Hi to you all! I came accross the site by accident, but I am SO glad that I did. My husband has BPH and recently went in to acute bladder retention. In the last 2 months he has gone from being permenantly catheterised to self catheterising. But my question to you is that he maintains that he still gets the 'urge' to go, but that it passes within a few minutes. When this happens should he immediately go and empty his bladder with the catheter, or should he just ignore it - as it soon passes and go when his next CIC clock based is due. Any replies would be most appreciated!
I don't know the answer to this question, but I do know that he should get a real treatment. He is risking an urinary infection and a bladder trabeculation.
Hi Deb, I recently had PAE procedure, after which I had a foley catheter for about 2 weeks. Then after finding this site and learning about self-catheterization, I gave that a try.
Having the urge is a good thing! What I was told here is to always try to naturally void first, then CIC. This helps prevent a lazy bladder. Your husband should try that. Also it's a good idea to keep track of how much he voids naturally and with the catheter. He should try to empty out more frequently, to help his bladder recover. I hope this helps.
Hi Deb,
I have the same problem but my acute retention only happens from time to time. The rest of the time I can go normally (although with a slow stream). So I cartheterize myself only when needed. I suggest your husband catheterize when feeling the urge next time and record the output. That will give a good indication on whether he can just wait until the next scheduled voiding. Our need to void can depend on how much intake we have. But if the urge to void is very strong, I would not wait. Especially if he finds the output is high during those times. Say more than 300 ML. I'm not a doctor or health professional, for a better answer you can call his doctor. I hope this helps
John
Why did you have the catheter? It normally is not required for PAE.
NEAL
Hi Neal,
I had a Foley catheter because I was retaining so much urine. Right as the procedure was to start, they drained 2 liters out, and kept the Foley in. The Doctor told me I could remove it in a couple of days, but he was going out of town, and I felt more comfortable keeping it in until he returned.
Hi 18R18. My husband got prostatitus at the beginning of July and was unable to pee at all. They kept him in A and E overnight and catheterised him, and since then we have been backwards and forwards to A and E virtually every day as the thing kept blocking. It was after several visits - each lasting several hours that me husband decided that he needed to learn to self catheterize - although he was not very keen at all! So since early July he has been anable to pee at all naturally. The hospital did try a couple of times to see if he could go if they removed the catheter - but he just kept drinking water and nothing happened only a lot of pain - so they re-catheterised him and sent us home. He says that when he gets the urge to go it is very strong but VERY shortlived - so by the time he gets to the bathroom, the urge has gone. We try every day to see if he can just do one or two drops naturally, but so far not a jot! I have very little faith in the urologist that we were under, as he was just hell bent on doing a prostate biopsy when PSA hit 5 and refused us a scan, unless we had a biopsy. But I thoght that a biopsy was too risky in terms of letting any possiblke cancer outside the prostate, but I might be wrong here? Our urologist almost insists that we have TURP - but I think that is because that is the only thing he is qualified to do. We are currently waiting to see a consultant wqho does urolift and HoLEP, but that is only on 2nd September - when he is back from holiday.
xx
Hi John, thank you for replying to me! My husband got prostatitus at the beginning of July and was unable to pee at all. They kept him in A and E overnight and catheterised him, and since then we have been backwards and forwards to A and E virtually every day as the thing kept blocking. It was after several visits - each lasting several hours that me husband decided that he needed to learn to self catheterize - although he was not very keen at all! So since early July he has been anable to pee at all naturally. The hospital did try a couple of times to see if he could go if they removed the catheter - but he just kept drinking water and nothing happened only a lot of pain - so they re-catheterised him and sent us home. He says that when he gets the urge to go it is very strong but VERY shortlived - so by the time he gets to the bathroom, the urge has gone. We try every day to see if he can just do one or two drops naturally, but so far not a jot! I have very little faith in the urologist that we were under, as he was just hell bent on doing a prostate biopsy when PSA hit 5 and refused us a scan, unless we had a biopsy. But I thoght that a biopsy was too risky in terms of letting any possiblke cancer outside the prostate, but I might be wrong here? Our urologist almost insists that we have TURP - but I think that is because that is the only thing he is qualified to do. We are currently waiting to see a consultant wqho does urolift and HoLEP, but that is only on 2nd September - when he is back from holiday.xx P.S. is 300ml a lot of urine? My husband seems to get the urge at about 150-200 ml - but in the early morning he has to get up around 5-6am to SIC where he voids approx 400-500ml. Once again thanks John for taking the time and trouble to reply to me. I can't wait for 2nd Sept!
Hi John,
I tried your technique, but honestly there is really no way to know how much you're retaining. The only way I found out was by a an ultrasound. That showed that even though I had no urgency, I still had about 70% left in my bladder. I didn't feel uncomfortable at all.
I don't understand why nobody (my doctors) suggested self catheterization. Is there a way for you to really know how much you're really retaining?
Okay. Thanks for the reply. It looks like it really had nothing to do with the PAE .
Neal
You're right, but they still wanted me to start with an empty bladder. Ultrasound showed that I was full. The Foley was not fun at all.
Hi Greg,
When I went for my ultra sound for urine retention, I drank so much water as to cause a bought of acute retention. I was unable to void more than a few drops. So of course, the ultrasound showed I was retaining it all.
So what I did was to urinate normally at home when not having an attack. Then I would insert a chatheter to see how much was left in my bladder after voiding. In my case, it was very little if any.
Of course this would not work for Deb's husband who is unable to void at all without a catheter. In that case it would mean nothing.
