University level Urologists.

Tony.....I’ve been following this blog for about 5 months and have heard a lot about cathing, drugs, and the various BPH procedures.  All useful info. Bottom line:  drugs may work for a while (for me it was about 2 years), but the answer imho is surgery, specifically HoLEP.  I did the research on all the procedures (except PAE….had not heard of it), and chose HoLEP.  It is the best surgical procedure because; 1) less time in the hospital and a on catheter (less than 24 hours), 2) less bleeding, 3) very small chance of needing a repeat procedure, and 4) they remove prostate tissue (instead of burning it), so they can biopsy it for cancer.  You do need to find an experienced doc to do this.  I too was retaining close to 800ml, and my prostate was 85 grams, PSA 3.8.  After it was 46 grams, PSA 0.2.  I had my surgery in January, and now have no problems at all.  Best of luck!

My doc was with Oregon health and science university. Pretty useless Imo. Lots of nothing.

Anthony,

If you are still having issues after the Urolift then something else is going on - possibly a median lobe extension into your bladder. The UL pulls the prostate away from the urethra so you will need a thorough exam. UCSF is one of the top urology departments in the world and they have all of the very advanced imaging techniques - if you go there you really could not be in better hands. 

Once you find out exactly what is happening and if you decide on HOLEP you will have to get it outside California - closest place would be the Mayo Clinic in Phoenix. 

However, until you have the tests and imaging it's really too soon to be making any treatment decisions.

Best of luck to you. Glad to hear the self cath is working for now. 

Tom

Since you are predictably retaining after you void, you may have a slack/stretched-out bladder.  I have such a beast, that, after years/decades, maybe of holding too much pee, will not return to a truly empty state.  Instead, it will hold up to 500-600 cc without complaining, and twice in the past month I've "caught" it holding 1,000cc!!!  

I too cath morning and night, and have started cathing midday as well, as it's a good idea to not retain large amounts of golden liquid.  "Jimjames," a frequent commenter, has his own thoughts about cathing MORE frequently, to bring the risidual amount down even lower than 300cc and give the bladder a chance to shrink itself.  He wrote that after two years of dogged draining, he managed to shrink that bag down to normal.  (Of course, your mileage may vary.)  I have gone from cathing only at night, to cathing first thing, midday and nighttime.  And if I want to try JimJames' approach, I will cath until I get it below 300cc each time, and then keep on going!  Not easy... and not what the doctors propose...

And be thankful for the upside:  At our ages, sleeping through the night is its own blessing!  :-)