionally, that I have to CIC more frequently than every 6-8 hours. Last night, for instance, I used a catheter about 11:30 before going to bed, then had to get up at 4:30 for same procedure, then again this morning at about 10:30. Getting up in the middle of the night is unusual for me.

I should add that I nearly always feel I've got a little bit of an infection going on or an inflamed urethra and that sometimes these can have the effect of making me want to void my bladder – and hence CIC – more often.

John

John, Thanks for that info. Did your Dr tell you why you are in retention?Is it your bladder? I know you have an enlarged prostate.I have the same problem John. I have to cath 6 to 7 times a day.I was thinking of seeing a void specialist like Jim mentioned.It would be great if i could cut down on CIC to 4 or 5 times a day. . I have to find a way to do this.

thanks John

frank,

 

Hello Frank

I was never given a specific reason for why I suffered acute retention but I think it was evident that it was due to having an extremely large prostate – around 110cc+ if I remember correctly – and a pronounced median lobe, the combination of which has really gummed up my waterworks.

I can imagine that having to self-cath 6-7 times a day can be a nuisance and the only thing I can think of is experimenting with your fluid intake. For instance, I restrict myself to one cup of coffee a day – never in the mornings or evenings – and drink alcohol very moderately – at Xmas, New Year, etc. I'm happy with this because, prior to self-cathing, I would avoid caffeine and alcohol altogether.

Good luck with trying to reduce need for self-cathing. Even at 6-7 times a day, I'd still recommend it over taking alpha blockers and Avodart, both of which have nasty side effects (particularly Avodart) and, for me, didn't work that well. As others have said, it's a great feeling having an empty bladder immediately after CIC.

Just to add: are you sure when you self-cath that you're completely emptying your bladder? I know that sometimes my self-cathing can be stop and start, so that when I think I've finished there's still more to come from some pocket I've missed. To get to this pocket, I have to move around a bit – a little Elvis-like wiggling of the hips can have the desired effect – and/or move the catheter an inch in and out, being careful not to remove it from the bladder, but reposition it within the bladder to get to the missed urine. 

I should also add that a lot of the choices I've made – preferring CIC over medications and surgery – is down to my age, and that these choices might not be right for those of a different age. I'm 53 and started having issues with not being able to empty my bladder in my mid-30s. This was wrongly diagnosed as an over-active bladder, and it was only in my mid-40s that I was diagnosed with an enlarged prostate and bladder stones. Even though I was still relatively young, my doctors put quite a lot of pressure on me to have a TURP, which, after investigation, I strenuously resisted. I'm still resentful of the fact that they put me on Avodart – which, after six months of taking and suffering the side-effects – I took myself off, without consulting my doctors. Last time I saw a urologist was about two years ago and was told to come back only when I was ready for a TURP. Since then, I've pretty much been treating myself.

I have two of the top URO docs in Texas. The lead URO at MD Anderson and the top doc/professor at UT Southwest in Dallas. They both suggest I stay with CIC and don't go with any rotor rooters. My prostate is over the top large BUT no cancer, I have had plenty of biopsies to confirm no cancer. So I will do my 5 a day forever I guess. Going on 8 years voiding 200 and CIC 400 down to the last drop!

 

Hi amiller,Thanks for your info on CIC,no roto rooters,meaing ,Turp,Greenlight I assume? I have been doing CIC 1 year.My prostate is 74 cc ,how large is yours. I was told my prostate was very enlarged.At 87 i refused surgery i think i made the right decision.

looking forward to your reply?

thanks

frank

8 years, doing CIC?  No problems with UTI"s?  After 8 years, is there a difference in the condition of your bladder?  Did it get stronger, so you can void better?

 

Hi John, I found out diet might have a important part in how many times i CIC. You are right about caffeine and alcohol. I also was taken Avodart and Flomax. I stoped after i started doing CIC.I don't know if the URO agrees with this? I also noticed exercise helps also. I wish i could get an erection,however i'm not sure if one could ejaculate having a enlarged prostate and a median lobe,which i have. You have the same problem. How long have you been doing CIC John?

frank,

You are SOOOO fortunate to have the urologists you have.   I was referred to a urologist who was from a very good medical school, so I went to him, and had the standard tests (urodynamics, ultrasound of prostate with probe, cystoscopy) and was told I had median lobe enlargement.  I asked about medications and was told that was not an option.  (I had a serious adverse reaction to Flomax a decade before and ended up unconscious with BP of 60/35 and rushed to the ER.)   I had never had acute retention, never had a UTI, never had an STD, etc.  I just had a slow stream and 3-5 trips to the bathroom at night.  But, I always went right back to sleep.

