Prostate and Bladder Issues

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?

@scwhandyman

I was recently diagnosed with BPH. Symptoms are not too bad except for nighttime trips to the bathroom. Urologist suggested urolift, but like Steve from Ohio I had some reservations and heard some bad things about the procedure. I am only 66 years old and my prostate will continue to grow. How often would I have to have the procedure redone?
So now he has me scheduled for the Rezum treatment. This is for 30 to 90 cm3 prostates and mine is only 28 cm3. He doesn't consider this an issue. My only concern is this going to be a problem. Can too miuch of the prostate be killed off? Do I have reason to be concerned about this?

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Scwhandyman, this is Steve from Ohio. I read your comment this morning. After thinking it over and doing some more reading and talking with the Urologist office I am going to have the Urolift done. I too was given an option of the Rezum which uses a jet of steam to selectively kill off tissue blocking the urethra. My prostate is also in the 30 + range which is the size the procedure seems to work best for. I based my decision on the fact that the Urolift is the least invasive, least painful, least side effects , no catheter most of the time, causes no sexual dysfunction. I had a lady friend of mine who worked as a surgical nurse for many years and had assisted in TURP operations do some checking up on this procedure. She found some very positive studies that really showed it was effective and also every man was able to get off medication soon after having it. The study was a blind study where they fooled some men into thinking they had the Urolift surgery but really did not, ( you would have to read how they did this it was clever), And the other half did get the surgery and the group that did get it reported real relief from their symptoms. Then the group that did not get the Urolift got the procedure and reported the real differences. The studies all only go back 5 years because that's when Urolift was approved in the US for use. Urolift is prt of the Neotract company a subsidiary of Teleflex, TFX, which is on the Stock exchange if you want to investigate it more. I also contacted Urolift in California and asked then outright if any of these sutures they use have ever broken off. I told them I exercise a lot and bike and lift weights and run and they said that although they didn't test it for every possible exercise none had every broken and caused trouble. If you have an e-mail I'll copy and send you these reports and studies. I guess the only real question is long term will it continue to leave me symptom free ? No one seems to know for sure. I too have not been able to find anyone locally who has had it but my Doctors office said they have done 5 and no one has complained about it. If you go on Urolifts website you can see videos of satisfied men talking about their experiences. My Doctor said that the outer tissue that is compressed could regress or die off a bit keeping the path open and the prostate may slow down it's growth or the growth could be so slow that you may never have to worry about it again. I just decided I would go for the least destructive surgery the first time around and if something more radical is need down the road I'll deal with it later on because the sutures can easily be removed at the time of another surgery. But all the other surgeries seem to a lot more risky. Good Luck I'll be posting my experience for sure. Steve Ohio

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@scwhandyman

I was recently diagnosed with BPH. Symptoms are not too bad except for nighttime trips to the bathroom. Urologist suggested urolift, but like Steve from Ohio I had some reservations and heard some bad things about the procedure. I am only 66 years old and my prostate will continue to grow. How often would I have to have the procedure redone?
So now he has me scheduled for the Rezum treatment. This is for 30 to 90 cm3 prostates and mine is only 28 cm3. He doesn't consider this an issue. My only concern is this going to be a problem. Can too miuch of the prostate be killed off? Do I have reason to be concerned about this?

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That should be cc3 not cm3. Cm3 would really be an enlarged prostate!!

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My sympathy for your bladder problems. I have had them all over the years None of these drugs did any good I had turps and the had the daddy of them all prostate cancer I still have my urgency problem. I am about to have BOTOX treatment. This was tried some months ago but it was found I neededa little surgery. This has been done. Shortly I will have the BOTOX. Doc is optimistic. I will be so relieved I have had this problem for 30 or 40 years. I will report in due course

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doncampbell, my problems seem small compared to yours. I am having the Urolift next Monday Feb 3. I am hoping that it will solve my problems and get me off of meds. I have had all the associated troubles of enlarged prostate for 10 + years. I think my Doctor wanted to start with the least invasive surgery which is Urolift. There are good results from it providing that your prostate is under 80 cc and prostate is not blocking or protruding into the neck of your bladder or at the other end. I intend to post my experiences after having this on Monday. Good luck to you. SK Ohio

