Self Catherization: Issues and Problems

I'm just so glad and its a Godsend that I can cath & relieve the pressure.  Thanks so much for legitimizing it and making it an alternative to other, actually bad options we have right now.

Hi Keith,

Can't hurt to see how you will react to Flomax and/or Daily Cialis. Both work similar but the latter a better sexual side effect profile.

A couple of thoughts as to the "push" or what I would call straining with some pain. I also have gotten this from time to time, both when I did CIC, and now when I don't. I've also dealt with it in different ways, at different times. I'm assuming this tends to happen when you bladder is on the full side?

At one end of the spectrum, if I felt painful resistance, I just stopped trying to do a natural void, and just went straight to CIC. In fact, I did this 100% of the time in the "on" phase of my "on/off" strategy. The idea here was to rest my bladder as much as posssible. At the other end of the spectrum, I pushed through it. This would be the "off" phase, where I guess the motto is "no strain, no gain"

Inbetween, I found that if I walked around for a couple of minutes -- deep knee bends also seemed to help -- that the strain would either lessen or completely disappear. If you haven't tried this, you should. In addition, you can try double voiding and time voiding where you don't wait for the urge, but try and see if you can void anyway. This will keep bladder volumes lower. 

As to the kidneys, I was told by my former urologist that kidney damage was unlikely as long as I was able to empty my bladder completely at least once a day. In your case, you empty it completely multiple times a day with CIC, so you should be OK in spite of the straining. 

That said, who knows if he's right, so the best thing is to have periodic kidney function tests via bloodwork, as well as periodic bladder/kidney ultrasounds to check for hydronephrosis. Why guess?

Lastly, I didn't know if you were speculating or not by waiting six hours, but at this stage I'd still try and keep total volumes under 400ml so the bladder won't stretch. Maybe, if you try the "on/off" strategy at some point, you can experiment with higher volumes intermittently. 

Jim

>Maybe, if you try the "on/off" strategy at some point, you can experiment with higher volumes intermittently. >>

Thats what I"m aiming for.  Thanks for the quick answer.  BTW - I was going to try 5 mg Cialis but I checked on the price.  About $130 a month and my medicare part D plan doesn't cover it.  Might be worth a 1 month try though. 

Urologist wanted to put me on Flomax and another prescriptions drug; an Alpha reductost inhibitor or something.  I talked them into letting me use Saw Pomento instead but they did want me on the Flomax.  

Keith,

It's unfortunate that such a fantastic option often gets so short changed at the urologist's office. Yes, some of them "support" it but often damning it with faint praise! Others, just use it as a stop gap or for some very short term rehab pre or post op. Some as a last resort, and some don't even mention it and use a Foley instead. 

But you, myself, and others know what a super low risk life changer CIC can be! Overnight, you can literally cure as many, if not more, of your BPH symptons as well as any procedure or operation including the so-called "gold standard" TURP, but without any of the side effects!

I don't know if it's the act itself, it's association with a Foley and bag, or the attitude of the urological community -- but CIC has a stigma attached to it that I believe prevents a lot of men from even trying it. 

I personally felt that stigma when I walked out of the urologists office after doing CIC for the first time. I felt depressed, defeated, like my life was over as I knew it. Boy was I wrong! Within a few months I realized this was the best, coolest thing that could have happened to me, and just wished I had started doing it years ago.

I think my feelings are shared by many in the CIC community, but unfortunately those who haven't tried it are often either not exposed or simply scared away. 

Jim

 

Keith,

Check the Cialis web site. You should be able to get the first month for free or a $200 off coupon, if they're still running it. My Medicare rx plan covered it but I still paid around $100 a month.

Jim

Keith, 

Like I mentioned, can't hurt to try with Flomax or Cialis, I'm a big fan of rational experimentation. See how it goes but no reason to continue if the benefits aren't there. Remember, CIC will protect both your bladder and kidneys so no worry there. Not sure if Saw Palmetto will make too much of a difference.

