Unable to urinate? Is it BPH or Bladder Disease caused by DMT2?

Posted by heysp22 @heysp22, Apr 15 2:57am

My dad is 79 yo male with history of DMT2. Who been to the ER on 12/25 and 12/26/22, He was brought in by ambulance for having pain and not able to pass urine, started today the 25th. After they examined him. Placement of foley on the ultrasound shows his has 957mL of urine in his bladder and not his prostate. Plan to start with Tamsulosin and see an Urologist. Next day 26th, back to ER for more pain with blood clots in the bag. UA shows WBC clumps cystitis, Keflex was prescribed. Lab work unremarkable for AkI . BPH with LUTS and change Foley size 16 to 23 then sent home the same day. Got an office appointment with his PCP 12/28. (At this point not impressed of communication from the involved doctors). My dad get an Urgent Urology Referral Appt for 1/3/2023 in Orange County per his insurance. That night he started to have seizures at my home. Call 911 and he was taken to Hoag Hospital ER and admitted. He stayed there for about a week. Now the hospitalist is explaining that had hypoglycemia, that caused ARF and infection on his prostate. What? My dad does not have a prostate problem ever. So now I do my owe collection of his medical records. Because I'm no doctor, and want to get an idea what going on and the research starts from Mayo Clinic, John Hopkins and Cleveland Clinic along with U.S. Department of Health and Human Services, National Institutes of Health . American Urological Association Education and Research, Inc. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Journal of Urology and Atlas of Human Anatomy book. By keeping his records and cc each doctor they were able to keep current. None of them use the same same labs. My dad decides not to do any surgery and want to try meds first for the enlarged prostate (Which we don't believe is causing this) and the Foley in and changed every month now is every three weeks because of plugging and bladder stones. A year is passing us by. His PSA Level went from 0.4 in 2015 to 56.92 in 2022. With meds it jumped down to 27.30 Dec 2022 and 0.6 in 2023 now its 0.3 in 1/2024. Whats was caused his infection his DM meds per the doctor at Hoag. He is home now. Mean time I am requesting for some type of rectal exam be performed or new x-rays be done for comparisons to see if worsen or improved from his hospital stay. Before any surgery happens TURP procedure. The doctor got put off by this. He gave us an order for an ultrasound of his Renal and Bladder finally. Had an appt to see him for the results. I got sick and unable to drive him, we missed our appt in Nov 2023, his next appt is not until Feb 22, 2024, more time is passing by. Stop me if i'm wrong how about a phone call. Something, We finally see the doctor and tells us that he referring us out to other Urologist for consult and HoLEP procedure. Trying to ask him why based on what? What changed to have TURP to HoLEP? When did he decide this? Why? Writes the referral and walks out. Now my dad is fed up with doctors with no answers. What are we missing? HoLEP first appt August 1, 2024. Anything?

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@heisenberg34

This is a bit off topic, but I recently spent 9 hours in our local ER for bloody urine (with occasional small clots). Final result: went home with Foley catheter and bag. The catheter was some of the worst pain ever. had to go to PCP to have it removed five days later. That was a week ago. I have not been able to get good control over my bladder. Up every three hours at night. Anyone have a similar expereince? The EMT who put the catheter in was not very gentle. I still have some pain in the urethra when I pee.

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Just a quick response re EMT. Generally, I think things can be done patiently and carefully and with less pain. And there are some callous folks out there who simply don't care.

I don't know if that kind of pain is common with your issues, but I do know that there are many people giving medical care, who do not belong near a single patient.

I know there are physical exercises which are supposed to help with frequent urination. But I would clear them with your doc first. You might have an issue which would be aggravated by exercise (or not).

Take care

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@colleenyoung

@heysp22, you and your dad have been through a lot. I moved your post to the Men's Health support group. You may find these related discussions helpful:
- HoLEP vs TURP: Looking for guidance
https://connect.mayoclinic.org/discussion/holep-laser-for-prostate/
- PSA numbers after HOLEP?
https://connect.mayoclinic.org/discussion/psa-numbers-after-hotep/
- HoLEP procedure experiences?
https://connect.mayoclinic.org/discussion/holep-procedure-experiences/

You mention that your dad also has type 2 diabetes. Has that been discussed with his doctor too? How is he doing?

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@colleenyoung , I got a chance to review, big time great. I'm really surprised that my dad doctors weren't feeling the need to get more involved in him. But seeing the urologist every three weeks for Foley change. Would spark something. But today see his PCP to review his tests. Lab, UA, MRI brain, Carotid scan, colonoscopy, and make some more sense of dad health.

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@samcal9977zz

Just a quick response re EMT. Generally, I think things can be done patiently and carefully and with less pain. And there are some callous folks out there who simply don't care.

I don't know if that kind of pain is common with your issues, but I do know that there are many people giving medical care, who do not belong near a single patient.

I know there are physical exercises which are supposed to help with frequent urination. But I would clear them with your doc first. You might have an issue which would be aggravated by exercise (or not).

Take care

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Fortunately, my regular bladder function seems to be slowing returning. I never want to go through that nightmare again.

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@heisenberg34

Fortunately, my regular bladder function seems to be slowing returning. I never want to go through that nightmare again.

