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jimb1950 (@jimb1950)

Bladder ureteral obstruction/stricture

Kidney & Bladder | Last Active: Mar 29 9:43pm | Replies (57)

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@alderton

I'm 70 years of age and had a TURP operation 15 months ago to reduce the size of my prostate. In short, the operation didn't work properly. Urinating during the day is normal but night time is a problem – up every 2 hours and then the sphincter muscles refuse to open resulting in my having to massage my penis to stimulate a flow of urine. My urologist has prescribed Valium to relax the sphincter but this isn't working either. No-one seems able to explain why this occurs at night time and why the sphincter muscles don't work as they should. I'm told the next step is a supra pubic catheter which I am trying to avoid. Has anybody out there had a similar experience?

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Replies to "I'm 70 years of age and had a TURP operation 15 months ago to reduce the..."

Hi @alderton and welcome to Mayo Clinic Connect. You'll notice that I moved your message to this existing discussion where @jimb1950 @jakedduck1 and @tom1984 are talking about similar issues with bladder and urether obstruction issues. I'd also like to bring @amgracing1 @palevsky and @predictable into this conversation regarding their experiences with the supra pubic catheter and problematic urine flow.

See more in this related discussion:
– Prostate and Bladder Issues https://connect.mayoclinic.org/discussion/i-am-a-68-nearly-69-year-old-man-that-has-had/

Alderton, it's interesting that the issue is problematic at night, while urinating during the day is normal. That would seem to indicate that movement helps and inactivity doesn't, but you need to sleep. Have you considered getting a second opinion?

Hi @alderton, glad to have a chance to share my experiences with you in hopes that they will relieve some of your anxieties about how to deal with urine flow problems. My personal experience is similar to yours — TURP a few years ago when I was about 75 years old and night time urination every 2 hours. Soon after the operation, my urologist started periodic cystoscopy to check my urethra and the sphincter just below my bladder. He's now scoping me out once a year, and I'm due for my 2020 appointment later this month.

One thing I'm preparing to discuss with him is my reluctant urine flow. My first "output" starts as expected, but doesn't remove enough urine, leaving a half-cup or a little more backed up in my kidneys and/or my ureter from the kidneys to the bladder. After a short walk around the house, I can finish the job. At night, this is a little inconvenient, but not enough to pressure me into more surgery or other medical interventions. I'm glad to report that the reluctant urine is not the result of a damaged or faulty sphincter, which the cystoscope passes through with only a little discomfort. I'd also emphasize that the night time inconvenience is not a big deal — I get up every 2 or 3 hours during the night, then go back to sleep without much delay.

A suprapubic catheter was my dad's problem. His TURP back in the 1980s essentially immobilized the urine flow through his bladder sphincter and in other points along his urethra. For a few months, he was able to self-catheterize through his urethra, but that caused a little internal damage from time to time, and his urologist recommended the permanent catheter connected to an external bag. That worked for him for several years at home, then his care takers at his assisted living facility helped him with it for several more years. During that time, he was able to dance with some of the ladies without feeling inferior about his special arrangement.

One last comment for now: Colleen as usual was on spot asking whether you have considered getting a second opinion. Both I and my dad had the good fortune of building a team of urologists and other medical personnel to deal with our needs. I hope you'll be able to do that as well. Let us know how we can help and what more information we can provide. Martin

alderton, Vitamin B1 is involved with the vagus nerve function and a deficiency of B1 (thiamine) may be the cause of your problem. Thiamine requires magnesium to become bioactive but excess carbohydrates or alcohol will turn thiamine off. Research the vagus nerve as it applies to the bladder sphincter muscle and the rest of the body. Then investigate thiamine deficieny and it's impact. Also research benfotiamine a fat soluble form of thiamine that passes through the blood/brain barrier more efficiently yjan water soluble forms.
https://www.objectivenutrients.com/insights/thiamine-ttfd-bladder-emptying-disorders-of-retention-and-incontinence-stones-interstitial-cystitis
https://nootropicsexpert.com/vitamin-b1-thiamine/
https://www.krispin.com/magnes.html