Jim

Hi Keith,

MY on/off strategy (can not let Jimjames claiming all the patents.) is taking doxazosin (~flomax) for a while to let the bladder rest (ON) and then stopped or reduced it for a while (OFF), repeat. This seems to help me. Hank

My attorney will be contacting you shortly

Hi, Keith,

You might research the side affects of Flomax and other BPH drugs, if you haven't already. Someone on this forum posted that Flomax and Rapaflo can cause Floppy Iris Syndrome, making cataract surgery difficult. I have a family history of cataracts, so I took that into consideration before declining my uro's drug treatment plan. I opted to do CIC instead.

Stebrunner

I had cataract surgery about two and 1/2 years ago.  Not entirely happy with the results however.  I may have to go back for some tweeking.  I don't like taking something orallly that is supposed to affect only one part of your body.  If it can affect and relax the muscles in my prostrate and in my bladder then what about my other muscles.  That probably a very laymans viewpoint but hey, I am a layman.

You mean: you take the flomax while cathing (ON) .  Does this give the bladder a rest?  If the drug works fairly well while taking it one would have to use less catheters right?  I don't think I understand you.

Ignore the cathing for now. I take doxazosin (similar to flowmax) for a few days to give my bladder a rest. Then I stop taking it for a few days, letting my bladder do all the work. The cathing is extra, only to make sure your PVR is not too high, to protect your kidneys, and UTIs. If your PVR is low, you can skip the cathing part. Right now I only cath once before bed, and occassional at different times for checking. Hank

Keith,

I probably shouldn't have brought up the whole "on/off" thing, and you should probably ignore the concept for now. You're new to CIC and that's really down the road. That plus, what I was talking about and what Hank is talking about are related but different. 

To answer your question, Flomax can sometimes decrease the frequency of CIC. Easy enough to find out. The question then is whether or not you prefer a decreased frequency with the side effects of Flomax (or Daily Cialis) or an increased frequency without any drug side effects. When I was self cathing, I finally choose more cathing and no drugs. 

Your other question about Flomax giving your bladder a rest. Flomax can give your bladder a rest during a natural void, but given your agressive cah schedule now, your bladder is being given the best rest by not having to work with CIC. 

So again, no harm in trying Flomax or Daily Cialis while you self cath. But it's not necessary.

Jim

Hi newbie, we must have confused you a lot (mostly Jim though, don't you think). Jim and I just have a slightly different approach (no patent claimimg here, so there is no reason for attorney threat. ) Jim is almost all CICs. I am CICs + meds. Both approach seem to rehab bladders. I started out cathing 4,5 times a day for 8,9 months due to the high PVR. Since my bladder tone has improved (lower PVR), I slowly decreased the cathing frequency and I am now a year later, only cathing once before bed. I have been taking doxazosin this whole time but lately I have been experimenting with stopping it days at a time, hoping maybe I will be able to get off it too. Hope this clears up any confusion that Jim caused. Hank

How caring of you to touch on this.  Seriously, feelings matter and yes, it has occurred to me that of all the tens of thousands of men that have this problem, there are just a handful on this site.  Its international isn't it?  

I felt so low before I discovered your advocacy.  I liked the releif I was getting from cathing and thought "I could do this for awhile."  I was scared of going into surgery especially when I read about GL and wanted to think about it awhile.  This has been invaluable to me being able to find Patient and especially sharing, intelligent men who have been through what I'm going through.  

@hank: Hope this clears up any confusion that Jim caused.  [smile]  Hank

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LOL. But seriously Keith, you should ignore the discussion I'm having with Hank about "on/off" strategies (I'm trying hard to  because really not relevant to what you're trying to accomplish right now. 

To keep things simple, you can self cath with Flomax or without Flomax. At this stage, the  main thing is to keep emptying your bladder completely and try and keep volumes under 400ml. CIC can do that.

Jim 

 

OK. OK. I agree. Hank

Keith,

I hear you. I felt exactly the way you did when I first walked out of my doctor's office with the handful of catheters the PA gave me. 

Just know that you are not alone. Self cathing (CIC) has been around since Roman times and I believe it was Ben Franklin who made one out of silver for one of his relatives. In the 70's it was revived by the work of Dr. Lapides who developed a clean (as opposed to sterile) technique called "clean intermittent catherization" (CIC). 

It is now the go-to and medically preferred method of emptying the bladder of the SCI (spinal chord injury) community. 

