Urinary retention - looking for help from those with experience in CIC

Men's health
21

So you use a Cure hydrophilic 12 fr? or a 14fr?. I have had several samples and with one of them the 12 was too flexable and I couldn’t do it one-handed like I can with the Coloplast. It might have been a Gentlecath brand that was so soft.

I just ordered my next month’s supply and ask them to go back to my straight catheter prescription. I like the little sticker on the back of the sleeve so that I can usually stick it up to the wall before getting my penis head ready to receive the catheter. That way I can grab the funnel part, pull it out of the sleeve being careful not to let it tough anything but air; and drop it right in. all using one hand on the catheter.

22

Wow, this is great. Thank you.

At Dr. Lingeman’s office, a nurse measured my PVR. Today, my urologist’s nurse practitioner did it. It was on a brand new device.

I don’t understand how I could have retained almost 400 cc a week ago and my bladder was empty this morning.

I’ll check PVR in two weeks.

I’ll keep a urine log. I have something at home I can bring into the office to take measurements with.

I’ll PM you, as I am interested in the device.

I have had four MRIs.All were 3T multi-parametric. The first two were with gadolinium contrast; the last two were not.

My first MRI had a PIRADs 3 lesion. I had a 16-core MRI-fusion biopsy, with four cores in the “lesion.” My biopsy was negative. One core had some methylation. My ConfirmMDx gave me a 19% chance of low grade cancer and a 6% chance of Gleason 7 or higher cancer based on the one core with methylation.

My 4Kscore was 3%.

My latest MRIs (December 2017 and April 2019) showed prostate volumes of roughly 120 and 130 cc, respectively. So, it grew 10 cc in just over a year.

Dr Karamanian looked over my 12/17 MRI and said I have a “moderate median lobe.” He estimated my prostate at around 132 cc and PVR at around 120 cc at the time.

My urologist is outstanding as a cancer researcher, and I have the utmost respect for him. I wish he did HoLEP. Dr. Lingeman is great at that procedure, but it’s a long road trip for me and whoever is driving me home. And it’s always good to have the doctor doing the procedure to be in your home town, easily accessible. Again, Dr. Lingeman is great but I don’t live in Indiana.

I have a median lobe (for as much as I’ve read on PCa and BPH, I still don’t understand “median lobe”), a very large prostate (somewhere around 130-140 cc), and chronic (and repeat) prostatitis. For the last 2 weeks my perineum has been burning. I thought my most recent PSA was going to shoot back up to around 10-11, but it was 5.6 - about the same as 5 months ago - even though my bottom is burning.

My PSA density is pretty low, far below 0.10. My % free PSA has always been > 25%, varying between 28% and 39% over a 4-year span.

If my PVR is not really in the 400 cc range and I am not facing true urinary retention, I might have time to try Finasteride or Dutasteride with Flomax and see if symptoms improve.

I did read on another thread where HoLEP can help with prostatitis too. Granted, that means RE but if I can pee like I’m 25 again and not have this perineal burning, I’d trade that for RE. And, to be able to sleep through the night would be amazing. It’s been a decade since I got 8 hours sleep with no interruption.

I’ve never had a Urodynamics study. Isn’t that a necessary test BEFORE undergoing any BPH procedure?

Thank you,
Michael

23

I forgot to mention that my last three 3T mpMRIs - all at the same institution (ranked in the top 12 hospitals in the U.S.) - showed no lesions.

My first MRI (at a different hospital) gave me a PIRADs 3.

The last three MRIs assigned no PIRADs score because none of them saw any lesions, and only noted BPH and inflammation.

24

Frank,

What does “N.V.” mean?

I was thinking CIC because a PVR of 389 cc scared me. I wasn’t sure I could make it to HoLEP surgery without needing a catheter.

I’m 61.

I take 0.4 mg Flomax once in the AM and once in the PM, about 12 hrs apart.

Thanks,
Michael

25

I am “self-diagnosing” my chronic prostatitis.

I did go for 12 months of pelvic floor physical therapy. It helped me be able to sit for longer. And it lessened the frequency of episodes.

My common symptoms: burning in perineum and rectum, increased difficulty in voiding, pain after ejaculation.

Those are classic of prostatitis.

I take natural supplements including garlic extract (if you PM me, I can give you brand name) and oil of oregano capsules, since both are strong anti-microbials. I also take Curcumin and Quercetin. And sitz baths help. When taking a sitz, I apply pressure just behind the scotum with one or two fingers for 20 seconds and exhale slowly. I then move back toward the perineum and do the same. I repeat about 3-4-5 times while in the tub. I was told it’s an acupressure point.

Michael

26

Michael, you have a great nurse. She was right on about soft vs stiff catheters. It’s what I’ve been trying to tell others, with my 3 plus years of experience. HoLep redo rate is something of 1% after 20 years, proven. It’s the best, imho.

27

Hank,

Haha, that nurse is my niece. She’s pretty special. She was the lead ER nurse in a major hospital in a major US city. She’s now a surgical nurse for one of nation’s top 10 orthopedic surgical practices. She’s got quite a few degrees. :slight_smile:

Dr Lingeman told me there’s a < 0.5% chance I’d ever need another procedure if he did HoLEP. I’m now 61.

Thanks,
Michael

28

When I was on Speedicath, I used 12fr, and 10fr if I bled too much in the previous cath. Now with Cure, with no bleeding, I am able to use 14fr and 16fr. Yes, 12fr Cure might be too soft to use one hand approach.

29

Michael, Frank usually doesn’t reply. NV means natural voiding, or peeing on your own.
Some people can pee some on their own before cathing.

30

Thanks Michael thankfully I don’t think I have the symptoms of chronic prostatitis from what you wrote. I hope you recover quickly, I don’t know if anyone answered but as far as self cath and PSA levels, I think if you are doing it 3-4 times a day it can cause it to go up, especially if you are not good at it, but if you get good at it and do it once or twice a day I know from my own experience it does not raise my PSA which is now like 1.9 and I’ve been doing it for like 2 years and prior to that my PSA was gradually going up to about 4. I did have a high readings of PSA when I first started doing self cath like close to 8 that is why I think it was because I was learning how to do it.

31

Oh, thanks Hank.

Yes, I can void on my own. Some days I have good flow, sometimes at night, it’s just a dribble or very slow. I void better at certain times of the day.

I can empty as much as 500 cc at one time. I typically go 200-350 cc.

Coffee makes me pee more frequently, sometimes every 30 minutes.

I’m thinking of doing something (HoLEP) so I can sleep through the night and not worry about being near a bathroom (or going into acute retention).

Michael