Self Catherization: Issues and Problems

Frank,

As I've mentioned before, I don't see any reason for you to be taking Flomax since you have no natural voids and it doesn't seem to be helping you with that. With dutasteride your doctor is trying to shrink your prostate. Has it shrunk any? Personally, unless I was getting a real benefit out of dutasteride I would stop that as well. 

I took Flomax a couple of times but stopped because not much of a benefit and I didn't like the side effects of feeling light headed and retro ejaculation. I never have taken dutasteride.

Jim

Hi Jim,I have been taken dutasteride for almost 8 months,no results still in retention.Jim did you take medication when you were in retention?If yes,did it help you?

Thanks my friend,

frank

Frank,

If I were in your position I would get off both of those drugs and see how you do without them. Again, I really don't see how they are helping you. Meanwhile the self cathing will protect your kidneys and bladder so I don't see any downside. As I mentioned, I took Flomax maybe for two to three weeks but only helped a little so I stopped taking it. I took daily 5mg Cialis for a couple of months and it helped a little bit more but I also stopped that. You could try the daily 5mg cialis instead of the Flomax but you may also find no benefit. You would know within a week.

 

Jim

Frank, As to the Dutasteride, why don't you find out what was your prostate size before you started taking it and what is your prostate size now. If it is shrinking then maybe worth staying on. If not, then again I don't see the reason you are on it.

Jim

Frank - try to get a prescription for alfuzosin (uroxatral). It is an alpha blocker like flomax and the one in cialis but was much more effective for me and with no side effects. I have used continuously for 13 years. It works in a couple of days. Give it a try if you can - it may help you.

Hi Neil, I can't have a NV.if i don't do cic i cant pee. This Cialis has a side effect that scares me. It can cause sudden cardiac arrest,{don't sound good}.I was taken Alfuzosin,then switched to flomax,i beleive i am going to get GL surgery after i do urodynamics test,thanks to Jim for telling me to do this first.

Hi frank, I am taking 4mg doxazosin and it helps me with NV. Uro prescribed 8mg but it lowered my BP too much so I am taking only 1/2 of it. I also do CIC to make sure my bladder can rest at times. I really can skip the doxazosin (I did for a while) but my NV would be lower and my retention (PVR) would be higher and I would have to cath more often. I also like to NV more volume to kind of flushing my urethra. Hank

Frank,

Just to be clear from your last post, I am not recommending GL surgery over one of the less invasive procedures like PAE or Urolift.  What I am recommending is that if you are going to have GL is that you should have urodynamic testing first to make sure your bladder is in good enough shape for a successful GL outcome. If it isn't, then you could end up with all the side effects of GL but without any of the benefits. Personally, I would get at least two opinions regarding my bladder condition before committing to a major surgery like GL.

Jim

Hi Jim, Two opinions ,do you mean i should get the urodynamics test done 2 times?before i consider GL Surgery? I asked this Uro about uro -lift? he said it won't work with retention? Idon't know.Have you heard otherwise?

Thanks

Jim,

Hi Hank, Have you been in complete retention? I have to CIC or i cannot pee. I wish i could have NV This medicine flomax and dutasteride is not working for me.I guess surgery is the other answer.

Thanks for this info.

Hi Jim, I had a cystoscopy taken. Does this test tell size of prostate?

After this test Uro recomended Turp.This was 7 months ago. 

reading my copy of cystoscopy, says Urethra normal,prostate enlarged about 4cm long with obstructing lateral lobes no tumor,stone,diverticulum.or glomerulation

UO's normal

Trabeculation-none

Does this tell size of prostate?

Thanks again JIm,

Hi Frank, I was very close to complete retention before a few times. I think my saving grace was the doxazosin which helped me to at least have some sort of relief even only in terms of few drips here and there until the problem went away. The last time I needed antibiotics for it to go away. Unless you have low BP problem, try doxazosin. It works for me. I am taking 4mg now. When I was taking 8mg, it opened up my urethra so much that I can pee a ton without any hesitancy and I was even borderline incontinence (I can see urine at the tip of my penis ready to come out any time and overnight I would not be surprised that there was some dripping happened). I may try 8mg again some day to see what it does to my PVR since I now can measure it with CIC. The problem was my BP went too low and I was dizzy at times. Hank

Does your doctor do Urolifts? If not, I would get evaluated by someone who does them. Same with PAE. Get evaluated by someone that does PAE. I know you've gotten names here of doctors that do both procedures. Maybe you can mail them your records and they can tell you on the phone whether the procedure will work for you or not.