We don't hear about it as much as we should because it doesn't fit neatly into the bph paradign which goes something like: watch n' wait -- take drugs -- if drugs don't work get operated on. 

Somewhere in that paradign should be CIC, but it's often left out, or pushed to the side. 

If this one thing I can impart at this stage, is that however you feel about CIC right now, your attitude will probably change dramatically in just a short matter of time. 

When I walked out of that doctor's office with the catheters that first time I felt depressed and defeated. A few months later I felt uplifted and liberated because I had found a solution I could live with.

I think people don't quite believe me when I tell them that CIC can within months be as easy and non eventful as brushing your teeth. But it became that way with me and others here as well. Just give it a little time.

Jim

Hank, If you haven't already, you should post your thoughts on this in the "on/off" CIC thread. They are consistent with the idea of alternatively relaxing and then stressing the bladder with the goal of accelerating rehab. 

Jim

I just want to pile on what Jim is saying. The fact is that for at least some doctors, their bread and butter is surgery. They know that the Medical Treatments they have cause unacceptable side effects. In those cases that's why they recommend them. When that doesn't work, the only logical conclusion that they can give the patient is, not surprisingly, surgery. That may also be why there are not any good medications without unacceptable side effects. It's difficult to believe that medical research couldn't do better after all these years.

Neal

I have a cystoscopy (sp?) scheduled for next week.  I'm wondering at this point if I need that.  I am not planning surgery any time soon.  Apparently, the  doctor wasn't going to scope me before he did GL because I was in the pre-op appointment one week before my scheduled surgery and they only offered to do it when I mentioned urolift to them.  This was the first time I'd seen my Urologist's PA and she seemed very interested when I mentioned the urolift.  With cathing about 4 times a day I don't know if I want the extra trauma that the scope might entail.  I've heard that it is not that traumatic.  If not, I guess just a little knowledge couldn't hurt.  They're pretty sure my blockage problem is solely an enlarged prostate but I would think they'd want to know for sure.  All they've done is the gloved finger test.  Ultrasound on my bladder but not prostate.

My cathing seems to be doing fine and I even have noticed a slight improvement in my NV, but my bladder has to get close to 400 ml before I get much out.  I've only been at it for about 2 months.  BTW - the deep knee bends do help.  That painful urge isn't near as bad if I'm careful about my coffee consumption.  At least that is my attribution.

In case you didn't recall, I did cancel that surgery but now have another appointment for just the cystoscopy.  Could you give me your opinion on this?

Hi Keith,

Don't see it necessary right now so it's a judgment call whether you want to do it this week, or possibly at a later date as part of an evaluation for surgery. Frankly, urodynamic testing will probably tell you more in terms of how much your bladder is impacting your bph versus your prostate. Both tests are realtively non evasive and you shouldn't really have much trauma since you are already doing CIC, the catheters of which are a similar size they use with both cystoscopy (I assume flexible) and urodynamics. That said, ask for prophalactive antibiotics for both, if they don't offer it. Have you had a bladder/kidney ultrasound? That's another standard diagnostic test and is totally non-invasive, so you could have that any time. 

Good that CIC is going so well at such an early stage. You seem to have adapted better than most. It took me months to feel comfortable. Deep knee bends are good to get the NV going, I have also found walking around for several minutes helps as well. It seems that doing a natural void after inactivity is the most difficult. I go on and off coffee, so not sure if it helps or hurts, but we're all different. 

Jim

Are you feeling the urge to urinate when you get close to 400ml or are you just doing a NV at that point because of your cath schedule?

Jim

No, I'm feeling it.  The other day I felt it; hadn't been but 3 hours since I cathed but I did it anyway and cathed about 300.  My 2nd and 3rd ones of the day after getting up and around evidently are going to have to be closer together.  I just did one today; waited about 4 1/2 hrs.  I just got back from a short ride on my Triumph motorcycle and felt urge to pee.  NV was 120; and CIC was 530.  Surprised me but I'd been drinking more fluids today.  This morning after sleep I could get no NV going; didn't feel it either.  Cathing was 450 after being in bed for about 5 hours.  Yes, excercise makes a big difference with me.