John
Hi Deb,
I find that when I have the normal urge to go, I will be at around 250 or 300. Occasionally 400. Your husband sounds pretty normal at 150 to 200 with 400 in the morning.
Good luck with the visit on the 2nd.
John
Hi John - what a relief! I am so glad that at the moment somethings sounds pretty normal x
Hi, Deb,
Nine months ago I had acute urinary retention and ended up in hospital where they drained 7 liters out. Then I was on Foley inplace catheters for 3 months. Finally I got started with CIC. While on Foley's and while starting CIC I frequently had urges to urinate that passed in a few minutes. In my case these were bladder spasms. I've now been doing CIC for about 4 months, and it rarely happens.
I learned to CIC while waiting to have a prostate artery embolization (PAE). CIC allowed me time to research the best treatment option for my BPH. I CIC 5 or 6 times a day. Had my PAE June 23, 2016. At the time I couldn't urinate at all. Now I frequently pee weak streams. It takes 4 to 6 months to see most of the results from a PAE so I'm hopeful things will get even better.
There is excellent informaion about CIC on a thread on this site. Here's the link:
Hope some of this helps.
Stebrunner
Hi Ste. Thank you for replying to me. Please can I ask you a couple of things? My husband aged 65 also has BPH and like you we have tried to look at different treatment options, and at the moment seem really impressed with urolift possiblity. Unfortunately we do not yet know the size of my husbands prostate, so we are not sure if this procedure would be the right one for him. But was also looked at HoLEP as opposed to PAE - really because we live a long way from Southampton which is where I think this is currently carried out in UK. Ste did you consider HoLEP and if not why? Also what is the difference between an 'urge to go' and a bladder spasm? I have told my husband that if he gets the urge to go - just pee wherever he is, to hell with the consequences, because by the time he gets to a bathroom the urge has gone totally. He did say this evening - about 10 minutes ago that for the first time since eraly July, he did pee a small amount naturally - not drops but a small very weak stream for a few (2-3 ) seconds - is that good ?, then it stopped and he had to self cath again. Ste are you pleased with your reslut from PAE and where did you have the procedure done? Uk, States or somewhere else. I have tried to follow your thread re CIC but the thing just keeps turning and doesn't take me there, but I will keep trying. But well done you! It sounds like you have made it through the maze of EBH! I hope that you continue to do well!And I hope that eventually you have a brilliant outcome!
Thanks Ste... Deb x
2 to 3 seconds is a start!
Neal
Hi, Deb,
Thank you for your encouragement! I live in the States, and yes, I did consider HoLEP, which I learned about on one of the forums on this site. Of the traditional BPH surgeries it seems the best in my opinion. My prostate was large--90 g--with a large mis-shapened median lobe pressing into my bladder. HoLEP was a good fit for that situation. The urologist said he would remove 80% of my prostate. He could not guarantee I would be able to urinate on my own afterward. He also said I'd definitely have retrograde ejaculation.
Compated to PAE, HoLEP has a longer recovery time and greater risk of complications. Four of 5 urologists told me I would never regain function of my bladder due to my extreme urine retention. I went with PAE because it had the quickest recovery time, and appears to have few chances of side effects. If the PAE doesn't work, it's still possible to have other procedures done, such as HoLEP.
My understanding of the difference between bladder spasms and the urge to go is that a spasm is the bladder sensing a foreign object, like an indwelling Foley catheter, and wanting to push it out. This occured, too, when I started CIC. A few times I had a spasm in the middle of CIC, and the spasm pushed urine out around the outside of the catheter. My spasms were very painful, and they felt like I had to urinate really, really bad. Usually nothing would come out.
The urge to go sensation is my bladder telling me it's full and needs to be drained. I always void naturally before CIC. In the beginning whenever I had the urge, I'd head to the toilet, and sometimes nothing came out. In the beginning, my natural voids were 1 or 2 drops. Gradually that became several drops, then dribbles--on occassion a weak stream for 2 or 3 seconds.
After my PAE, my natural void volumes were 20 to 30 ml. The weak streams were more frequent. Now my natural voids are 70 ml, and I've had several at 100+ ml. My best has been 175 ml. I'm hoping to eventually get to a point where I only have to CIC once or twice a day.
Hopefully you can get to that link to the thread about CIC. You might want to shorten it to see if that helps. There is also a good thread about "PAE has anyone had one". PAE was pioneered by a doctor in Portugal. I had mine done in Denver, Colorado in the States and had to travel 1,000 miles for it. My insurance denied coverage so I paid out of pocket. I'm planning to appeal their decision.
When looking at treatment options it's important to know the size of the prostate, and if it has a median lobe. Some options don't work well if the prostate is too large. Others don't work if there is a median lobe--of if the median lobe is large.
I consulted with 5 urologists, and none were supportive of the PAE option. I believe that's because PAE is done buy interventional radiologists. I think I made the right decision for my situation. Fortunately, my primary care doctor was very supportive.
Along the way, several of the urologists tried to pressure me into making a decision for their procedure. I'm very thankful for the forums on this web site. I learned a lot about how to CIC, and I learned a lot about treatment options available. Keep researching. I know you and your husband will find the best treatment option for your situation.
Stebrunner
Hi Neal, my wife reminded my that the reason I had a Foley was because the Doctor knew I was having trouble voiding, and he expected that my prostate would become inflamed after the procedure, so he felt that was the best thing to do.
I am considering PAE or another new procedure, FLA, that I learned of on this site. It has been some time since you had the procedure and I wonder if you could describe your experience and recovery.