Can anyone explain to me why urologists don't just put a stent into the urethra (above the sphicter muscle), rather than the patient having to self-cathetarise 3 to 4 times a day? Surely this would be a better option, in terms of risk of infection and also expense.
Hello Frances31245,
I do not have a comment as to why there is not a better option when it comes to self cath. However I would like to hear why or when a Dr would recommend on to self cath. I had the Urolift done last year and still retain close to 400 cc after voiding and my Dr has not brought that up as an option. Any thoughts on that?
I don't think they do that anymore wirh all the other procedures today. I do have a friend that is 85 that had one put in 20 years ago. It worked for a while but he is having a problem now with infections. I had a urolift done last year for the same problem. It worked great and I'm on no meds. And it's less traumatic on a mans body and no sexual side effects I'm 60. Take care Ken
Have you ever used the Foley catheter with the bag?
Dear Frances: Not being a doctor I can only recount my own experiences and hope that they will help.
I was experiencing reduced urine flow and moderate post void retention. As a second option, following failed chemotherapy, I was prescribed weekly self-catheterization to reduce urinary retention. After a few weeks into this regimen I noted that my urinary flow had improved significantly. My diagnosis was changed from 'enlarged prostate' to 'likely stricture'.
The inserted catheter provides clear passage through both the stricture and the inner sphincter allowing the bladder to empty completely. Withdrawing the catheter permits the sphincter to close immediately while the stricture closes very slowly.
Unfortunately I had to undergo some surgery which disrupted the above regimen. Self-cathing was suspended for 6 weeks pre-op and another 6 weeks post-op. The only catheterization performed over this entire 12 week period was the routine indwelling catheterization which remained in place for approximately 3 days.
Upon completion of the final 6 week period I resumed my self-cathing routine. The catheter passed through the stricture and sphincter with surprising ease given the prolonged wait times that had preceded the procedure.
Frances, does this answer your question?
In any event, please feel free to get back to me with your comments.
I suggest you just ask him/her directly. It is not a big deal although my internist does not see it as a solution to the problem. I asked my Uro for directions and samples and was provided same.
Frances, I just copied this text from the EUA guideline on BPH written in 2012, on the section about tolerability of prostatic stents, hope his answers the question.
"Tolerability and safety: In general, stents are subject to misplacement, migration, and poor tolerability because of exacerbation of LUTS and encrustation [386]. The main immediate adverse events include perineal pain or bladder storage symptoms. A systematic review of the UroLume reported a 16% failure rate within 12 months, mainly due to stent misplacement or migration (37%) or recurrent obstructive or irritative LUTS (14%). The overall failure rate at 5 years was 27% (50/188 stents) [392]."
I've used intermittent self-catheterisation, mainly to chack how much urine was still retained in the bladder, as Tamsulosin has usually been effective. However, I found that during an infection, the drug was not enough. I therefore asked for a Foley catheter as I didn't like the idea of a repeat visit to A & E that happened after a minor op and general anaesthetic caused an incident of major, painful incident of alarming retention a few years before! So my GP arranged a nurse visit for Foley insertion, but we agreed I could remove it myself, using the syringe that came with the Foley pack and did so after completing the course of antibiotics a few days after insertion. I've since successfully self-catherised with a Foley (indwelling) catheter when I got yet another infection. The main advantage was getting the first uninterrupted night's sleep in my own bed at home for some 5 years!
Anthony, I had Urolift done two months ago. Severely-distended bladder leaves me with ca. 400 also, at day's end. I cath then and then only. My hope is to allow some shrinkage of the bladder while I sleep. At the very least, I get 7 or 8 hours of sleep, straight through, every night! :-) This, after self-cathing for 15 months until the Urolift..
Sounds like you have been dealing with BPH for a long while as I have.
My doc prescribed Bethanachol, 3 time a day, he says that this helps the bladder to be compressed, I am not so sure about all that.
I set an apt with another dr for another opinion and coincedintly it happens to be in the same week that I have an apt with the doc who did my Urolift.
I guess what I want to know is holding 400cc after feeling like I have completly voided too much?