Urine production isn't even throughout the day, so sometimes you will get more than other times. Not always possible, but best to adjust things so total volumes remain under 400ml. That way the bladder doesn't stretch, hopefully will regain tone, and more natural voiding  then can follow. So until you get to the point where your bladder signals you at around 250-300ml, just cath anyway to keep the volumes down. 

Jim

Just to give you a personal reference, when I started CIC, I often didn't feel any sensation even when my bladder was holding over 1000ml. Gradually, I started getting sensation around 400ml, later even at 250ml although I could hold it till 400ml. This took me over a year. After three years of CIC my bladder regained enough tone that I don't have to self cath on a daily basis, in fact I've been off the catheter for several months. My bladder volumes now are always under 400ml and my natural voids are around 250ml. So after a single void, I'm probably down to 150ml and if I do a double void, I can get down under 50ml.

Jim

Got it.  You're experience is invaluable.  I guess I feel fortunate to already be feeling it at 350 or 400.  I'm hopeful.  I'm already sure I'm in a much better place just right now and tomorrow than I would have been if I'd have okayed the surgery on the 31st.  

JIm, Were you ever in complete retention?

Thanks my friend.

frank

Yes, I've been incomplete retention, but unlike yourself, it was intermittent and not chronic. When it did happen, I could usually go back to some sort of natural voiding after CIC. 

Jim

Jim, you must have had chronic retention (and acute also) if you had to cath for 2 years. Either I don't understand CUR or you are low on sardines. Hank

Hi Hank,

When Frank says he has "complete retention" he means that he has zero natural voids and must rely on the catheter 100% to void. 

During the 2 plus years I self cathed, I had episodes of not being able to void without the catheter, but much of the time I was able to have natural voids in varrying amounts. 

I have not had my sardines today (or even coffee for that matter) so hopefully this answers your question

Jim

@hank: Jim, you must have had chronic retention (and acute also) if you had to cath for 2 years.

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No sardines yet, but I just had coffee

Part of the problem is terminology. As best as I can find, "acute retention" is defined as a medical emergency where the bladder cannot empty at all. "Chronic urinary retention" is defined mostly as incomplete bladder emptying resulting in bladder stretching.

When you self cath, these definitions do not always work, since you can have no natural blader emptying without it being a medical emergency, because all you have to do is self cath. 

Like most in this type of cycle, I started with CUR with increasingly higher PVRs and a resulting stretched and trabeculated bladder with a diverticulum (pouch) probably formed from all that stretching. 

A few months before I started CIC, my bladder got so stretched my detrussors could not empty the bladder on their own and I started to use the Crede Manuever (external bladder pushing) to empty my bladder. By the time I walked into my urologist's office I was holding close to 2L of urine. I suppose this technically was still CUR, but very, very close to AUR.

Once I started CIC, sometimes could void on my own either before I cathed, or between cathed, but I still had residuals in the beginning as high as 1000ml. Gradually those residuals came down.

A couple of years later, my bladder was rehabbed to the point where I could go off the catheter for days or weeks at a time, with acceptable PVRs, meaning I did not have CUR. However, I still had occasionally episodes of AUR, usually with a very full bladder after inactivity. At this point, I would simply self cath. Sometimes these episodes of AUR occured once a day, sometimes just a few times a week. 

For the past several months, these episodes of AUR have been replaced by what I would term "strained urination". Happens about once or twice a day, with the same parameters (very full bladder and no activity) as my older episodes of AUR. While this means I don't need to use the catheter, I'm unsure whether this is a positive or negative development, as in theory it could suggest bladder stretching, or it could suggest progress. I am hopeful but certainly haven't thrown my catheters away!

IPSS now is still mild or at the mild/moderate border which is much better than I lived with for twenty years prior to CIC, so I'm content to let things ride as they are. Other than the occasional straining, the biggest problem now is nocturia, which I doubt would be helped by any sugery since in my case it's  more related to night time urine output than obstruction or retention. 

Of interest is that my nocturia seems to have gotten worse since I switched to a very low fat (under 10% total calories), low protein (close to plant based) and low sodium diet. However, my heart health trumps my sleep cycle, so not going to go back to a higher fat and protein diet to save maybe one trip to the bathroom at night.

