I've using the CIC method for the last 6 months and I'm glad I didn't rush into the suggested TURP surgery. I'm heading to a different URO this week and would like some suggestions on what to ask to see if I'm improving. I had a stretched bladder with an obstruction in the lateral lobes, prostate size was 25 cc. PSA test was low so other than asking to check the size of the prostate and maybe the size of the bladder, is there anything else to know?
I also know that he will ask if I stayed on the generic Flowmax that was prescribed 6 months ago and I didn't stay on it long. My theory was that it's my bladder causing most of the problem and I didn't think the drug would clear the obstruction. From what I read, it relaxes the muscle and I didn't feel anything was changing but I was only on for a month.
Should I be asking for a different prescription? Is there anything that can help a stretched bladder, other than exercises and time? Or anything that can clear an obstruction, other than surgeries? And does it make sense to do a surgery for the obstruction, if the bladder is stretched? I'm thinking I need to rehab the bladder before fixing the obstruction.
What is the reason for the CIC ? Because you can't pee or because you can't empty your bladder? What is your PVR, post void residual ? Hank
Medications like finasteride and dutasteride were proven to shrink the prostates and therefore might reduce the obstruction. However, there are many side effects associated with them. Hank
Urologists told me there was nothing I could do about my stretched-out bladder, four years ago. There was NO voiding possible, and I was holding 900cc and not even feeling it. Instead of listening to them, starting three years ago, I went on the JimJames Incredible Bladder Shrinking Regimen (Available in our files here on patient.info). I now have a PVR of anywhere from 250-350cc. And sometimes as low as 150cc.
I'm glad you're doing CIC (I've been doing for most of the past 4 years.). If you follow the practice Jim James lays out, you too may be able to shrink your bladder. In spite of what the uro-docs will tell you!
Hi Tom,
I'm not qualified in the field of medicine so I can only pass on my own experience to deal with a condition that sounds similar to yours.
I have been practicing C.I.C for over 2 1/2 years to counteract urinary retention as the primary goal, and secondary goals of a stricture in my prostatic urethra plus significant erectile dysfunction. I cath early morning and bedtime using a straight Fr 16 catheter and started with a straight Fr 8 for the early afternoon session.
I progressively increased the size of this last one until I was passing a Fr 18 straight into the bladder with ease. A few weeks back I took the plunge and substituted the Fr 18 for a Fr 16 identical to the ones I use at the beginning and end. The stricture has gone completely, so I'm eager to see if it stays that way.
The urinary retention issue is gradually improving, now at a 50/50% ratio natural void and cathed urine. The ED has also resolved to a functional level. A final note: I did not suffer any bleeding other than one occasion when I was up to the Fr 14 and too zealous; the catheter buckled when it encountered the stricture.
So, there you have it. Take it for what it's worth!
Warm regards, alan86734.
I have been performing CIC for 14 months and also have an enlarged bladder. I cath 4 times per day and have no natural voids. I was on Flowmax for a year before I started CIC and about 6 months after. I was also given a prescription for finasteride shortly before I started CIC. My urologist had me stop taking it a few months ago. I don't notice any difference in performing CIC since I stopped taking the drugs. I haven't had a doctor visit since I stopped the finasteride, so I won't know until my next visit in October whether anything has changed.
Alan, do you know how you acquired the stricture ? Also, what catheter are you using? Thanks. Hank
Hank, I'm trying to CIC 4 times a day and keeping my voids under 400. I don't really have any void with out CIC unless I am holding more than 400.
That's excellent Alan and I appreciate the feedback. I had just tried to drop down from FR14 to FR12 and I was having some difficulties with the FR12 but I think it was just me getting used to the flexibility in the FR12. I like the idea of slowly going bigger to try to remove the stricture. I will try and get some samples of the 16 and 18 and give it a try in the AM and at Bedtime when I have more time.
Tom I think you should do what Cartoonman said get a hold of JimJames for you help with your bladder. He will be able to help you. Don not rush into any surgery before the bladder is taking care of. That may be all you need. You do have a small prostate. I can't believe a doctor wanted to do a TURP on that small of a prostate. Good luck Ken
Tome there are some meds that can help you that do not have any side effects Just take care Ken
Hi, Hank. Yes, I should have made this clear up front. It was the result of having a Foley balloon accidentally inflated while it was still in my prostate. This happened 20-odd years ago when I had been rushed up to the ICU. Years later, when I started CIC I realized that my urethra was a little longer than usual and the two nurses were not to blame. Unfortunately the two la dies had move on and I was unable to set the record straight for them.
It was because of this that my uro felt that the procedure I followed was worth a try and I had a good chance of success. If it does fail, and I am still here with you all (I'm 89 yo), I'll let you all know,
The "expansion catheters" I used were all Coloplast Seedicath straight.
I hope this nswers your questions. Regards alan86734
Hi, Tom, I think you are now on the right track. Good luck!
Warm regards, alan86734
Yes, I am trying to follow JimJames CIC method. I know he mentioned that it takes time, just wanted to know if there were some other things I should be doing other than CIC.
Thanks Alan! Did you experience any soreness at the prostate area when you move up on catheter size ? I have 2 years of CIC but I am afraid I am still at where I started, still using Coloplast speedicath 12 straight. A white back I was trying to go up to 14 straight but experienced soreness that lasted for hours afterwards so I went back to 12 straight. Sometimes I even have to use 10 straight when I encountered difficulty with 12 straight.
I don't see how people can use such large size. One fellow on this forum even uses size 30, LoL. Hank
Typo there! For "SeediCath" please read "SpeediCath".
alan86734
Yes, it takes time. I'll offer this thought: TAKE NOTES! Record your amounts, where practical. I kept a gradated measuring device in the loo for a couple of years, and recorded amounts peed, plus PVR, each time, missing very few. And I'm NOT the meticulous type.
I found the amounts were my "cheering squad," and kept me honest. I recorded the diminishing amounts of PVR, and those times I missed, and had larger quantities. I did this recording of amounts for about 18 months. I established a number for my stream, and know that (on average) I void 100cc/10 seconds, so I now just count while voiding, and while cathing, so I know what I'm carrying in my bladder. I also pay closer attention to my body's signals. As mentioned, 4 years ago, I had NO sensation of needing-to-void, even with 900cc in my bladder. Today, I'll get the alert with as little as 150cc, and certainly with 250/300cc.
Good luck!
Hank, absolutely no pain throughout the entire process. But, you must keep in mind that I am one of those weird types who takes catheterization and cystocopies without analgesics or numbing agents of any sort; just oodles of lubricant. No, please do not jump to conclusions: I do not enjoy pain! but this way I retain maximum feedback which, in turn, allows me to control both sphincters. Perhaps I have an unfair advantage here because I have taught natural childbirth (Grantly Dick-Read method).
Psychoprofilaxis does work for most women and I applied the same technique to myself each time I dislocated my left shoulder (27 times in all). And that's a long mariner's story of itself!
Warm regards, alan86734.
Do you still have retention ? If you can get a 18fr straight through easily, you must not have much of an obstruction anymore. Perhaps bladder problem ? Hank
I have a neurogenic bladder. The nerve signal to void - the urge - disappears too soon. In other words sends the "all done" signal which closes the bladder sphincter way too early, trapping urine. This is due to some form of nerve damage and, sure enough, I remembered only recently that some 65 years ago there were two occasions when I was handling mercury. I had put on gloves but the "protective gear" in those days was laughable by today's standards.
Moral of the story: take great care of what you touch!
Warm regards, aan86734.