The doctor said I needed to have TURP, and if I didn't I could have acute retention, the bladder could stretch and just become "like a dead bag" that wouldn't work to expel urine, I'd have to have a supra pubic catheter or my kidneys would fail, etc.   Not one word about CIC as a possibility to help my night-time trips to the Loo.  I was so concerned that I quickly agreed to surgery.   I did go online and found a reference to Greenlight Laser, something the urologist had mentioned.  I called and asked about it, and said I liked the promised of less bleeding and asked if it would be possible.  Several days later, his nursed called back and said, OK, he said he would do the Greenlight.  Biggest mistake of my life.  That was on March 10 of 2016, a Thursday.  The catheter came out the next day and by the next night, I was in acute retention.  My wife took me to the ER, in so much pain I was brought in in a wheelchair.  It took forever to get to an open room, it seemed, and with much effort, a Foley was inserted.   The Foley was removed 5 or 6 days later, and I never regained continence.  After many months, I went to a different urologist who determined that I have a long stricture from the external sphincter out.  I've been to top specialists, and it is so complex that urethroplasty is not a very certain option.  So, I expect to live out my life this way, surviving with diapers or condom catheters and bags.  As I have constant leakage, is now been over 18 months that my wife and I have not had sex.

With all of the visits to other urologists I've had attempting to resolve the strictures, some across the US, seeking to find a solution to my problem, and the cost for Depends and condom catheters and collection bags, and skin prep pads and sprays, I've spent close to $10 K over those 18 months in non-reimbursable expenses under Medicare and BC/BS.

So, I will say again, you are really fortunate that you were presented to an alternative to TURP surgery.

 

Hi Glenn, did you already have low BP before the Flomax and er episode ? Hank

You poor man; I feel so bad for you.  I know what its like to have to live with incontinence; thank God for me it was temporary.  It was overflow.  Now that I'm cathing thats gone away.  

Its always seemed to me that almost everyone who talks about TURP, GrnLIght, HOLEP, whatever, never mentions anything about the urethra.  It IS a different entity is it not?  You know what I mean?  They say we have to cut out part of the prostate... but they can't get to the prostate without going through the urethra.  I always wondered why its seemingly never mentioned.  Is it just no big deal and it regrows with no problem?  Or is it because there's a passage there no matter what so the lining doesn't matter?  

Hi dennis, Thats great 8 years CIC no UTI.Do you have acute retention?No natural void?I have been doing CIC 1 year? I would like to ask you ,do you use BZK wipes? also how many times a day do you do CIC?I wash my hands always ,then use a BZK.So far so good.

Looking forward to your reply?

Thanks 

frank,

Hi Frank,   Yes Turp etc. I will not go that route what so ever. Sooner or later someone will find a way to end CIC. But I can deal with it with no problem. I'm turning 67 in October Don't know actual size of my bladder but I would hold sometime all day due to my job of editing video production with clients sitting in the suite watching. So my bladder stretched for years and I see no site in it shrinking. I have had biopsies almost every year since 2010. I see my Dallas doc for the Caths and keeping the UTIs down and get the prostate checked at MD Anderson 6 months later in Houston. I love the Cure Catheter HM14 out of 3 others I have used. Hardly know I'm using it due to the drain holds are supper polished and there's plenty of liquid to make sure it's lubed up all the way to the sleeve that helps me guide it in. As far as I am concerned YOU made the right decision. At 87 things don't heal near as fast as they use to. I'm seeing that at my age. Take Care Sir!