Jim

OK Jim, explain it away. I still think you need more sardines. I had problems with too low protein diet before, but not any thing dangerous. Hope it will work out for you. Hank

Jim, straining can not be good. It and nocturia may be caused by your new 'low salt, low fat, low protein' diet. When I went for that diet, I had constipation, and it increased BPH symptoms. You may have constipation without knowing it. Daily BM does not mean anything unless it is substantial. Sometimes I did not know that I was constipated until I had a huge dump. Hank

The "straining" simply replaced my former sporadic episodes of AUR when I had to cath. Maybe once or twice a day, rest of the time things are fine. Correlates with a very full bladder and/or inactivity. Does not seem to correlate with constipation.

So the difference is that before I self cathed when this happen, now I don't have to self cath but I strain some. Not sure if this is positive development or if it suggests some bladder stretching, which could be viewed as negative. In any event, my PVRs are fine and I'm otherwise practically asymptomatic other than getting up once of twice at night.

Jim

On a positive note re the low fat, low protein diet. Total cholesterol below 150, LDL almost 70, albeit still on statins. LDL previously was over 100. Trying to figure out if I should stop statins now or just own these numbers for a bit. 

Jim

Jim, stop the statins. I just found out recently that too low cholesterol levels increase morbidity risk. There are many studies from all over the world confirming this. Basically, TC below around 160 and above 260 double the risk of TC of around 200 or so. Hank

I believe those studies are flawed or have been debunked. Most studies suggest a correlation between low cholesterol and a decrease in heart disease and stroke. So does the work of Pritikin, Ornish, Esselstyn, as well as various epidemiological studies such as those of the New Guinea natives where cholesterol is under 150 and heart disease non existent. There may be some controversy over statins, but not over low cholesterol.

Jim

So I just looked over some of those studies and the main problem I see is lack of cause and effect. In other words, nothing convincing that would explain why low cholesterol in the elderly causes earlier death. On the other hand, Ornish has shown plaque stoppage and even regression on a low cholesterol diet. 

One supposition -- again just a supposition -- is that low cholesterol could possibly make one more susceptible to other diseases like cancer. But even if this is the case, I guess one has to look at both their individual and family history and decide which poison is better. Cancer does not run in my family, but heart disease does. 

Jim

Someone did mention that perhaps too low cholesterol doubles the death rate, but those more deaths are from other causes, not heart disease. Similar story is some studies show that as far as morbidity is concerned, the best BP for kidney patients is 130-150/90-100 not the 120-80 or lower, with the implications that the lower, the better. Hank

The diet thing is very confusing with conflicting studies. Unfortunately, the only thing they seem to agree on is that chips are bad  

Anway, I'll stick with trying to lower cholesterol for now although pondering on whether to stop the statins. 

Jim

I also don't trust the pharmaceuticals. Years ago, 300 was acceptable for TC. They kept on lowering it and trained doctors to sell statins. There were some studies indicated that more people die from statins than from from heart disease. Of course, doctors will just say that they 'die from heart disease". Hank

Hi JIm, Today i had my cystoscopy ,my 5th URO.He said i have a very enlarged prostate,and a diverticulm, also median lob. This is all new to me since the last one i had 8 months  ago. He  said Uro Lift will not work for me i would need 6 implants. He recommends Turp or Gl. ,with no guarantees that i would not have to CIC after this procedure.The reason for this very enlarged prostate is age related.Wanted to know if i wanted a follow up vist,i see no reason for this.It appears i will be doing CIC forever.I asked if he knew about ITind? Never heard of it.I asked if medicine would shrink the prostate ,he said maybe in 20 years. I asked if CIC would rehabilatate the bladder ,he said no. Do you have follow up vists with your URO? What does he do?

Whats your opinion of this vist?

Thanks Jim

frank,

 

Hi Frank,

Yes, a median lobe can make Urolift more difficult but it should have showed up on prior cystoscopies and bladder/kidney ultrasound studies.  Did the doctor who recommended the Urolift look at those studies?

As to the diverticulum, it also should have shown up on prior cystoscopies and bladder/kidney studies. I would speak to whoever gave you the last bladder/kidney ultrasound study and get the report. It should tell you the size and location of your diverticulum. 

