What should I do for my prostate obstruction and bladder retention problems?

Men's health
21

@OB:  I did (self cathing) for 3 weeks after Rezum and would have been unhappy if I had to do it indefinitely. 

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If I stopped self cathing after the first three weeks I would not be as kind as you. But soon thereafter my body adjusted, and like many it wasn't that long before it became a non issue in my life. The beauty about self cathing, as opposed to surgical interventions, is that it's totally reversible. If you don't like it, all you have to do is stop and you will be no worse for wear. But first you have to give it a try, and I would say three months is a more realistic trial than 3 weeks. 

Jim

22

jimjames - my situation was different than yours in a couple of ways. FIrst, I only had one sort of semi retention issue over 4 years, so it wasn't a necessity and probably not even recommended - although I was glad I had that catheter in my bag on that business trip when I couldn't get empty at 2 AM.

Second, I never had much trouble getting used to the process, just didn't like always having to have catheters wherever I went and didn't want people to know. Grabbing one out of my locker at the gym, needing to find a stall at a bar/restaurant was the kind of stuff that I would have prefered not to deal with long term - but fortunately I never was faced with that. My guess is that you can learn to accommodate a lot of that with practice and ingenuity.

23

From what you say I don't think your urologist is the best? Mine diagnosed a greatly enlarged prostate within 15 minutes with a TRUS done in the surgery. He also saw a protruding lobe causing a partial blockage. I was sent for urodynamics in case my enlarged bladder (twice normal size and found with the TRUS) was dead. The pressure was 140 and way above normal. I was told normal was 40-60 units. I was offered HoLEP and referred to an expert colleague in Cambridge, UK. 100% successful 2 years later apart from RE. I can't fault it apart from the RE but being 70 who cares! I wouldn't have the TURP. Find out what the REAL problem is and have a modern treatment. BTW HoLEP does not normally cause ED; I'm fine.

24

From what you said, sounds like three weeks was enough time for you to make an informed decision, but for many of us, including myself, it takes longer. I realize many scoff at my "as traumatic as brushing my teeth" analogy, but that's what it became. And if it became that for me, it can for many, as I had a bad first few weeks. Really bad.

Jim

25

I printed them both up so I can read them again.  You know how they write on trials.  It also said that you do not see any improvement for 12 weeks.  But I am happy that they are doing something for men instead of this is what I have will cut out the problem.  Take it or leave it.  Time will tell  Ken  

26

No doubt for many its a good and viable elective option - you're a perfect example. And I was glad I had the option after Rezum. 3 weeks on a Foley would have been agony

27

Thanks jimjames. I'm getting natural voids, but I think more with the catheterizing. The tamsulosin has helped, but as I mentioned the stream was stronger from the Rapaflow. I don't have too many opportunities to measure, but it's usually around 200 - 300 ml when I finally self cath. The last time I measured both natural and cath the total was around 400 - 500 ml. Before I started the meds I was getting around 600 - 700 when I catheterized.

I really like my Uroligist, but I think I need to be scheduling some second opinions.

28

Thanks reg. The meds are tolerable, but I don't know if I can do them long term. For now they seems to be helping and give me time to look at my options.

29

Thanks David. Sounds just the opposite as me, my Urologist has wanted to remove my prostate since my first diagnosis. Good luck with you getting the procedure covered.

30

Thanks Kenneth. Has your doctor said how long the Urolift stays affective, and does it need to be repeated at some point?

31

Thanks rogcal. I don't think anywhere nearby me does this procedure, but I will look into it.

32

Thanks nick67069. Good idea on the list. The physician assistant said he can try with the insurance on the rapaflow again if it's working better, I may ask him to try. I also need to ask him about the other available meds. I've read Cialis can have good results, but I'm concerned with the very rare cases of hearing loss as I have single-sided deafness.

33

Yes ir's Ganges, and pretty close to where I live. I think I need to get an appointment with him.

Still taking me a while to get internal notification, but things seem to be slowly getting better.

34

Thanks hank1953. I've never heard of iTind but will look into it. I've started to look into FLA also, but it sounds like it would be out of pocket.

35

Thanks oldbuzzard. For now, like you mentioned, I'm continuing to self cath and hope it continues to improve my bladder while I look into my options. Sometimes I think my Urologist has been chasing the wrong problem all this time.

36

Thanks dai12345. I like my Urologist, but will be getting some second opinions.

37

Thanks Z. Sometimes I wonder if some of my problems are from all the biopsies. For me the RP would be a very last resort.

38

I don't know what level of social and physical activity you refer to, but I find self cathing much better than having the sudden and frequent urge to urinate hit me while I am away from home.  I cath when I get up in the morning, when I go to bed and twice during the day.  I just returned from a 5 day trip.  I have a kit I made up that I carry with me when I am away from home.  I have compact catheters that I can put in a pocket when I want to be more discrete.  I have no trouble cathing in airports, on the plane, in restaurants, etc.

​Each person has their preferences.  I find cathing meets my needs without surgery.  Hopefully, my distended bladder will recover normal function.  However, until that occurs, I don't have to worry about finding a place to urinate when I am on a long walk or driving in the car.

39

HEAR, HEAR!  I'm with pluff mud!  SInce I took up CIC, I've traveled to France for my honeymoon (one month), California a couple of times, Colo and Utah a couple of times, back to France, England, Italy, Germany... Even using the regular SpeediCaths, I just roll 'em up and tuck into my pants pocket, or stick one down my pants if I'm heading right to a WC.  My abbreviated prep system adds only 30 seconds to a natural session, and after three years of CIC, I hardly notice the extra time and prep.

40

Pluff Mud & Cartooman   I applaud you both.  You have found a way to live your life without being force into a procedure that may or may not work.  I think it great.  We do what we can to enjoy all we can  Take care  Ken