Urodynamic tets booked for male who is CIC

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Hello to you all. As you may or may not know I have been on this site for about 3 weeks in total and have found it - YOU ALL to be invaluable! My partner who is 65 and who was being monitored 'watchful waiting for a rising PSA level - started at 4,  then went up to 5 a year later and was this year at a 6, until he got 'suspected' prostatitus in July this year when it rocketed to 12. In July he had to go to the emergency hospital as he was totally unable to pee. His bladder was drained by catheter and he was eventually sent home. Next day he was back at A and E with exactly same issue - totally unable to pee and in much discomfort.  He was again catheterised and bladder drained and sent home with catheter in situ. He was told to attend an out patient appointment a weel later where the catheter would be removed. He attended and despite drinking large amounts of water was still unable to pee at all. So he was recatheterised and told to come back in a few days and they would show him how to CIC. He has been doing this (CIC) for almost 3 weeks and he has an appointment next Thursday where they are due to perform urodynamic tests. I can't find any information on the internet re urodynamic tests in men who are CIC and I am quite worried that these tests may cause more problems than they solve. Have any of you gents had this kind of experience? If so a reply would be VERY MUCH apprecieted by me. He has BPH or at least that is what we have been told, but has never had anything  other than a digital rectal exam where the consultant said it was 'BIG'! A couple of years ago we refused a biopsy, and they said no biopsy - no scan so we really have very little - well no accurate information re his prostate size etc. I have read that in urology testing they fill the bladder for numerous bits of these tests, but I am scared that they may damage his bladder by overstretching it. He is currently peeing between 150 and 300 mls when he CIC - which is usually 4 times per day. Any information or advise would be brilliant!

?Deb x

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  • Posted

    Deb,

    I was in a similar situation:  AUR, then 3 or 4 trials without catheter that failed.  I did the urodynamic testing (uncomfortable but manageable) and my bladder checked out okay although the urologist said it looked worn out.  That was 2 years ago and I'm still having to CIC.  I had a PAE a year ago but it only helped about 5% - probably because I have a large median lobe.  If he doesn't have a large median lobe (and maybe even if he does) he should definitely look in to the PAE.  My doc was great: Ari Isaacson at UNC Healthcare.   Good luck!

    • Posted

      Re median lobe I am in similar boat, I am confused about it some say it doesn't make any difference, some say PAE won't work if you have one. I am considering having a second PAE

    • Posted

      Me too; however, from talking to the doctors and reading this forum for 2 years, it's pretty obvious that the PAE is significantly more successful without the median lobe issues.  So, I would need to see more success in that area before I go forward with a second PAE.

    • Posted

      Have you had a scan since your PAE to see what, if any, overall decrease in your prostate was acheived?  I haven't yet - but plan to.the

    • Posted

      I am going to have another MRI and then discuss with surgeon - like you I feel about 5% improvement or maybe a bit more so that meds make it tolerable.
    • Posted

      Are you still CIC'ing?

      The most improvement that I did have was in the area they told me it probably wouldn't help!:  nightime bathroom trips were cut in half.

    • Posted

      I've never done any catheters, want to avoid that, I get up every couple of hours sometimes less and I can live with that for the moment

    • Posted

      Yes - best to avoid if possible.  If you ever need them go straight to CIC as it is much less painful and healthier than an indwelling foley catheter.  I didn't need them either until I went in to acute retention as a result of taking antihistamines!

      Best of luck to you!

    • Posted

      Thanks for your replies! I'll keep it in mind re second PAE.

    • Posted

      Hi Arlington. Thank you for your reply. We are looking in to all the options at the moment which seem to be urolift, PAE and HoLEP. Arlington, is the reason that you are CIC because of your median lobe? I thought that with urolift they could possiblyt pin it back? Do you know if this is the case? Also would you consider PAE a better option than HoLEP and if so why? You don't say how old you are, but, do they/you ever think that you will be able to pee again naturally? Did they ever establish that the cause of your inability to empty your bladder was due to the large median lobe ? Or do they not know whay this heppened to you? Sorry for so many questions, but I am just trying to find out as much as I can. Thank you for replying to me and take care you!

      ?Deb x

    • Posted

      I sent a reply to you before reading this.  I'll try to respond:

      - I went in to AUR because I had been prescribed antihistamines for hives - I was not told that was a possibility.  That was in 7/14 and I can't get off catheter since.  I was 57 at the time.

      - don't know a lot about urolift or holep but when I was doiong the research the PAE seemed to have the lowest side effect/complication profile and didn't cause much if any irreversible damage.  It helped me only about 5-10 %.  Ironically, it helped in the area they said it probably wouldn't: nightime bathroom trips (cut from about 4 to about 2).

      -  no, noone thinks I will be able to get off of the catheter/drugs without another procedure (whether this will be another PAE is dependent upon whether they find a way to get beter results with enlarged median lobe).  nothing else looks better to me than the status quo.  Hopefully they'll come up with something new.  There is one procedure in Israel that looks intriguing (sp?): the GatGoren method.  It's very new, only done in a very few places and was performed on the Prime Minister of Israel. 

      - in my case my inability to empty is definitely caused by the enlarged median lobe which I can see on the scans is pressing directly in to the left side of the bladder neck.  It is very big and closing off the opening in a crusial area.  My prostate overall isn't that big (in the 50s cc)

    • Posted

      Hi Arlington, you know my partner also went in to ARI after taking cough medicines, they really should make BIG warnings about such side affects, coz it seems that so many me are affected by over the counter medicines for one thing or another. Would you not consider HoLEP? It looks to me like the least evil of all the options when you take out eurolift and PAE. I believe from what I have read that HoLEP is very effective at putting that median lobe out of action, but have also read that with urolift -especially with a small prostate, they can pin the begger back to one of the other lobes. You don't say if you have a partner or not, but as a partner all I would say is I have told him to self cath forever if it keeps him safe from all the other possible side effects/complications of surgery. My partner is not very adventurous - I have had trouble convincing him to go to the South of England or even Portugal to get the best possible treatment, so a new treatment in Israel would be a definate no no. But if I were you I would definately look in to urolift and HoLEP. I know that urolift doesn't stop the begger growing, but it buys you time, if you want to go down that path. PAE sounds very promising to us as a couple, but if the risks are such that we can avoid, I would be happy if he self cathed forever.... Its just said that he doen't feel the same as me. He just wants to pee normally again!

      Take care Arlington. Thank you for replying to me.

    • Posted

      We had somone in another thread who also went into long term retention after taking antihistamines. I have avoided them for the past twenty years. Actually I have had hives/urticaria on my arms for a long time and just two weeks ago got a cream that has cleared them up.   
    • Posted

      Thanks Deb. fyi: I've found the speedicath compact male to be the easiest ones to use.

    • Posted

      Dermovate cream, clobetasol 17 propionate 0.05%. To be used twice a day for no more than eight days

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