 

As to GL, you want the urodynamic test before the surgery. The results will give you a better idea whether GL will work or not. 

Jim

Hi Jim,  No my doctor does not do uro lift- I'm going to get urodyynamics test in this office. I was thinking of checking out uro lift with another doctor. i believe he would want to see test results of urodynamics also.I have a copy of my cystoscopy.I hear that if i get the uro-lift and it don't work ,their is a problem getting the implants out ,to do Gl?

Have you heard this?

Frank,

 

Hi Hank ,Thanks for this info.Did you have turp surgery?What was the problem? enlarged prostate,bladder stretched out/I have these these problems. Wow what a mirale this would be if doxazosin got me out of retention< iv'e been there for 7 months now.It sounds like you had prostatitis?

thanks Hank,

Frank, That would be an excellent question to ask the Urolift doctor.

Jim

Hi Jim, They never told me my prostate size. June 1st i was put on dutasteride and flomax,I have been to 4 uro. THis time i asked for the urodynamics test,i believe they have to do a prostate ultra sound to get size of prostate,is that right Jim? I guess they can't tell size by rectal exaim?

They took me of medicine today as i am getting urodynamics test jan 25,

It sure feel great to ge off that medicine.One thing else i don't get,if i get GL  My dr said he would keep me on this medicine for 3 to 6 months,i don't get it?

Thanks JIm

Rectal exam is not very accurate for prostate size. Transrectal ultrasonography (TRUS) is the one many urologists use.  I believe keeping you temporarily on meds like Flomax is part of the post GL protocol. Once you get your TRUS and urodynamic results, why don't you send those results and your records to at least one doctor who performs a PAE and one who does Urolift and get their input to see if you're a candidate. No need to rush into GL. I would also consider staying off those drugs until you do have a procedure and if you want you could experiment with some of the other drugs that have been suggested to you like 5mg Daily Viagra or just be off the drugs for a bit and see how you feel.

Jim

Hi Frank, I think I have BPH + stretched bladder. i never had any operation though my uro would love to do a turp. There are ways you can try to get some urine out. Jimjames's was to recline on a recliner and pee into a bottle. My way is siiting on the toilet with on leg lifted high (yes, like a male dog, now you know why) and pull down stretching a bit on your penis. This seems to open up the urethra. Another is lying down on your side and pee into a bottle, again, pulling down on your penis. These methods helped me during my acute retention. Hank

Hi hank , You say you think you have BPH,did you get a cystoscopy <

This will tell if you have an obstruction,BPH.

AS far as the acute retention,iI do  CIC.It 's worth a try to do your method.

Thanks 

frank,

Hi Jim, You are the man>Thanks for this info JIm.

frank,

Frank,

As far as natural voids are concerned, by all means try different positions such as sitting or leaning or lifting a leg. You can also try very light tapping on your lower abdomen to stimulate the detrussors. But beyond that don't force the process such as pushing or pressing down very hard. If the urine flows relatively easy, fine. If not, at this point you're much better off with CIC.

One thing you can do to exercise your detrussor muscles is to gently -- and I emphasize gently -- simulate the urination process during CIC. If it works, you will notice the urine comes out of the catheter a little faster than if you didn't use these muscles. When I wasn't able to do any natural voids, I would do this for maybe 10-15 seconds or so every other or third void. 

Jim

Hi Jim, Do you think kegal exercise  would help retention?maybe help the detrussor muscle,or the bladder?

Thanks JIm,

Hi, Jim,

You and Dennis better be on your guard--I hit a new personal best time of 15 secs to reach my bladder! I'm gaining on you guys! Actually, it happened so fast that I thought I had done something wrong like make a false passage--but then the urine came out. Whew!

More and more I'm amazed by how inter-connected things are in our bodies. I've taken some of what I've learned here and applied it to other health issues. My last CT scan showed I have an inguinal hernia. As I researched treatment options for that, I came across a study that shows inguinal hernias can increase a man's IPSS score. I don't that it did in my case, but found it fascinating just the same.

Stebrunner

15 seconds. Impressive! 

So what is your current status? When are you doing urodynamics? Are you still planning on sending out your records to a PAE and/or Urolift doctor for evaluation or are you leaning toward Green Light?