Well, "too much" is the question, isn't it? In my case, the bladder was stretched out so much, for so long, that it no longer returns to "normal." Something like what happens to some women who have several pregnancies. As I understand it, there is no problem without completely voiding. And in my case, I only cath at night for the reasons mentioned above. I've never used Bethanachol, but what I just read about it tells me that it deals with nerve-response, and perhaps you have a similar structural issue: stretched-out bladder muscles that won't return to their old "normal," regardless of what you do to them! I just read the side-effects of that drug, and hope you're not having any of them!! I spoke with my Uro-doc just yesterday, 2 months post-op, and he agreed with what I'd chosen to do, including going off my meds and night cathing. Looking to re-create the old "normal" with the bladder muscles is a loooong shot, though: the bladder muscles are not like the long, sinewy muscles of the biceps: they are small, compartmentalized box-like structures, that once stretched out for too long, remain stretched out. Which may be what you have. "I'm not a doctor; I don't even play one on TV," but it sounds to me like taking Bethanachol, with its possible side-effects of dizziness, lightheadedness, nausea, vomiting, abdominal cramps/pain, diarrhea, increased saliva/urination, sweating, flushing, watery eyes... may be barking up the wrong tree! Good luck with BOTH visits! :-)
I've just looked up 'urolift' and this sounds like the answer. My partner hasn't seen a urologist yet - his appointment is on 25th February, so he doesn't know if his enlarged prostate is benign, or cancer. So until then, I suppose he will just have to put up with the catheter with bag. He couldn't get on with the self catheterisation, it was happening too many times throughout the night, whereas with a bag he can sleep through. thanks for your reply.
It would be an idea for you to ask your dr. for the self catheter that you could use, as and when you feel it is needed. My partner did not get on with the self catheter as he was having to use it all through the night and it got too much, so he's gone back to the catheter with a bag. Thanks for replying
My partner has used the catheter with a bag - not sure if it's a 'Foley' or not. He prefers the bag catheter to the self catheter as he was having to use it too frequently, whereas at least with a bag he can forget about it until it needs emptying. thanks for your reply
Thank you Alan. I hope your healing continues. It is my partner who is using the catheter. It is all new to him and me, as it was three weeks ago when he found he could not urinate at all. After a few trips to A & E, they fitted a catheter with a bag. He hasn't seen a urologist yet - appt. on 25th February - so he doesn't know if the enlarged prostate is benign or cancer. If it is benign, - thanks to replies on this page I have found out about the Urolift, which sounds like the answer. He had to return to hospital for the catheter with bag to be removed after about 8 days (I'm not sure how long these in situ catheters are supposed to be in?). Anyway a nurse mentioned self catheterisation, which my partner tried. But after only one day found it wasn't suitable because he was having to use it all through the night - so he's gone back to the catheter with bag. thanks for replying
So sad to read your brief comments! The Bag approach was a holy horror show for me! I put up with it for ONE LONG WEEK. I'm 66, and used to be up often. From my experience (15 months of self-catheterizing!), cathing before bed COMPLETELY emptied my bladder, and I slept through the night ALMOST EVERY NIGHT! Please show him this! I used "Speedi-caths," pre-lubed silicon devices (NOT RUBBER CATHS!!!!!), which worked and still work well for me. I can't help but wonder if he was doing the cathing correctly, as I am able to completely drain the bladder before sleep, and don't get ANY "urges" before waking in the morning. And sometimes not until I've had my coffee!
Yes, there are caveats re UROLIFT: non-cancerous, prostate between 40-80 grams, no median lobe. In my case, my prostate was only 39 g, small, but still swollen. And a note: My original urologist said No median lobe, but then the radiologist, a year later, said there was one. The expert surgeon I chose (Dr. Steve Ganges, Salt Lake City (I'm in PA) said he thought there wasn't one, and there wasn't. Please have your guy get second opinions!!!! I can't stress it more. My uro wanted to give me a TURP in Aug 2014; I said no, and went searching. It paid off, big time. And now... my original uro is doing the UROLIFT too--- but as a "newbie." He's now a convert, but I went with Dr, Ganges (Google him), as he did the original FDA trials before the procedure was accepted in the US. Most experience, and I'm glad I did.
Thank you so much Twiglet. I can understand now why the stent wasn't offered in the beginning. In my 'simplistic' mind I couldn't see why my partner had to go through so much pain and discomfort in this day and age when a simple stent would solve the problem. But now I understand that the stents can move and cause more problems. Anyway, I've now learned about the Urolift which sounds like a good solution - if my partner has benign prostate enlargement. Thank you.
By the way, does anyone know what LUTS is? And have I misunderstood about the stent and the Urolift and UroLume? Are they the same thing? I'm confused.
The urolift worked great for me I have 4 implants. Good luck to your friend Ken
...and I had six implants, the max allowed for this procedure. And so far, two months post-op, all is very, very good. Btw, the change was immediate: I gingerly climbed out of the stirrups(first ones for me! :-)  , and asked for a bowl, and peed right there, first time doing it "naturally" in 15 months. True story, and even the doc was surprised!
Please keep us apprised, and ask questions; there's a lot of experience on this thread! And we want the best for your guy.
And if I didn;'t mention earlier, I had the UROLIFT on a Tuesday, flew back to PA on Thursday, and was stacking firewood on Friday. Truly different from the old standby, TURP....