Mild thickening of the bladder wall

I had thickening of my bladder wall when I was experiencing severe urine retention, where my bladder was forced to hold up to 1000 cc's of fluid. I believe the thickening was related to this. Have you had a bladder scan to see if you are retaining urine? If you have to urinated that often, it seems likely, as you are not emptying your bladder when you urinate. For me, this led to kidney disease, etc. All due to an enlarged prostate. Yours may be a completely different situation but worth checking it out.

Hi Paul,

I was told that I had been retaining excess urine for so long that it thickened the bladder wall and when this happens the bladder doesn't contract the way it used to. This is what caused me to urinate often, even though I was still not emptying fully. This resulted in a reflux back up the ureters into the kidneys hydronephrosis. The hydronephrosis was causing the dizziness, elevated blood pressure. After the catheter was put in, the blood pressure eventually returned to normal, but kidney function has been affected. My function fell to 55, but then with diet it went up to 75.
Recently, I had a urodynamics test. This torture showed that I was retaining more than what I was sensing, but I wasn't able to pee on my own for the Flowmetry, past the thin catheters, because of the prostate. Surgery has been offered as the only option. Which kind, has not been determined. I've yet to have a face to face with THE surgeon.

Delmar, sorry to hear about your problems. My original issue was urine retention due to an enlarged prostate which undetected then caused kidney damage. I got my prostate problem solved with HoLEP surgery, which worked great. Unfortunately my kidney damage is permanent and I have been diagnosed with Chronic Kidney Disease 3b. My eGFR has been around 45 for the last two years without much fluctuation. I'm impressed that you were able to improve yours from 55 to 75. How did you do that?

Regarding surgery, the only good thing about my experience is that the surgery became a medical necessity and so was completely covered by my health insurance. Prior to that I had discussed surgery with my urologist for my enlarged prostate (about 135 cc's) but it would have been elective and so not covered. However, had he told me this could happen I might have opted for it anyway. Never did any bladder scans or flowmeter even though he knew I was having peeing issues.

I would be happy to share more information about HoLEP surgery if you are interested.

I already have one kidney due to cancer back in 2017. Which I’m so scared it will led to that.

Dear Paul,
In answer to your question about raising eGFR from 55 to 75, I got the idea from one of the people here. I don't know why I cannot remember their name. It was all dietary. They mentioned that they pared their daily meal down to a chicken sandwich in the afternoon and a homemade vegetable soup with a chunk of fat-free beef in it for dinner. After doing this, my following result changed. I bake a package of chicken tenders and eat two of those with a fistful of arugula or a mixed lettuce and have a soup at night. Lately I've been wondering about what my function is because they want to schedule an MRI of the prostate using a gadolinium contrast. This contrast poses a concern to me. My last eGFR was around December 19 last year and eGFR has been known to fluctuate depending on factors like diet, hydration, any strenuous activity before a test. So, I tried to order through their internet portal a request for a renal function AND thyroid test. Not a peep. As of today, I do not know if I am at 75, have moved down, or elevated to normal. They keep changing the test values too.
On one test I see the normal range as greater than 90, or >90, then on the last test it was >60, or greater than 60. So, what is the normal? Is it greater than 60, or 90?

On Holep, I have an appointment in April, the day before my 60th birthday of all times, to see the surgeon who uses the Holep laser. Your experience with it sounds encouraging and yes, I would like any details about your experience before and after surgery. Your recovery process, did you have help at home around the house, how mobile were you? Pain level? What anesthesia did they use? What did they give you post op for pain? Incontinence issues, how long? Because, in spite of the differences in kidney disease, it appears that the sequence of events which led to our current state are almost parallel.
Thank you, Paul, for commenting.