You know the issue you have of feeling like having to urinate shortly after CIC? It's possible that is because of the diverticulum. I can go into that in more detail once you find out where the diverticulum is located and how big it is. 

Once you collect your records, you might want to go over the  median lobe issue with the doctor who does the Urolift and see what he says. 

Jim

Hi Jim, This Uro i can't figure out.I asked for his email, gave me the wrong one. He said i had a very enlarged prostate and a median lobe,also diverticulum.He said this was age related. I said these tests i had done 1 year ago or less. This bladder/kidney ultra sound is this a blood test,or part of the urodynamics test Jim,If my prostate is very enlarged,would this be a problem if i just let it be and keep doing CIC?This Doc put more fear in me then i every had.Now he's at the UIC.I don't get it?This is the second cystoscopy .The first cystoscopy said i have an enlarged prostate about 4cm long with obstructing lateral lobes. Bladder normal ,no tumor,stone,diverticulum,or glomerulation.Prostate doesn't seem to large?

This sudden change has taken place since this was done August 23,2016.

I don't get it?

Thanks for your concern JIm

frank,

Hi Frank,

Sorry you're getting the runaround and confusion from the uro. 

"Age related" isn't very helpful, I guess what he means is that the enlargements are not cancerous, which is good. FWIW you can say BPH is age related as well, since it's not common in younger men. 

An enlarged prostate should not be a problem with CIC, in fact that's why most of us do CIC, because we do have an enlarged prostate. If it ever becomes a problem with CIC, that's a bridge you can cross another time but I wouldn't stress over it or let it effect any decisions. 

No, the bladder/kidney ultrasound is not a blood test and not generally part of urodynamics per say. It's basically like the office bladder scan but with better equiptment and they also scan the kidneys as well. Usually they will do a residual test (scan before and after voiding) but in your case you don't void. 

I assume you had a bladder/kidney ultrasound since its a basic test generally ordered before a cystocopy or urodynamics. Why don't you check with your old uro's and find out if you had one. If so, get hold of the full report for yourself. If you haven't had one, then I would have one scheduled, but no emergency on it. The bladder/kidney scan will give information on both bladder and kidney architecture, and will confirm if you have a diverticulum plus give the location of the diverticulum and its size. 

You say your last cystoscopy was August 23, 2016? When did you start to self cath? Diverticulum's in cases like yours are generally caused by bladder pressures from an obstruction so it should pre-date when you started to self cath. Self cathing will not cause a diverticulum, in fact it might prevent one. FWIW I have a large diverticulum myself. Nothing to necessarily worry about but again, I would find out its location and size with a bladder/kidney ultrasound. 

Jim

Jim,I don't recall having a bladder/kidney ultrasound. Would this be the same ultra sound they did to find i had 800 ml in my bladder that had to come out?This test like you said should confirm if i have a diverticulm?This sounds great ,then i should know if this URO is telling me the truth? Istarted CIC in October 2016.

Jim,what does FWIW mean?

THANKS SO MUCH JIM,

frank

Frank,

It could be the same test where they found 800ml residual.  Did they do it in the doctor's office or somewhere else? Do you remember how big the ultrsound machine was ? More answers will be on that report, so request a copy. FWIW=For what it's worth. 

Jim

Jim ,The bladder/kidney ultra sound was done in the URO office. THen they caterized me took out 800 ml

This was my 2 nd URO, who was not very nice.I refused to do the urodynamics test,never liked the office,he in return called my home and started telling me how long he was in practice and how dare me to tell him i don't want the urodynamics test.I will call the office to see if i can get a copy,however i doubt it?

frank

Hi Frank,

Maybe the best thing is for you to request a bladder/kidney ultrasound study from a uro you have confidence in. Right now it's unclear if you had one.

It's a fairly standard test to examine bladder and kidney architecture so I don't think you should have a problem getting it, plus it's non evasive so no down side. In addition to giving useful information on your bladder and kidneys it should show a diverticulum if you have one. 

No rush in this, but that is what I would do. 

Jim

 

Hi Jim, I asked for a coppies of the ones they did in the office, bladder/kidney ultra sound.

These copies should show if i have diverticulum? If they show no diverticulum,then i would know this last URO is corrupt?I also asked for a copy of the cystoscopy that was done Aug 9.

