Prostate and Bladder Issues: What to do?

Posted by ch665296f @ch665296f, Apr 19, 2016

I am a 68, nearly 69, year old man that has had bladder issues for years. I had green light prostate surgery 8 yrs. ago which helped for a while. Now, my prostate has had some regrowth and I have developed several bladder diverticulum. I have had just about every bladder test possible. I also have some incontinence issues, and manage by wearing diapers when necessary. I'm ok with that. My urologist had me on a combination of tamsulosin and finastride, but have not realized much of a difference. I'm a bit afraid of some of those drugs because I have read that they could mask the development of a more serious prostate cancer.

My urologist suggests that I may be a candidate for surgery, but what kind? Turp or total removal of the prostate? I have also read that turp sometimes needs to be repeated. Don't want that to happen either. What to do?

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Thank you.....yes, I think it has sometthng to do with the excessive FOLEY, doctor said I would have to learn to Urinate all over again. I do not have problem laying down, just when I am activity during the day.

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@kayak461

Sorry to hear of your sometimes “immediate” urge to empty. I did not experience this when I had my HoLEP procedure. I’m wondering if your symptoms are a result of having the Foley in for the extended period prior to your HoLEP procedure last month. I went back to see Dr. Dora at 90 days…..are you planning a follow up? Would be something to ask him for sure! You can probably ask that question now from your patient portal as well. Hope your symptoms improve soon.

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Yes, I think the long use of FOLEY has a lot to do with this.....I have a revisit after 90 days...I am ok at night, but during the day I need a bathroom close. Hopefully, this is someting I need time to heal and not a permanent issue.

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It sounds like overactive bladder. There is Myrbetriq ($) and Oxycontinin worth trying.

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@rfherald

It sounds like overactive bladder. There is Myrbetriq ($) and Oxycontinin worth trying.

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Thank you for the info.

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@rfherald

It sounds like overactive bladder. There is Myrbetriq ($) and Oxycontinin worth trying.

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what are the signs of overactive bladder, please?

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For me, it was like this: my life is going fine, I'm walking, driving, eating meals, and then all of a sudden, BAM! I have to urinate! No waiting! There's no holding it in, GO NOW! Of course, I could hold it a little while and occasional "leakage" would occur, but you get the idea. A way around this is to pay attention to your urination times and cut short the time between visits to the toilet. Myrbetriq and Oxycontinin worked at first but no longer. See
https://www.healthline.com/health/overactive-bladder

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@anonmike

what are the signs of overactive bladder, please?

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Sometimes overactive and "nervous" bladder are synonymous. Associations with outside circumstances, people, places, things and an association with anxiety, excitement or past trauma can set off the urge. We're creatures of habit.
Having to make a phone call can trigger it. Being just fine with your continence during a ride home, car, bus, walking and then as soon as you reach your front door and fumble for the keys BAM! time to GO, sometimes pain, spasms as you fight the urgency because you know subconsciously that home is where the safety and a toilet is. This last example has always been a trigger for me. I've asked around and it seems I'm not the only one. It's an "anticipatory" thing about the urge and the external associations. So it seems.
One good indication is "bladder shyness." When in a public restroom, does your urge to go diminish when someone else walks up to the urinal? Did this happen before you were diagnosed and needed a Foley? Nervous or over-active can go both ways because of the muscles and bladder sphincter. When someone enters the restroom, the "clench" happens, muscles tighten and you retain pee. When you arrive at your front door, muscles relax because you know there's a safe quiet place to pee at home.
Urological medical trauma and surgical trauma associations with procedures can also contribute to how the bladder functions. Then again, it could be lengthy use of the catheter. You might try Kegel exercises as often as you can, clenching and releasing 30 reps with a ten second hold. At least five times per day. You can do while sitting, lying down or standing (the best).
I've read up on the meds mentioned, the side effects didn't seem appealing. I don't know if I'll need them- I hope not. We've been wearing a Foley for about the same time. I'm still using one. I'm doing Kegels now, before surgery.

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@delmar418

Sometimes overactive and "nervous" bladder are synonymous. Associations with outside circumstances, people, places, things and an association with anxiety, excitement or past trauma can set off the urge. We're creatures of habit.
Having to make a phone call can trigger it. Being just fine with your continence during a ride home, car, bus, walking and then as soon as you reach your front door and fumble for the keys BAM! time to GO, sometimes pain, spasms as you fight the urgency because you know subconsciously that home is where the safety and a toilet is. This last example has always been a trigger for me. I've asked around and it seems I'm not the only one. It's an "anticipatory" thing about the urge and the external associations. So it seems.
One good indication is "bladder shyness." When in a public restroom, does your urge to go diminish when someone else walks up to the urinal? Did this happen before you were diagnosed and needed a Foley? Nervous or over-active can go both ways because of the muscles and bladder sphincter. When someone enters the restroom, the "clench" happens, muscles tighten and you retain pee. When you arrive at your front door, muscles relax because you know there's a safe quiet place to pee at home.
Urological medical trauma and surgical trauma associations with procedures can also contribute to how the bladder functions. Then again, it could be lengthy use of the catheter. You might try Kegel exercises as often as you can, clenching and releasing 30 reps with a ten second hold. At least five times per day. You can do while sitting, lying down or standing (the best).
I've read up on the meds mentioned, the side effects didn't seem appealing. I don't know if I'll need them- I hope not. We've been wearing a Foley for about the same time. I'm still using one. I'm doing Kegels now, before surgery.

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Similar situation....had the Foley in and out for 18 months..mostly in. Now that Hotep is compleate, I have to learn how to urinate. I think some of us get too dependent on Foley, so trigger of when to urinate exists....it[s very hard to get this back to normal, but I try.

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@cent66

Similar situation....had the Foley in and out for 18 months..mostly in. Now that Hotep is compleate, I have to learn how to urinate. I think some of us get too dependent on Foley, so trigger of when to urinate exists....it[s very hard to get this back to normal, but I try.

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I don't remember if I asked you before. Did you wear a leg bag during the day, or did you have a tap / valve that you'd pee through during the day and use a collection bag during sleep?

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I had HoLEP surgery and so far it has completely resolved my urination issues. My prostate was very large--128 cc's, I think TURP is advised for smaller prostates. Or you could try arterial embolization--I have read that is very effective. Until then you might consider self-catherization, where you slide a lubricated catheter up through your penis into your bladder. I did that for several months and it sure beat having a bag. More importantly though, for someone with your issues, make sure your urologist is regularly doing bladder scans to make sure you are not retaining urine that then could back up into your kidney's and cause permanent damage that could lead to dialysis, transplant and death. Very serious!

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