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For those new here, three years ago I went into what can only be described as near chronic urinary retention where my bladder had lost so much tone that the only way I could void was to push hard on my abdomen (Crede Manuever). That meant I literally had to pump the urine out.
Not as many options then, and my doc suggested TURP, the only procedure his hospital performed. I ended up deciding against TURP and went on a program of self catherization (CIC) starting at 6x/day. My doctor said it was my choice, but unless I had an operation I would never be able to void normally without a catheter. He was wrong.
Three years later I am voiding normally without a catheter and for all practical purposes have almost no symptoms of LUTS/BPH. If interested, more details in the self catherization threads I started.
One technique I used as part of my bladder rehab process is for lack of a better name the “on/off” strategy. Actually in the beginning it was less of a pre-planned strategy and more of what I was doing, but then as results came, I made it a strategy. So here it is. YMMV.
Starting around the six month mark, I would switch from 4-6x daily CIC to either once or twice a day, or no CIC. Sometimes I stayed off the cath for a day, sometimes for a week, sometimes a month or two.
During the off the cath periods, I would assist my voiding sometimes with double or triple voids, easier voiding positions (reclined back in a chair) and at times some gentle Coude (mostly tapping). And very important, I would check my PVR's periodically via catheter to make sure my bladder wasn’t getting too stretched out. Void logs also helped in this regard.
Then, at a certain point, usually when I got fed up with the off the cath route , I would go back to an aggressive cath schedule of 6x/day for a period of time which was really much easier for me. Just cath and be done. No double, triple voids, etc. So that was the cycle, off the cath, then back on agressively. And then I would repeat. At one point I used daily Cialis during the non-cath periods but most of the time not.
My theory, and it’s only that, is that the on/off CIC helped my bladder rehab in the same way as muscle development is helped by hard/easy days or weeks. The time off CIC was the “hard” period that stressed my bladder muscles. The time back on CIC was the “easy” period that gave it a rest.
Obviously, if you’re not having any natural voids, or very little natural voids, this will not work. However, if you have a decent mix of natural versus cath volumes, you might give this a try. And again, can’t emphasize the importance of periodically checking your PVR through void logs and periodic reality checks of self cath’s during the “off” period.
Alternatively, you could check your PVR at any point in time with a home bladder scanner which I didn’t have then, but have recently purchased.
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