Dad suddenly around April stopped being able to pee on his own. At first the hospital said, it was a constipation issue. After we got that taking care of, he started swelling again and we found out he has a severely enlarged prostate. We have been back and forth to the hospital so many times. First couple of times, because the aides didn’t know how to change him without it pulling. Next time him as a dementia patient.
This weekend however, I’ve noticed that he is swollen at the shaft and where the hated catheter goes in, it is split. Now the urine that normally does not smell, has a smell when the bag gets empty. He is set to see yet another urologist this week to be considered for urolift or subpubic catheter. The later I believe will be same trouble. At his age, the other two urologist refused turp.
You go to the ER and they say see a urologist. You see the urologist and they tell you to go home.
I just don’t know what to do to help dad for the first time since caring for him! I know he has to go somewhere but then what. What should I ask?
Go for the suprapubic catheter. It’s better than the previous urethal cather. Urolift can cause other problems.
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I’ve been reading on the forum about the UroLift. Would the suprapubic catheter not also pose the same type trouble? I will try almost anything to get him comfortable at this point.
Urolift success rate is low, according to patient reviews. When it failed, he will end up with some staples inside his prostate and bladder. To repair this, when they can, a TURP will be required. Google Urolift horror stories.
If his uro refused a TURP due to excessive bleeding, ask for another procedure that will bleed less, one example is hoLep. There are also others. You may need to go to different uro.
Suprapubic catheter is the least invasive, and easiest to maintain. Google suprapubic catheter vs foley.
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The first two stated they refuse to be the ones to put him to sleep for a turp, and he does not wake up. Your reason is probably the unmentioned concern. I will see what this urologist states this week. The home health nurse has confirmed that trauma or erosion is happening. For now, the home health nurse believes we can get to appointment day as long as his fever doesn’t come back like Saturday. Thank you so much and that was so kind of you to take time out to respond.
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Another option is medications. One is an alpha blocker to relax his prostate and bladder. The other one is a 5-alpha reductase inhibitor to shrink it. Both will help urination. Maybe that will be enough for him. There are side effects to these medications. The main one is sexual. The second is hypotension, which may cause dizziness. You should look into them.
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Sounds like he has a UTI take him back to the ER and make sure they run a culture on him to find out what type of bacteria he’s infected with so he can get the right kind of antibiotics for it.
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My nose says he has a UTI/bacteria infection since his urine use to be light yellow and no smell. Come to think of it, last weekend when I visited I mentioned to the nurse that his urine is coming out very clear (not his norm) but was told….not to worry.
Then this weekend he is swollen beyond belief. Where the catheter use to go in and would be enclosed has shifted and is split in half. The urine coming out is murky or cloudy looking but thankfully the fever has gone away.
He has been on 0.4 mg of tamsulosin forever. Low does of finasteride 5mg since April. Only had one void test and never given another opportunity and now he is just getting torn apart. The urologist will not even put him on the table and just keep saying to go home and the catheter is the best option.
I’m so torn. I hope this urologist tomorrow will take a look down there. We will be driving over an hour and if not, its back to the hospital that will be telling us to see a urologist.
Its one reason suprapubic catheter is better. UTI is much less likely.
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Another option is a procedure called FLA that is only uses local anesthesia. The problem is the cost because Medicare only pay a small portion of it. Google FLA prostate. It’s usually not performed by urologists.
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Thanks so much for sticking with us. We made it to and from the exhausting urologist appointment. This office was willing and did get him on the table. Urologist says nothing can be done about the torn open on one side of the penis. Want to say it will make catheter changes easier. I would like to know for whom?
The swelling was also stated nothing could be done except squeeze the head of the turtle and shove it back in the shell. Was advised to keep the turtle in the shell moving forward. Well, that will be hard to do and it is already back out a day later. With the swelling, I don’t feel up to the verbal lashing we got at the appointment and the hands grabbing to stop you from doing what is suggested.