If you decide to do Green Light, just make sure that your urodynamic results suggest a good outcome. Also, GL has a significant incidence of retro ejaculation (dry orgasm). Many men are OK with that but some are not. Have you ever had retro like when on Tamusolin? 

Meanwhile, seems like self cathing is getting easier, so no rush to make a decision as I see it.

Jim

HI jim, This reply sounds like one to me. Thanks for the info again. Jim i don't have to worry about retro,as my sex life has been over many years ago.At 87 my most concern is to get back to normal,urination,stop retention.

Thanks,

frank,

Frank,

Well, then hopefully your urodynamic testing will indicate that your bladder is in good enough shape for a sucessful surgical outcome, be it GL or another procedure.

One additional thought is that Dr. K. in Houston is starting a small trial where he will be paying part of the cost of FLA. You might want to check out the Focused Laser Ablation thread and think about getting in touch with Dr. K. or at least talking to John about it. John just had the procedure with very good results.

Jim

Hi JIm,I should also get a ultra sound of my prostate size,right?to add to my records ,maybe i can quailfy for the uro lift?Is this a rough test?

Jim,if your PSA is lower than it was before i started taken dutasteride,then i assume the prostate is shrinking? Is this right?

Thanks JIm,

 

Transrectal ultrasonography (TRUS) is a good test to have. You can also just contact the doctors and find out what tests they want. For example, Dr. K. who does FLA will write you an rx for a specific MRI scan if he thinks you might be right for his study. The best way to find out if your prostate is shrinking is to do imaging before and after.

Jim

Congratulations!  you are now close to the " 4 Second Club," I think we may have to start the "Jim-James 4 Second Club" 

Hi Dennis,

Have you tried the FR12's yet? You may lose a second or so because of its more flexible , but a smaller size in theory means less irritation. Also, are you still cathing just 2x/day? What are your NVs and PVRs? 

Jim

Sorry  for the long delay.  I tried ordering the FR12, but the order taker, told me that I would need a doctor's prescription.  I will see my uro next week. I am cathing two to three times a day.  Usually morning, mid-day and at 5:30PM.  My NV's are not good, around 100 ML's. My PVR's are anywhere from 300 to 400 ML usually.  Sometimes, it can be as low as 100ML to 500 ML.  I went flying with my pilot friend yesterday, in a Cessena. It was three of us.  I hadn't seen one of my friend's that is 60 years old.  I notice that he kept on going to the restroom wherever we went. Restaurants etc.  That reminded it of me when I first started having problems with my prostate.  I told him about CIC and mentioned that it will save your bladder from weakening.  I don't think he took me seriously, and will instead order some supplements he saw advertised of TV.  I am here for my friends, if they need help, since I am going through it before them, it seems.  I am pretty sure I can save them the unnecessary surgery etc.  Mahalo, for all your advice on this forum!  By the way, I stopped trying to out-speed myself, cathing.  I tried for speed, the other day, and drew a little blood. Now, I go slowly, and not  count the seconds.

Hi Dennis,

FWIW I started at 100NV and now they see to be mostly 250 and up. Maybe throw in another cath or so if your total volumes are over 400ml which they appear to be at times. The more the merrier if you have time because more cathing gives the bladder more rest. You might even want to try 6x/day for a couple of weeks, then go back to your current schedule and see if your NVs improve. Yeah, you seemed to be exceeding the speed limit

-- Jim

Hi, Jim,

Last night and off and on today, my urethra has been aching. My urine is clear. No odor. No painful urination when I naturally void. No urgency. No increased frequency. Any ideas on what this might be?

I've been trying to research it, and haven't found anything that seems to fit. It's been 2 weeks since my bladder stone removal. They removed the stones via my urethra. For the first week, my urethra was pretty sore. This past week it's been almost normal; however, I'm still having trouble getting past the external sphincter. Don't worry, I haven't been trying to time my cathing!

Sometimes the aching will happen a while after CIC. But it isn't painful while doing CIC--other than at the sphincter. Didn't know if you've ever experienced this.

Stebrunner

Hi Stebrunner,

Sorry what's going on.

If the pain is similar to after your stone removal, then I would guess it's still related to that. Something might have gotten irritated or damaged. Maybe time to discuss with the doc that did the stone removal. If it doesn't get better soon perhaps a look inside or at least some imaging. Hopefully, the CIC isn't irritating whatever might have gotten irritated. If it has, then you might need a urethral vacation with a suprapubic. If it's not one thing, it's another, as they say.

-- Jim