Not much change in my bladder at all Dennis, I CIC around 5 time a day now that I just retired. I have had my share of UTIs several times a year since I started in 2010. I keep a bottle of Microbid pills handy just in case. But I have been voiding more often and staying uninfected. When working I have caught myself only voiding 3 times a day. That's when I start making wine in there. And it smells bad. Now it's not a clear yellow as I would like, but it consistent and less smelly. Water is your best friend.  Wife & I are leaving for 16 days and I'm packing 70 Caths for the trip. Wonder what the Feds think of my luggage when they run it through? lol

 

I think I was about 60 years old, and my BP was always good....around 115-120 over 70.  I didn't consider that low.  I was active with plenty of exercise.  After the Flomax episode (a single tablet), I suddenly developed high blood pressure.   I was put on a low dose of Lisinopril (10 mg), and recall monitoring it while we were at the beach.  While lying on the bed, it was once 190/ something and that really scared me.   I finally got the BP under control with 20 mg of Lisinopril daily, and I continue that dosage at age 78.5.

You are exactly correct in pointing out that the urethra is cut or obliterated as the prostate is opened up by cutting or laser obliteration.   I suspect that in my case, the surgeon accidentally engaged the laser in the "no touch" area where the sphincter is, leaving me with the long stricture (scar tissue) that I have.  It's essentially irreparable.  I was really distraught, needless to say and started asking my doctor about getting an artificial sphincter.  He said he didn't want to even talk about it until least a year after surgery as it would me "we" were admitting failure.   I learned too late hat in our state, there is a one year statue of limitations for filing a medical damage suit.  I would give any amount of money to be the person I was before the Greenlight procedure.

Glenn, how did you get to 60/35 BP from high to normal BP ? You could have had a stroke. Hank

It was the adverse effect of a single Flomax tablet that dropped my BP.   I never took a second Flomax.  Then I soon developed the high BP that required me to take a med for management.

Glenn

WOW! What an adverse effect, no kidding. Hank

Yeah, my new and much younger urologist after we reviewed all the things that have gone wrong, especially the Greenlight Laser disaster and the strictures and incontinence, said, "You've had a real $hitstorm of events."

Frank,  I think there's some kind of misunderstanding.  I've been doing cic for a little over a year.  At least two times a day,  sometimes three.  I can natural void a little, not much just enough so that I'm not in complete retention. I use hydrogen peroxide to wipe the head of the penis before inserting the catheter. The reason for peroxide, is that because I am doing it constantly in the same area, I thought it best not to use alcohol or some other kind of disinfectant, just in case too much chemicals, may produce other problems.  Hydrogen peroxide, if It's food grade can be taken in internally, I beleve.  I never wash my hands before cic. I just make sure that the tip of the penis, has been sterilized.

Dennis, Thanks for this info.Did you have surgery  on your prostate?I'm trying to figure out why i have to CIC 6 to 7 times a day, of course i don't have a natural void.

Thanks 

frank,

Hello Frank

My very large prostate and median lobe don't give me problems in terms of erection – which is a lot better since I stopped taking tamsulosin – but I do have some retrograde ejaculation still, which I don't know what to put down to. Jim has said that he doubts it's anything to do with CIC and I tend to agree.

I've been doing CIC for about 18 months now; sporadically at first, and more regularly, on average four times a day, for about a year now. Also, I've been trying to take on board Jim's suggestion about not letting the bladder get too full before doing CIC as a way of rehabilitating the bladder and improving stream, and I think this is very good advice.

John

Hello amiller

I'm from the UK, and our health system is a bit different to yours in the US. Ours has its advantages, but it's pretty hopeless when it comes to fairly benign and chronic conditions like an enlarged prostate. Basically, my impression has been is that the doctors simply want to get you off the books by giving you a TURP so that they have the time to deal with more serious urological conditions, prostate cancer, bladder cancer, etc. It's understandable from their point of view, but not from mine. 

Hi John, Thanks for that info. John can you do a normal void? I can't do that. I wonder if this is a reason for not getting an erection?

Thanks John for this info.

frank,

No chance of a normal void, but doesn't seem to harm erections. Are Viagra/Ciallis not good for you? 

Thanks John,

frank

John, This is a question for a urologist , one that would answer. If having ejaculations ,is it possible  to shrink the enlarged prostate?Any thoughts on this John?

frank,

I always thought the issue with ejaculations and prostate surgery wasn't that the surgery would result in an inability to ejaculate but that the ejaculations would be dry (retrograde ejaculation). The promise of some of the newer treatments – embolisation, ablation – is that they preserve ejaculation. Indeed, some proponents of embolisation have said it improves erections. As far as I'm aware, there is a connection between an enlarged prostate and erectile dysfunction, but this is not uniform. Some BPH sufferers seem to have ED, others, like myself, are more lucky. Again, though, is Viagra not an option for you, if you're worried about ED?