I am not an expert on EGFR, but I think anything above 60 is considered fine. Regarding the MRI, I suspect that is checking for prostate cancer. I have had several of those. That looks for areas which based on things I don’t understand look like there could be potential cancers. Then they focus in on those areas when they do follow up biopsies as opposed to just the usual prostate biopsies where they basically take 12 biopsies from areas around your whole prostate. If they find suspicious areas in the MRI, they focus the biopsies on those areas. but very importantly, the die they use can have some complications for kidneys. So you should make sure they know of your kidney problems. I think it may be OK to have it anyway, but they definitely should take it into account when they make their plans for your MRI. Regarding the Holep, and you are given a general anesthetic meaning you are put to sleep. They didn’t give me some kind of strong pain medication. I could take if needed but I did not need it. I think I just use some Tylenol. I had some urine leaking problems at the very beginning, but that quickly went away, and I have not had any further issues. It sounds funny, but the only time I ever have any leaking now, and it is slight, is when I hug my wife. Regarding urinating, are usually have one very strong urination a day like I did when I was younger. Again, it sounds funny, but it is very good to have that experience after so many years of not being able to urinate much at all. I still have times when I feel like I have to urinate and then only have a few drops though. And I still wake up once or twice a night and have to go to urinate. But it is an overwhelming improvement from before the surgery. Most importantly, I don’t have to worry about my urine backing up into my kidneys, which is disastrous, of course. not sure if I mentioned this, but because that was the reason I needed hold of the surgery it was considered a medical necessity, and everything was covered by my health insurance.
And whatever you decide to do, I hope things go as well as possible. And keep your eye on urine retention. Make sure your urologist is doing bladder scans on a regular basis. Until you get your whole life, if you are became urine, you have to do something to make sure it does not become a problem for your kidneys. Self catheterizing, is one way to do this. I had to do that for about a month between when I had my crisis, and when I had my Holep Surgery. I did not think it was that bad.

Forgot to mention some things about my recovery regarding your questions. My own experience was that had to rest for several days, but was just fine after that. Very little problem with movement. I think I had some kind of a bed pad in my bed for a couple days just to make sure I was not leaking, and maybe wore a pull-up for a couple days also. I did have blood in my urine for a short time after the surgery which was normal. again, everyone has a different experience, but that was mine. Really the only lasting thing about the HoLEP Surgery was the retrograde ejaculation which I think we have already discussed. While I would rather that not have been an outcome, it has not proven to be a big deal.

You have no idea how grateful I am for your answer. The pads for the bed did cross my mind, so, add that to the list because "ya never know . . . " As far as the RE, this is expected and it's the trade-off, preferable to worse outcomes. At this moment, I am hoping that there are no malignancies, this will change the mode of surgery to one I will not be so eager for the trade-offs. That's a different animal altogether. One day at a time.

Also, I did not mention that I consume at least 2 liters of water over the course of a day. I put it in a glass refillable bottle and make sure I drink two. Maybe one more if I'm active. It really clears up the urine. I track the output using a large measuring container in the bathroom before I dump it. I can check color, etc. and sitting makes it easier. But, you don't have to think about this part anymore! If the outcome of mine is the same as what you've described, I will be very pleased. The whole prospect gives me the willies.
Thank you, Paul.

please share more on holep surgery. how log did it take you to stop incontinence?

Delmar, luckily I did not then and have not since had much of a problem with incontinence. I will explain but keep in mind this is just me, I have no idea what the general or average result is for most people. First, the great thing for me was I went home from the surgery to my hotel room and no longer had to use a catheter (I was self-catherizing and could not urinate without that). I wore a pull-up for the first few days or even a week, but really did not end up with much leaking. After that and since then really no leaking at all. It is funny, but the only time I leak, and then very minimal, is when I hug my sweet wife. Honestly. Other than that, and retrograde ejaculation, which I already discussed with you, it was a fairly normal experience. My wife and I went to the hospital, my surgeons team got me ready for surgery, and I was rolled into the operating theatre. Bright lights! The anestheiologist appeared over my head and asked me a few questions, and tried to calm me down, and then either gave me another shot and/or put the gas mask over me (cannot remember if that happened). After that the next thing I knew I was waking up in recovery. I was told just to stay in bed for a few days, but ended up getting up and walking around a little (slowly). I was in contact with my surgeon/urologist for a few months, then my aftercare was taken over by my local urologist since I live in the Twin Cities and the surgery was in Chicago. I think a lot what I consider to be my good outcome is a result of the excellent surgeon I had, Dr. Amy Krambeck. I am pretty sure she has done more HoLEP procedures than anyone else in the county, or she is way up on that list. She also did a fellowship at Indiana University, which is where (I think) the procedure was developed or where the doctor who developed it works. I am sure there are many other urologist/surgeons who have done that or a similar fellowship and have done a great number of procedures. Just try to find one that has as much experience and training as possible--don't be afraid to ask how many procedures the person has done and whether they did a fellowship in that area. Before I contacted Dr. Krambeck, I was set up to have my procedure done by another doctor who had only done about 60 procedures and had not done a fellowship. That doctor probably would have done a perfectly good job, and of course even Dr. Krambeck only had done 60 procedures or so at some point in her career. But that is what I decided to do. Anyway, best of luck as you go forward with your medical issues.