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I was in the ER with severe respiratory distress. That had not seen assessed what was going on. Stuck me on a gurney in a hallway. But another gurney next to me. That guy had pneumonia.

Doing that was a clear breach of any medical protocol. Either he could have killed me or I could have killed him.

I complained.

Lovely nurse stuck a shunt in my arm, in a painful way and left it in there for something like 12 hours...while they kept me on that gurney, in that hallway, untreated.

Plenty of these folks belong in prison.

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@samcal9977zz

I was in the ER with severe respiratory distress. That had not seen assessed what was going on. Stuck me on a gurney in a hallway. But another gurney next to me. That guy had pneumonia.

Doing that was a clear breach of any medical protocol. Either he could have killed me or I could have killed him.

I complained.

Lovely nurse stuck a shunt in my arm, in a painful way and left it in there for something like 12 hours...while they kept me on that gurney, in that hallway, untreated.

Plenty of these folks belong in prison.

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I know what you mean. I think that many of these people become desensitized to the things going on...patients, suffering, death, etc. The only person during my 9 hour ER stay who had a modicum of empathy was the orderly who wheeled me from my room to the bathroom. Everyone else had little compassion, even respect for me. Just get the job done and move on.

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@heisenberg34

I know what you mean. I think that many of these people become desensitized to the things going on...patients, suffering, death, etc. The only person during my 9 hour ER stay who had a modicum of empathy was the orderly who wheeled me from my room to the bathroom. Everyone else had little compassion, even respect for me. Just get the job done and move on.

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Well, there is always a way to try and be kind. It is sad that people give up on morality and surrender to doing what is convenient.

In my case and in the case of many others, it goes far, far, far beyond just getting the job done and moving on.

These folks were actively vindictive.

And, under the law, those all become criminal acts.

If they did this to a celebrity or a wealthy person, they would all get sued into poverty and also spend some time in prison.

This all comes from that HMO /corporate culture...where a bunch of ravenous sociopaths dictate medical care to society. They have already harmed thousands and probably killed at least a few hundred people.

Why society does not view those acts as criminally negligent homicide is beyond me. I guess with that crowd it is all bribes and threats. No one has the courage to act with morality. And they are so used to breaching civility and all kinds of norms, that they actually believe corporate spin that "this is the way it has to be" or whatever spinning lies they play.

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@samcal9977zz

Well, there is always a way to try and be kind. It is sad that people give up on morality and surrender to doing what is convenient.

In my case and in the case of many others, it goes far, far, far beyond just getting the job done and moving on.

These folks were actively vindictive.

And, under the law, those all become criminal acts.

If they did this to a celebrity or a wealthy person, they would all get sued into poverty and also spend some time in prison.

This all comes from that HMO /corporate culture...where a bunch of ravenous sociopaths dictate medical care to society. They have already harmed thousands and probably killed at least a few hundred people.

Why society does not view those acts as criminally negligent homicide is beyond me. I guess with that crowd it is all bribes and threats. No one has the courage to act with morality. And they are so used to breaching civility and all kinds of norms, that they actually believe corporate spin that "this is the way it has to be" or whatever spinning lies they play.

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I have always wondered, how do I find one of those hospitals like the ones on TV where the patient is seen immediately, assessed by a team of ER docs, sent to a beautiful room, then another team comes in to give the final diagnosis. If none is found, the team members will spend time perusing journals, past history, eventually coming up with a unique and effective treatment plan. I want to go to one of those hospitals...PLEASE!

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@heisenberg34

I have always wondered, how do I find one of those hospitals like the ones on TV where the patient is seen immediately, assessed by a team of ER docs, sent to a beautiful room, then another team comes in to give the final diagnosis. If none is found, the team members will spend time perusing journals, past history, eventually coming up with a unique and effective treatment plan. I want to go to one of those hospitals...PLEASE!

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That was standard medical care in the 60s and 70s. And not just for rich people...for everyone.
And it could be standard medical care today if medical care was not controlled by corporations, to glean the profit margins they want. I guess folks don't know, but back when I was a kid, hospitals were not run for profit. And I think some of them ran at a loss. They just did what was necessary for patients. And if they went into the red, they contacted some wealthy donors and got their funding that way, not on the backs of sick people.

As of about oh, maybe 10 years ago, 25% of the major US corporations paid exactly ZERO in taxes. If they paid their fair share? Yes, medical care in this country could be entirely different.

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@heisenberg34

Fortunately, my regular bladder function seems to be slowing returning. I never want to go through that nightmare again.

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@samcal9977zz and @heisenberg34 , did you ever find out what body part failed to cause you from urinating? Are you wearing a foley catheter presently? My dad is really not liking it, any suggestions? Still trying to get an earlier appt at UCI for Consult to see if he can have a Holep procedure?

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@colleenyoung , for an update, we did see his primary doctor and explained the result of his tests. The 2 scans came back according to his age okay. Lab result ( Kidneys) are still consider high but lower in the high level. I hope that makes sense. I just hope that we are not following the wrong diagnosis but with same problem body area. I still believe that when he had a seizure from him being hypoglycemia and the injury with his kidney, that it
could did/do damages to his nerves end that control the bladder neck area. With Chronic UTI on 2 different spots in his bladder. Its hard to say what stopped him from urinating This is a hard subject to fully understand about my dads privates.Something is not adding up right.

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