John I wasn't so concerned about ED,i was saying perhaps ejaculations could shrink the prostate? Just a thought?

frank,

Hi John,My urologist tells me not to wait more than 6 hours to CIC,don't  go beyond 6 hours.I was concerned if your urologist said the same thing?

Thanks John

frank,

Hi Frank

I was told four times a day by a nurse. I was shown how to use them once, then given a load and sent on my way. Every six hours sounds about right. Not too sure about your theory about ejaculations shrinking the prostate. I've not heard that before, though ejaculations certainly help, for me at least, with my flow immediately after. I can virtually do a normal void after ejaculation. I don't know why.

John

Hi John ,4x a day sounds great. Do you get urge to pee , or do you do CIC after 6 hours ,even if you don't get the urge to pee?

Thank John

Hi miller, Thanks for your info, its always good to hear from someone who has the same problems.You have been doing CIC a lot longer then me.You say you get the prostate checked every 6 months? Can you tell me what test they do to check your prostate. I have not had my prostate checked in a year.

Thanks my friend, amiller

frank,

Frank, yes what the uro did was ream out the prostate.  It was blocking the passage way so he got his device and from what I can tell was to burn out a hole through the prostate. Got rid  of all that extra tissue, and make a wider opening, so urine can pass through.  I think your prostate is swollen, so it is blocking the urethra.  Are you OK, with going 6 to 7 times a day?

Hi Frank

I used to wait to get the urge to go before using the catheter; but following on from what Jim has been saying about not letting the bladder fill beyond 400ml, the last week or so I've been trying to CIC every six hours or so regardless of urge, and I've been finding this very beneficial, in terms of a much smoother process – the catheter seems to slide in better and I'm not getting hard to reach pockets of urine – and today, when I tried to void on my own, I had some sort of stream going, which is very unusual for me.

John 

Hi John,Thanks for that info John, Jim is so right,we are blessed to have him on this forum.Glad to hear you can have a natural void.I have got to find a way not to cath so much.My output most of the time is under 400ML.I can hold it for 5 hours,and sometimes 6,maybe it just takes practice.With me i always get the urge,however, sometimes 1 or 2 hours after cic.Well I think we made the right decision,no surgery. 

Thanks John

frank,

 

Hi Dennis, I don't mind having to CIC 6or 7 times a day however i hope i can find a way to cut down to 5times.

Are you doing well since your surgery? i beleive you said it was Turp or Grennlight ? I do have an enlarged prostate with a median lobe. I was told,the Uro Lift would not work for me. I am still thinking about getting the surgery,but  at 87 i'm not sure?

Thanks Dennis 

Frank, I had the greenlight laser done first, then the next two times were the turp. In my case, the prostate must have grown back, so here I am about a year after the second turp, and doing CIC. Did you consider doing Holep procedure?  If you are going to do surgery, sounds like the Holep is the way to go for very large prostates.  You must be in great physical shape to be able to have the coordination to do CIC?  At my  age of 68, I notice my balance is not what it used to be.  At night, if I have to walk in partial  darkness, I feel off balanced.

You DO know don't you that you can sit down and do CIC; or lay down for that matter.  I prefer to stand. To me doing CIC doesn't take a whole lot of coordination; does take some I suppose.  Usually I'm not under some kind of time constraint because I'm retired but its a pretty simple procedure.  I'm having to do @ 4 times a day.  Still sleep about 6 hours a night which, fortunately, I'm kind of used to anyhow.  Even after sleeping 6 hours when I get up in the morning I don't feel the urge at all.  In that case after about 45 minutes I cath anyway.  Last couple of days I only get @ 300 cc for my first one.  So nice not to have overflow incontinence at night.

