Why is it that I can have such a hard time starting a stream when visiting the toilet during the night (after having been asleep for several hours) and have little problem during the daytime when awake and alert? As I see it this has less to do with BPH than with mind/body connections.
Any thoughts on this?
I'm not sure but i do notice that when I'm moving around a lot or after running or aerobic exercise the flow seems to be easier.
I hv similar issues. What works for me is to walk around house/room for 2-5 minutes and then urinate. Alternatively, might also try rocking in place (one foot to another) for a couple of minutes. Took me some time to figure out the fix but it almost always makes stream easier to start and in my case without pain. Please let us know if this works for you. FWIW I'm sure it does have to do with BPH and nothing else. Jim
It has something to do with "laying down" vs standing or sitting up. I have noticed the same exact problem. I sleep on my back or sometimes on my left side but do notice the same issues.
I asked a Urologist that question - it's got something to do with warming up your body by movement, definitely a physical reason, not sure if it's muscular or the bladder itself gets warmed up. That's why you should walk around a bit like jimjames wrote.
I have the same the problem
I was the same James before PAE but improved dramatically after.
I also notice I pee much better standing up than sitting down. Anyone else experience that?
To elaborate, prior to using the "moving around technique", at times I could not initiate urination without significant pain. So much so, that often I would resort to self catherization (CIC) in these instances. But, by moving around a few minutes prior to urinating, the pain is gone and will usually pass around 250-300cc of urine leaving no more than 100-150cc in the bladder which is acceptable. I also have found that if I then lean back in a chair and slightlty tap my bladder (coude technique) I can then usually eliminate the remaining urine into a vessel, leaving close to no post void residual. For various reasons, I only optionally do this in the evening before bed time, or if awakened, with the idea that eliminating the last 100-150cc will give me some extra sleep.
As with the original poster, any of this is only necessary if I have been in a static position (sitting, reclining, sleeping) for a period of time. During the day, witbh normal movement, there are no issues, and I pass urine normally with very little post void residual.
I have asked several urologists their opinion, but no answers. At one point I thought it may have had something to do with mybladder diverticulum, but now that I am hearing similar from others, it may not be that.
The one other thing I have noticed is that the difficulty to initiate and pain are only present when the bladder is full which in my case is around 400-450cc. If not full, then no issues even if I am reclining or asleep. However, given my tendency for excessive urination when sleeping (or reclining) the two (lying down and full bladder) often tend to go together.
But whatever the dynamics behind it, it seems to work and certainly this technique is worth experimentation for anyone having more difficulty passing urine after a period of inactivity versus activity.
Jim
Thanks for the info I have not trtied that techniqe, at the moment I am like you except even during the day I still have issues, not as bad as at night when it's really bad and painful.
Is it hard to learn the CIC thing? I am planning to travel overseas soon and my big worry is that is the time where I have to be prepared in case it blocks up completely.
Not hard at all, and what a load off the mind when you know that you can take care of this on your own. I have four visits to th ER behind me and said that's it, no more! My Uro gave me instructions and the materials needed and I am so much more relaxed when I go to bed each night.
If you search under "self catherization" you will find some threads detailing my experience with self catherzation (CIC), as well as some others here.
But briefly, I was on a regular schedule of CIC for over two years due to large post void residuals (PVR) and finally an inability to urinate at all without having to push on the bladder (crede manuever).
Eventually, through CIC (4-6 times per day), my bladder apparently regained much of its lost elasticity and I was able to urinate naturally most of the time only resorting to CIC on occasion. Now, with the moving around technique, I find I can dispense with CIC almost entirely, although I keep the catheters around just in case.
CIC is certainly a great tool to have in your bag and can save trips to the doctor's office or hospital for caterization. It can also be an alternate approach to drugs or surgery for bph, as it was in my case for a couple of years. Should things get worse, I would probably still go back to CIC as opposed to one of the drug or surgical options.
Jim
Thanks again!!
I have found that the fuller my bladder the more likely the flow would be problematic. In the day we feel the urge earlier, so the bladder isn't pressing on the prostate as much but during sleep it takes longer for the body to wake us with the urge to empty and there is therefore more pressure. Just a theory deduced from subjective experience.
