Self Catherization for BPH

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I'm 64 and was experiencing slow flow and was pretty sure I was not completely voiding my bladder.  Peeing several times a night and hourly during the day.  Mu Uro diagnosed BPH. I don't want to get hooked on meds. Initial cath'ing showed I was retaining 4 litres. Shocked, I am considering either a TURP or Urolift. Meanwhile I am self cath'ing and confirming that I do accumulate 4 litres of pee over a 3 day time frame. 2.7 litres after 24 hours! After cath'ing, I have no pee urge for 12 to 18 hours. This seems to make sense since my bladder is empty and, before this cath'ing started, apparently I was walking around with a gallon of pee in me which is hard to believe. I'm 8 lbs lighter after cath'ing!

Anyway, looking for recs on Uro lift versus TURP especially as it related to reducing retention. Or additional information on self cath'ing. I'm using the red ruibber cath with KY lub.

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  • Posted

    If you are holding that amount of urine, you are stretching your bladder and in the end there will not be any flow at all.  Also if urine is backing up to your kidneys...that is not good and could cause kidney problems.   You should self catheterize 4 to 6 times a day.  Even if you have no urge to do so.   If your are full of stale urine and you have an infection  that will not  be good.    As far as surgery is concerned that is a personal matter between you and the surgeon, but in the meantime make sure you drink plenty of water and void regularly to avoid damage to your kidneys
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  • Posted

    Hi Having had the same I had the same problem and the Urolift did not correct the problem thus opted for the Greenlight Laser from an experienced surgeon vs Turp.  I pee like a teenager, stop completely without dribbling, empty my bladder completely and ejaculate normally.
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  • Posted

    Hello and welcome. Yes, 4 liters is quite a lot to be holding so your bladder must be very stretched by now. Because of that, before you can even consider TURO, Urolift, or any other procedure, you must make sure that your bladder is strong and elastic enough to empty after the procedure. The best test for that is called Urodynamics. If your urologist hasnt mentioned it, he should.

    Meanwhile, self cahterization (CIC) can help you rehabilitate your bladder and get it ready for surgery, although there are no guarantees.

    I refer you to several of our self catherization threads for details, but very briefly you want to set your CIC frequency not by urge but by bladder volume. The idea is that your bladder should not be holding more than 400ml at any one time. If it does, it will remain in a stretched state. For someone like yourself, this generally comes out to cathing 6x/day.

    Self catherization thread: https://patient.info/forums/discuss/self-catherization-an-alternative-to-turp-greenlight-holep--336874

    Jim

     

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    • Posted

      Agree with Jim. And if you have enough bladder function for a prostate procedure to work, I would recommend against Urolift and TURP. If you're retaining that much you probably have a large median lobe which rules out Urolift and even if you don't, if your prostate is that big, you probably would be better off shrinking that strapping it. TURP is an outdated, highly invasive procedure with a long recovery and (although pretty rare) the possibility of life long devastating side effects like complete incontinence and/or impotence. 

      The go-to, non invasive non surgical procedure for most BPH is Rezum. Recovery can be annoying, but because you're already self cathing, other than some blood for a few weeks, for you it will be business as usual, until you start having better natural voids. But don't consider a procedure until a urodynamics confirms that your bladder functions well enough for any prostate procedure to help.

      Because you still have some natural voids - chances are decent that if it doesn't function well enough now, a good, timed self cathing regimen could get it there.

      Good Luck!

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  • Posted

     You may avoid cathing or surgery by requesting a prescription for a diuretic for retention. There are no side effects but you do have to drink a lot of liquids to avoid dehydration. Have been taking one small pill a day for over a year and feel great.
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    • Posted

      Hi Lester, diuretic is known to reduce water retention, usually to lose weight, but water retension is a lot different from bladder retention, which most people on this prostate thread have. All diuretic does is dumping a lot of urine into the bladder in a short period of time. This actually may present more of a problem for the bladder. The difficulty is how you are going to pee all that urine out of the bladder and that depends on the bladder strength as well as as any obstructions that are present. You mentioned that you feel great taking diuretic but have you actually measured your post residual volume (PVR) with and without taking diuretic ? Hank
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    • Posted

      I was admitted to hospital in 2001 with hypertension and had a stress test ECG that they said indicted blocked arteries. They kept me overnight to do an angiogram. At 6.30 the following morning they added a diuretic bendroflumethiazide and Losartan to the meds I was taking. By the time I went to the cath lab at 1pm I had not passed any urine. After the angiogram that showed the stress ECG  to be a false positive it was still some time before I passed anything. Over the next few weeks despite my BPH my output was well down and I developed pain in the pubic area and had to stop the diuretic. I tried it again a few moths later with the same outcome . 
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  • Posted

    Given your situation, I would not take a diuretic, as suggested, unless for some reason your urologist tells you to. My non professional view is that it could be counter productive and run you into real trouble given the fact you were retaining 4 liters.

    Jim

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