Hi Dennis,I have a night lite in my bedroom and my bathroom. I watch what i eat ,cut down on coffee and fats. i walk 3 times a week left some weights and keep my weight down.Exercise is really good for the prostate.I read where "Advance Prostex"  will shrink the swoolen prostate?It sounds to good to be true.I might try it.Wow! You had greenlight ,then Turp 2 times,and now your doing CIC.What went wrong? Sounds like a law suit?After the Greenlight how long did you wait to do Turp?

frank, 

I think it was around 2 or 3 years.  AFter the greenlight, I still had to be on doxazosin.  It helped to get the flow going. Now with CIC, no medication at all!

Hi Keith, only 300cc overnight is very good. How do you manage it ? By limiting liquid intake ? What is your total daily intake ? Hank

Hi Dennis,Thats one of the nice things about CIC,no medicine? Are you able to have a natural void?

frank,

I must confess I don't meter my daily intake very well.  I just take a shot of water sometimes when I'm thirsty.  Also drink probably 8 cups of pretty strong coffee black every day.  I say like 6 oz cups.  However, I do stop the coffee a couple of hours before I try to sleep and, since doing CIC, I also stop the water.  I just finished hep c treatment in July and was drinking about half my body weight in ounces for that.  That was before I realized I was in trouble with retention.  I knew I was not draining naturally very well; frequent trips, urgency, then overflow incontinence; and my good ole country doctor didn't figure it out I guess.  I was unaware of this problem myself.  I was nervous about the side effects of the DAA drug but it was nothing compared to how the urinary retention was making me feel.  So much better now.  

Sorry such a long reply.  Probably the reason I posted was I have noticed and am a little curious, that I am back to cathing about 3 times a day.  I'm going in this week for my 12 week SVR on the hep c (hopefully undetected) I think there is a delayed effect of several days with one's bodily fluid levels.  There is an immediate effect but I think there is a long-term one as well.

Thanks Keith for the response. It is amazing that you have little urine overnight and you are not limiting your fluid intake at all. I thought maybe you have a trick  that others and I can pick up from but I guess not. Glad for you though. Hank

Its almost as if my system shuts down at night, which is good I guess.  Only the last week or so have I been able to only do less than 4-5 CIC a day; once I do the first one in the morning I don't usually go too long before I have to do another and then sometimes the 3rd one is only a couple of hours.  Right now I'm really not able to go by the clock or by feeling alone;  I'm kind of using both.  Been keeping a log as Jim James suggests.  Trying to keep it under 400 cc. all day and night.  I'm probably not getting enough sleep. Sometimes able to do an NV before cathing but its usually less than 70cc.

Yes, but not good.  I still have to do CIC. Today I did CIC three times.  Once in the morning, then early afternoon, and the last one at 6 PM.  I have a natural void, but not much urine.  Enough where I can keep from feeling too much pressure, but I still need the catheter for a full void. I am wondering if JimJames, has an exceptional bladder?  I keep hoping that I'll be improving as time goes on. No use "kicking a dead horse" as the saying goes, but I wish I had the choice of doing CIC when I first started having problems with my prostate.  Perhaps, I would be in better shape now.

Hi Keith, i am just the opposite of you. My kidneys don't make much urine in the morning, but a lot at night. So now I only sip water after 2pm. I also eat all my wet foods like fruits, vegetables, soup, rice, pasta, etc.. during breakfast and lunch. Yet I still have to get up once a night to pee. Before my liquid restrictions, I used to get up every couple hours.

Hank

Hi Dennis, I am surprised that you are not cathing just before bedtime. How do you manage from the last cath at 6pm to morning, without much natural void ? Hank

Hi Dennis, Jim is a blessing to all of us on this forum. I don't have a natural void, but i never had surgery, I been doing CIC,i refused Turp and Greenlight. IYou said you had this surgery,and still have to CIC? It seems a lot other guys have that same problem.Hope you start feeling better.My problem now is i have to CIC at least 6 times a day.

frank,

Just for the record I would have to say I cath on average more like 4 a day.  That's what me prescription is for and thats typically what it turns out to be.  Not regular at all.  This A.M. I got up around 8:30 because I couldn't go back to sleep and was feeling kind of restless; tried to NV but nothing.  Waited about 45 minutes, got kind of an urge.  NV @ maybe 30cc; cathed and got @300 I'd say; maybe a little more.  Then 3 hours later got a pretty strong urge; double-voided over the course of next 30 min. Second void I cathed and got another 360 or so.  My first 3 or so usually go like that.  Not drinking much water or other liquids but drinking strong black coffee.  I take several herbs and drink water or milk or juice with those and sometimes take a shot of water when I'm thirsty.  I'm sure if I drank more water; especially with the coffee working as a diuretic I would be getting larger cath volumes.  