Firstly James, thank you for your quite timely post. Timely because recently I've been curious to know the reason, if not answer, to the same question as you enquired about on this most useful and helpful forum.
So like you I found significant problems starting a stream after sleeping in bed, perhaps for just even only a few hours. Also I can experience similar difficulties in starting a flow after sitting for just a couple of hours too. However the two-hour sitting problem usually only occurs when I'm attending a show at the theatre. Attending the theatre means that for a number of reasons I'm somewhat restrictively 'boxed in'. Obviously when sitting for long periods and wanting to spend a penny at the theatre can be a problem but say at home, the 'boxed in' situation doesn't apply.
This difficulty starting a flow probably goes back to about 18 months ago and it's only been in recent months that I found taking exercise, such as a walk/stroll, does for whatever reason, helps to initiate a stream . I should also mention that for myself an even more noticeable improvement in both sleep length and lack of BPH symptoms, I personally find after playing 18 holes of golf. Unfortunately given the English weather I'm not able to utilise at this time of year…
So in in part it would seem one answer the initial enquiry of james87669 about poor stream start is related to lack of physical activity, which perhaps points to a relationship in causing muscle tightness and maybe in turn increased stress of the prostate? Which is thus possibly reduced when physical activity takes place? Just whether more physical activity is, as James mentions in his initial post, anything to do with "mind/body connections" I'm not entirely sure?
Perhaps it's worth mentioning that over a year ago in a private consultation with a urologist I mentioned my problem of difficulty of starting a flow, and was in no uncertain terms told by the urologist to take tamsulosin. Which although I was reluctant to do so, I did and it did to an extent help with initiating flow. However, chiefly due to the tamsulosin side-effects, a few months ago I gradually eased myself off tamsulosin. Fortunately since completely stopping taking it, so far, touching wood, apart from the experiences described above, starting a flow hasn't been a significant problem. What the reason is for the improvement I'm not altogether sure.
Perhaps though it's worth noting I have for the last 12 to 14 months significantly changed what I eat to an even more I believe healthy input of foodstuffs and liquid. E.g. for breakfast, I now eat a avocado, a papaya, home-made muesli made principally from various nuts, dried fruit, quinoa, sprinkled with organic wheatgrass powder, chlorella and/or spirulina. I have also installed a good four stage water filter and drink non-caffeinated herbal teas. If nothing else, since starting this change to a more natural food non-processed food diet (not that I ate much rubbish processed stuff before though), however since the change of diet, apart from finding it easier to start to a stream, I do have a good deal more energy than previously was the case. And this without having to put up with the well-documented side effects of tamsulosin!
Just out of curiosity, I wonder if some urologists or medics when dealing with patients that experience such urinary problems as described above, like poor stream start, if sometimes first they recommend the free more natural fix/workaround, i.e. such as, taking a stroll/walk etc for a few minutes.… And/or also do the medics enquire about their patient's diet. And if so, where appropriate, perhaps recommend to their patient/s to improve the diet? I'm tempted to ask if generally they don't mention these things, why is it?
Oh incidentally caringbah , yes I also find a much better flow when standing up as opposed to sitting down, I suspect gravity plays a role in the reason for this.
What side effects did you find w/ tamsulosin? Thanks
Retrograde ejaculation. Makes no big difference to feeling of orgasm with intercourse, but much less satisfying with masturbation.
Thanks for your really helpful input. Having put up with nocturnal urination difficulties for years I am really interested in anything that might help.
You mentioned the ‘coude technique’ but I haven’t found it described anywhere. Can you give a link or further explanation?
Also I’ve noticed a ‘sensation’ in my feet when attempting to urinate and wondered if this only happens to me?
Alan
Sorry, meant "crede technique", not "coude". Crede involves gentle external pressure with hands. There is also "tapping" which is what it sound like -- rhymic tapping with the fingers over the subpubic area to stimulate the detrusor muscles. Both these techniques can help start the flow.
I once had some reflexology treatment for sciatica. There really does seem to be something in their system whereby areas of the feet are in some way linked to specific areas of the body. I haven't had the sensation you describe with urination, but I have with sexual sensation, particularly as a teenager.
Using 400 µg daily tamsulosin, I personally fairly quickly noticed a general lack of libido. Manifested mainly in reduced drive/energy and to an extent physical strength.
To sum up, I became quite lethargic!