Hi. My husband suffered urinary retention for the first time just over two weeks ago. He was seen in A & E and urine drained via catheter. Went home that morning with the catheter which filled with blood so back to A&E where they decided he needed a larger catheter and bladder washout. He was admitted for one night. He was discharged and told appointment would be made. However the next day we saw a urologist privately who explained what he thought the problem was and ordered blood tests plus PSA and ultrasound. He also started him on antibiotics and Tamsulosin. Tamsulosin had a very quick good effect with his peeing.
When we saw the consultant again last week he said the PSA was 1 point something and blood tests and scan OK. He has suggested he continues with the Tanmsulosin and considers TURP. We've put that on the back burner for now but what really worries me : is he likely to have further retention or do the tablets prevent this. I think I worry more than he does as it was such a shock!
After a couple of episodes of retention, I've learned to use an intermittent catheter. I take it with me on journeys and holidays so that if ever I experience full retention again, I can relieve the problem myself without having to go to A & E. I find this very reassuring.
I dont know anything about Tamsulosin....but I had retention (not able to go at all ) some 9 years ago. I self catheter 6 times a day... It is not such a big deal if it comes to that. I know there are operations you can have but I have not explored the possibilities . I know it is all scary if you are new to this but when it is sorted out ...and it will be !! so go with the flow (excuse the pun) and I know you will worry. I have had scans etc but nothing showed up regarding the bladder or prostate, so it is something that a lot of men get when you are over 50 ish
and live with without complication. so please dont worry !!
Have you got any information on residual volume retained in bladder, volume of urine he is peeing per second and size of the prostate? This information will decide how long he can go with medicine (normally years). Ultimately, some kind of intervention (TURP, green lase or any other treatment) will be necessary. Do not hurry for TURP!
How large did they say his prostate is ? TURP is an old procedure and HoLep or GL are newer laser versions with quick recovery and little bleeding. There is also non surgical options Urolift and PAE that you can google.
Beware of Tamsulosin as it causes sexual problems. He might be better with one a day Cialis.
When I asked our practise nurse what is the most complained about drug she said Tamsulosin. I sad yes by men but she replied No, by their wives.
Another warning if he was prescribed Cipro or a Fluoquinolone drug, look up the latest warning on it by the European Medicines Agency or the American FDA
These Neanderthal URO's always seem recommend TURP as mine did. He said he didn't think the more minimally invasive procedures get as good a result. It's the "gold standard." Well, before you drill a hole in me, I'm going to try something and I am exploring the PAE. I would try FLA next as well.
He did have an ultrasound Joseph. and when we saw the urologists for he results I think he said there was 35 mls residual of urine. Might have got that wrong. I expect he will confirm in his letter but think he is on holiday so there is nothing forthcoming at the moment. It looks as though there are alternatives to TURP but hopefully we can wait for a while. Oh I forgot to say that when we were seen in A&E they thought the retention had been caused by constipation and strong painkillers for a back condition although he'd only been taking those for a day or so.
Ur husband is suffering from BPH. Retention is the consequence of the urine channel is blocked or severely constricted.
obviously, the first step of treatment from all urologists is drugs. If drug works why suffers the complications from surgical intervention as all surgical technologies have complications? There are only two classes of drugs to treat BPH though with different brand names. The class ur husband is taking has the effect of relaxing the muscle around the urethra or channel and as a result, the channel is More opened up. Ur husband is lucky as the drug work.
The next step is to check if the drug has any side effects on him and how much the drug is helping him. If the answers are no side effect and help him a lot then do nothing as the problem is resolved.
to find out what is wrong with the prostrate. There are 3 tests. Cystoscopy: a scope is put inside the prostrate to find out the seriousness of blockage.. Urodynamics: a plastic tube is inserted inside the prostate and measurements are made to decide the bladder pressure,retention or post void volume, urine discharge volume, urine flow speed, etc. Rectal 3D unltrasound: measure how much the prostrate has enlarged. But all these are not treatment but to understand the situation. If insurance covers them, u may consider doing them, but also listen to ur urologist.
the next step is when the drug has side effect, ur husband does not want these side effects or simply does not want to me the drug year after year, then the only option left is surgery invention.
there are many technologies for BPH symptoms relief, it will take a long time to understand the advantages and disadvantages for each and which is best suited for him or u could just follow the advice of ur urologist.
>>Cystoscopy: a scope is put inside the prostrate to find out the seriousness of blockage.. <<
I don't believe it is put in the prostate. It is put in the urethra and snaked up the entire length to the bladder.
>> or u could just follow the advice of ur urologist.<<
I would be careful doing that. They can have a procedure that they recommend because they have a lot of experience with it, when another procedure might be a better choice. Particularly if it's a procedure performed by IR's and not urologists, such as PAE and FLA.
What preceded the emergency is important. Was he drinking too much at one time? Was he holding it in when he needed to go? How active was he? Those first two habits he should avoid.
How much urine did they take out of him ? After the catheter is removed, have his bladder scanned for retention (how much urine is left after voiding). The results will help to determine his best courses of action, if any. Hank
If your husband had a retention episode, he may well have another. First thing is to have your urologist teach him how to self catheterize, give him a prescription and order some Speedicath 14 coude tip disposable catheters. He should keep one in his glove box and travel bag. I had a retention episode, then didn't have another for 3 years, but it happened 1000 miles from home at a very public business trip. What would have been a very embarrassing trip to the ER was avoided by the catheter in my bag. I went to bed after and woke up feeling fine and peeing normally (for me).
Alfusozin does pretty much the same thing as the drug your husband is taking with a much lower side effect profile. He might want to try that if he has any side effects from his current one - which many to most do. If BPH is becoming a problem for your husband, non surgical procedures should be his first consideration. The lazer procedures all require anesthesia, typically leave you with dry ejaculations and while rare, can leave you impotent or incontinent. Rezum and Urolift can both be done without being put under and almost never leave anyone with long term problems. Urolfit is more limited in who is a candidate, most men are candidates for Rezum which has been a life changer for a lot of men.
If your husband typically pees OK and this was an unusual event, he might consider keeping some catheters handy just in case, but if its an ongoing/worsening problem, he should have a scope and urodynamics test to see if he is a good candidate for a procedure. Again, I would exhaust the (typically just as effective) non surgical procedures before going under.
TURP should almost NEVER be the first option - it should be the last and is pretty much obsolete. Any doc who recommends it as a first line treatment for BPH is committing borderline malpractice. I would find another urologist ASAP