 

Hi Keith, what would you say your typical diet is like ? Low or high fat, carb, protein, sodium, etc. I am looking for a clue here. Hank

Hi Hank.  Probably your everyday American diet.  No sardines though  I often crave sweets and salty stuff like pretzels or potato chips; but I don't eat too many at a time.  

I'm not working now; recently lost my job with USPS as a contractor mail delivery person.  Since I'm not working - maybe have to retire at my age 65 - no real career - So anyway, I'm able to sort of fall asleep on the couch until I REALLY get sleepy and then go to bed.  I've spent a lot of my life playing in saloons when I'm not on my day job; so I'm used to staying up late.  If I go to bed around 11:00 or 12:00 I'll sleep a couple of hours and then wake up.  So I usually cath @ maybe 2 AM before I try to sleep for awhile. Plus I pretty much quit drinking anything after about 9:30 or so.  I don't worry too much about sleep; maybe I should.

The reason for the 6 PM void, is that we go out to dinner at 6 PM amd so actually my last cic is at around 5:40 PM.  This way, I can eat comfortably without having to be concerned about using a restroom.  Depending on how much water or tea that i consume at dinner, I'll get up maybe three or four times at night to use the bathroom. I am a light sleeper,and so I am always getting up, and falling back asleep during the night.

Frank, I called and made an appointment with my urologist.  I woke up this morning and urinated blood.  It was pretty bright red, and so I was very concerned.  The last time I had blood in my urine, it was because I had bladder stones.  That was about three years ago. The urologist goes in with a laser and zaps the stone, then vacuum it out. By the end of the day today, my urine was back to normal color. I'm still going in on Wednesday to get it looked at.

Dennis. i hope everything will work out for you.Don't hesitate to go to other urologists for other opinions.

I have been to 6 urologists.

frank,

 

Hummm Keith. Everyday American diet. That means high sodium ? That may be the reason. Sometimes when I had salty foods for dinner, I didn't have to get up to pee. Time to order some sea salt. BTW, sleep is very important, second only to the sardines. 😁

Hank

I seem to be in a state of flux right now.  Things seem to be changing, but I haven't quite figured out myself what is causing what.  This morning i had a strong urge right when I got up after sleeping about 6 1/2 hours.  When I am laying in bed I don't feel an urge; just restlessness.  I have to get up and walk around a little before the urge comes.  I was able to NV around 80cc which is an anomoly for me, especially lately. Then I CIC and did about 360.  Then about 3 hours later after having had a couple of urges during that time, I cic again and got 430.  Then about 2 hours later I had to do it again.  After one more later around 6:00 it definitely has slowed down.  I don't know; but I'm still very grateful that I discovered this support for intermittent catheterization.  Thank God, I still have all my options open to me.

Hi guys struggling big time at the mo. I CIC 4-6 times per day and have got the residuals down to around 300 which is much better than before. However I appear to have developed prostatis as a result CIC'ing or the camera which went in a few months ago - boy did that hurt. I'm getting a creamy discharge at the end of the CIC void. Dull pain, urge to go, water samples show no UTI. I'm 2 weeks into a 6 week course of cipro and the symptoms haven't really improved. I'm losing the will to live with this awful condition. Anyone out there been here ? I'm 48 yo.

How do you know it's prostatitis ? Hank

A while back when I was using non-hydrophilic I was using a different kind of surgilube to coat the catheters.  Anyway, I was a little alarmed once or twice to see the discharge you described as I cleaned up.  Now I think it was just the lube stuff coming out.  What kind of catheters are you using?

I was diagnosed with prostatitus as a result, I think, of having chronic urinary retention for so long unbeknownst to me.  Finally with a urine sample my local doc diagnosed me.  Put me through two rounds of two different antibiotics Cipro being the last one.  I did get rid of the UTI or prostatitus as a UTI is called in men.  My doctor told me that UTIs in men are almost always centered in the prostate. 