Thanks 

frank,

Frank,

I doubt very much a urologist would "make up" a diverticulum. Some more likely possibilities are: (1) The scan you had in the office wasn't a real image scan; (2) Your diverticulum wasn't large enough to be noticed or noted on the scan report; (3) You developed the diverticulum after the scan (very unlikely given the timing). 

Let me know what  the report says but I wouldn't stress over it because you can always have your doctor order a proper bladder/kidney scan in the future. While useful information, it probably won't impact your decision significantly in terms of any treatment although it might answer some questions you have regarding the void urges you sometimes feel after your CIC.

Jim

Jim, This URO also said i have a median lobe,diverticulum. When i get a copy of the cystoscopy it should say this right?My last cystoscopy in june 2016 said no diverticulum,nothing about median lobe

bladder was normal?

Am i right on this?

thanks 

frank,

By all means ask for the cystoscopy report, but what's on it will depend on how thorough the doctor was both with the cystoscopy and report. On the other hand, the bladder/kidney ultrasound will generate a picture of the bladder that can be put on a CD for your records. Cystocopies on the other hand usually aren't recorded so it's really up to what the urologist observed and recorded. 

Jim

Jim, They never did a bladder/kidney ultra sound. I also was told this test would not show a diverticulum?  They only did a bladder ultra sound.I don't get it. They said a ct scan is the way to find out if i have a diverticulum.

Whats your opinion on this JIm?

thanks

frank,

Are we talking about a bladder diverticulum or another type of diverticulum?

Any real time ultrasound bladder scan should show if you have a signficant bladder diverticulum. It could be just a bladder scan in the doctor's office, or part of a bladder/kidney study. The caveat is that it must be a "real time" scan that shows an ultrasonic picture of the urinary system as opposed to one of the popular digital units that only give a digitial read out of the residual.

If the diverticulum is elsewhere other than the bladder, or if it's small, then maybe a CT scan would show it better, I really don't know. 

Either there is a miscommunication probem you have having with your doctors here, or they are flat out misinformed. CT scans and MRI's can also be used. 

If it were me, and considering you apparently have never had an ultrasound bladder/kidney study, I would ask for one. If your doctor tellls you it won't see a diverticulum, see another doctor. You really want a bladder/kidney ultrasound irrespecitive of the diverticulum issue as part of your active surveillance strategy.

Jim

Hi Jim,  of this subject but have you heard about Quercetin with Bromelian  I'm thinking about taking this. Just read about it on another post now. 

Not familiar with either, but then again I am not really that well versed on supplements. 

Jim, When i had this last cystoscopy the Uro said i have a diverticulum

and a median lobe. Can a person have a diverticulum in the bladder as well as the prostate?I am getting a copy of the cystoscopy .

Thanks  Jim

frank

I'm assuming we're talking about a bladder diverticulum. See what the cystoscopy report says. 

Hi Jim, This is the answer i got from my Uro who was the best so far on my least. He said urodynamics test won't show diverticulum. Cystoscopy is the most definitive test. Maybe i should be lookong for another URO?

What do you think JIm?

frank,

Frank,

Yes, that is correct, urodynamics tests will not show a diverticulum. As I've said before, you need a bladder/kidney ultrasound study which will show a diverticulum. 

Jim

Hi Jim, This is the doctor who does Uro Lift.He's the one who gave me the cystoscopy,and said i have  a diverticulum,a median lobe ,and a very enlarged prostate.I had him write down his email and he did ,it was the wrong one,'no such address', I think he got upset with all the questions i asked. I think like you, if i had a diverticulum and median lobe,and a very enlarged prostate ,why did this not show up on my last coystscopy

frank,

I can relate. Doctor's sometimes have a short attention span when it comes to answering more than one or two questions or emails on the same subject. 

So, if the doctor seems uncooperative, I would call his office and tell the office manager you would like a copy of the cystoscopy report. I would also request your older cystoscopy report from the other urologist. I would also have a bladder/kidney ultrasound study scheduled with whatever urologist you feel comfortable with, or a new one.

No rush on any of this, as I do not think the diverticulum will significantly affect your treatment, however it is part of the overall picture, and you are right to find out as much information as possible. I certainly would. 

Jim

Jim