Urologist upped the tamsulosin to twice a day. Would not prescribe a low does of tadalafil I’ve read to be helpful with the tamsulosin since finding this forum. Also asked about trying a catheter valve and got no response. So I will have to do so myself with very careful monitoring during the day.
The only other thing he did was take a urine sample that I’ve heard nothing back on yet. Also in two weeks, he will have the catheter removed by home health to see if he can pee on his own. This will be a miracle if he does because all I know from the ct scan previous done is that his prostate is severely swollen. I’ve looked at all his medication that can cause retention like the newest xanax started earlier this year and removed since he only needed to take it as needed if he can’t sleep from the regular old regimen.
We go back in six months unless something happens.
I believe with all of it, something can be done. However, because of the age, doors are being closed.
I’ll look into the last suggestion to see if available in our area.
Urologist also suggested the suprapublic catheter would carry same risk so not interested in performing at this time unless I believe his specialist will give the all clear.
A urinary tract infection can cause dementia. My husband had full on dementia after the hospital messed up his urinary function. At 91, he’s sharp as a tack. Take your father to a top hospital in a major centre where he will get proper care. Forget staying in your area. What you are describing is so sub-standard it’s appauling and his level of suffering doesn’t even seem to get through to these folks. Just makes me angry. As a caregiver, sometimes you have to fight for good care for your loved one and sometimes, that means moving them. There are all kinds of levels of care within the system and there is definitely much better care available than you’re getting. In the US, you can find the best specialists and hospitals online. In Canada, you go to Toronto General, Mt Sinai or Sunnybrook rather than the Milton or Brampton hospital. Get Uber to do the driving but take him where they will address his issues and alleviate his suffering.
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Cloudy urine and urine that smells…classic UTI symptoms.
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Google suprapubic catheter vs foley uti risk. His urologist is either ignorant or not caring enough to say that they carry the same risk. Insist on suprapubic catheter. Beg if you have to. It’s easier to keep a stomach sore clean than his penis clean. Some people have suprapubic on for years without a UTI.
If your dad keeps hitting a brick wall consider the Citizens Advice. Good luck.
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You might want to do some research on the FLA procedure which goes through the rectum. Far less invasive than TURP or Eurolift and less likely to cause complications. I read about the procedure on the forum from a gentleman who received the treatment in Florida. The prostate is fully mapped first by MRI and semen is tested to ensure there is no bacteria. The procedure is carried out in an MRI machine. Sounds like you need to get swelling down and any infection under control.
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There is a new procedure that uses a drug coated balloon to create a channel in the prostate. This is a simple procedure and may be a good option for your Dad that is less invasive than a traditional TURP. Google optilum BPH
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sophster078 - Nitrofurantoin (Macrobid) is what they are using to attempt to treat the UTI. He has a week and three days left. He was still cloudy today in the line but not foul smelling any longer.
Thank you all so much for sticking with us through this ordeal. As probably expected, dad failed to urinate on his own. Home health gave him five hours to attempt but dad takes in water so slow now and doesn’t guzzle anymore. In fact, in that time, he got in three glasses of various fluids. The urologist was willing to give ten hours but home health wasn’t willing to come back out. So now, he has the catheter for another 30 days. I’ll look into the additional procedures mentioned. But for now, I will continue to attempt usage of the catheter valve and hope we can at least rid the UTI.
I also begged the urologist to look into what test or other procedure we could safely try.
It was so heartbreaking. You could tell a difference today in his demeanor while it was out. Not giving up yet although kind of being forced to throw in the towel.
Hopefully he’ll be more comfortable and prostate will settle down. UTI gets the prostate very swollen and irritated. Might want to look at bringing inflammation with an anti-inflammatory. These are delicate parts of a man’s anatomy and even more delicate in an elderly person.
You might want to consider a prostatic stent to keep the urethra open. There are different styles both temporary and permanent. The placement of a stent is less invasive than TURP and is often used with elderly patients not suitable for surgery. He’d need to be free of any UTI before placement. Would be more comfortable than the catheter and less likely to get UTI. Like any procedure there are still risks and potential for complications.
https://chinnurology.com/prostate-stents/
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