Uro suspects I have prostatitis, symptoms mirror exactly, recurring pain, negative samples etc. Now going through the ruling out process which is likely to take months. I am using the speedicath flex hydro's. Did wonder whether the lube they pre-apply aggravates the prostate, however not seen this reported elsewhere.  The frustration for me is that anti'bs have an initial benefit but eventually conditions return. Surely the cloudiness (which isn't from the caths) has to mean some kind of infection down there ?

 

Tim and Keith,

I am also using Coloplast SpeediCath straight and have noticed significant variations in the quantity of saline fluid which serves as a packing medium then as a lubricant. Those times that I seemed to be short on lubricant would often result in a catheter stuck at the inner (bladder) sphincter during withdrawal, particularly if I had taken too long to complete the cathing procedure, >15 secs. Not good.

I’m currently in the process of evaluating a different brand of catheter which has won high praise from some of the members of this forum. I should have results to post towards the end of October.

In closing, I notice your mention of Cipro as one of the antibiotics you are using. May I suggest you Google Cipro, if you haven’t already, and Fluoroquinolone Toxicity Syndrome in particular. There are several relevant threads here. Draw your own conclusions!

I wish you both the very best in resolving your urinary issues. Alan.

 

I assume they did a culture and the bacteria was sensitive to Cipro? It could be CIC and/or your cystoscopy. Did they give you one or two antibiotic pills at the time of cystoscopy? It may seem counter intuitive, but you really want to cath more, not less, if you have a UTI which could be the case.  More cathing means less stale urine. You say your residual is down to 300ml, but what about the void just preceding the residual? The total should be under 400ml to keep the bladder from stretching and the urine from getting stale.

Jim

@keith: I seem to be in a state of flux right now...Then about 3 hours later after having had a couple of urges during that time, I cic again and got 430.  Then about 2 hours later I had to do it again.  

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

Hi Keith, Apologies if I answered this before, but I'm catching up on a lot of older posts. 

There are multiple factors that effect voiding volume and patterns, and trying to isolate can often be frustrating. This doesn't mean that you shouldn't try various strategies, but in the beginning sometimes I think it's best to just "go with the flow", pun intended  

As long as you adjust your cath schedule so that your total bladder volumes (cath void and natural void just preceding it) under 400ml, don't be overly concerned about the void volumes and patterns. Just give it some time. 

Jim

No pills Jim. Straight in there without too much warning. 4 girls (trainees) watching too. Not too fussed about that but doesn’t exactly help one relax. I am convinced this caused the flair ups and the cathing since just aggravates it. I was recommend to use ibuprofen and have started trying this. It does seem to help and appears to have reduced the pussy wee bit (for a better word !). Early days 

Hi Keith, I tried your typical American diet (salty) dinner for few days and voila, the result is just like what happened to you: no night  urination and lots of pee in the morning. The only problem is my blood pressure was elevated a little bit, not too bad really. Before the sardines, Jim James used to eat a bag of potato chips before bedtime, achieving the same result. Hank

>>just like what happened to you: no night  urination and lots of pee in the morning.<<

That is what happened THAT time.  This morning I had slept about 4 hours then had to get up due to discomfort & restlessness.  I won't lay there long if I can't sleep. Cathed about 360 then again @10:30 a.m  I think that was a pretty small one @320 or so.  Then the rest of the day hardly anything.  No urge and I cathed one more time.  Urine was quite dark yellow and it was only about 210 or so; after 6 hours.  I hadn't eaten any breakfast.  In fact about all I did was drink black coffee.  I had to go to a band rehearsal and I didn't want to drink water with my coffee because that causes me problems.  

Like Jim James says, it can be frustrating to try and predict and schedule this at first.  I'm taking saw pomento w/pumpkin seed oil but I don't really expect to see any effect from that for a few months if at all.  

Ah ha ! It is hard to keep a schedule with band rehearsals participation. Eating and drinking are both out of wack. What do you play ? Hank

I'm a drum-player.  Trap set so I'm sitting a lot but at rehearsal I can stand up a lot.  I don't do it for a living at this point.  

They should have given you prophylaxis antibiotics at the time of the cystoscopy. Did they do urine culture before prescribing Cipro? 

Jim

I was a keyboarder. Quit after it started to affect my health. Late nights messed up my sleep. Junk foods raised my BP. Now, less money, better health. Hank