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Hello everyone I had my Urolift procedure this morning, Monday at 10 AM, The procedure is only 15 minutes or so. Barley enough time for a good nap. I just got home and it is a "bit uncomfortable" to urinate but other than that I feel good. The anesthesia is much less than a full surgery, I was fully asleep, but woke up quickly afterwards in recovery with no hangover. I left the hospital on my feet with no catheter and before leaving was given one pain pill and a hand held urinal container for the ride home. The Doctor had to use 6 of the Urolift implants instead of the 4 originally scheduled. He put 4 on one side and 2 on the other side. I got photos showing the before and after and it looked as if it had opened up the pipes. Time will tell if the results turn out to as good as I hope for. Since this is a newer procedure and the followup data only goes out about 5 years I plan to post my experience and progress so others considering having this can get an opinion from a regular guy in Ohio. I thank God everything went well and I am hoping for the best. Take Care SK Ohio

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Day 2 Post Urolift surgery. I don't have any experience with BPH surgeries except for the Urolift so I'm basing all this on my personal experience. Yesterday was an uncomfortable day. Urinating every 15 minutes or so and the best description is it was like pouring Iodine on a cut all through the urination. I did not want or get any pain pills so they suggested Advil, ect. Unfortunately due to all the sports injuries I have dealt with and many years of OTC pain killers I can't tolerate them anymore. I manage to take a few but that's it. I slept in a reclining chair with my portable urinal near the bathroom and managed to get some sleep. I passed a couple of dozen blood clots but no big deal. I just took a nap and today is better, no signs of blood or infection. I can't say that I notice any dramatic differences yet. More than likely there is still swelling and disruption. I do have sudden urgency, "when you gotta you gotta go". There is still constant burning but flow is OK. I plan to go to back to the gym tomorrow for walking light upper body exercise. No leg exercise for a least a week. Hoping for a big improvement, time will tell.

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Day 3 Urolift procedure. Pain is less but I see no improvement in BPH symptoms or urine flow. After talking with Doctors office they say it is because of inflammation. I am again taking 1 Tamsulosin a day, Motrin for inflammation. They tell me they do not know if the muscles, and nerves that regulate bladder function like in a man before having BPH for years will ever return to normal functions even after having this procedure. They tell me take it may take 6-8 weeks to see any results I hope so, because so far this not what the Uroflift brochure advertised. I'll post again in a week or so for an update.

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@amgracing1

Day 3 Urolift procedure. Pain is less but I see no improvement in BPH symptoms or urine flow. After talking with Doctors office they say it is because of inflammation. I am again taking 1 Tamsulosin a day, Motrin for inflammation. They tell me they do not know if the muscles, and nerves that regulate bladder function like in a man before having BPH for years will ever return to normal functions even after having this procedure. They tell me take it may take 6-8 weeks to see any results I hope so, because so far this not what the Uroflift brochure advertised. I'll post again in a week or so for an update.

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Hey @amgracing1, It's been a couple of weeks since your Urolift surgery. How are you doing? Improvements?

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It's been 3 weeks since I had my Urolift prostate surgery. I seemed to get a bit better after I started taking a lot of noninflammatorys like Motrin, Advil. But all in all I have to say that this procedure did not significantly improve my symptoms. On a scale of i-10 this is about a 3. I am still taking one Tamsulosin a day instead of 2. I guess that could be called an improvement. But the goal was to be completely off medication and have a big improvement. I am going to give it some more time I see the Doctor again in 3 weeks, I'll wait and see. So far this is a disappointment.

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Where did everyone go? I hope Steve from Ohio is doing well. My name is Bill and will soon be 69 y/o, a former athlete still very active cyclist (split seat), elliptical and moderate weight conditioning. Good overall health except….. I've had BPH for at least 3 years with some problems I'll talk about, I'm doing fairly well on Tamsulosin. I have been seriously researching other options as I know the future of this condition doesn't get any better on it's own.

My problem started with a retention incident of my own making, waited too long. I knew I had a problem so I took myself to the emergency room. Voided over 1000cc. Found a good Urologist that I vetted best I could at a urology group nearby. Did the usual exam and put me on Tamsulosin that immediately helped. I do void a decent amount with about 60cc or less remaining in bladder as ultrasound has shown. I usually sleep about 6 hours but don't drink anything about 2-3 hours before bedtime. I easily void about 12-14 oz in the morning, a little slow but usually within 1-1 1/2 minutes. I do have moderate pain upon starting the stream which could take about 10 seconds to start.

Here's my concern and problem. My prostate is 150 grams according to Uro's estimate. About 6 months ago I saw a little bright red blood before the stream started. Saw the Uro and urine analysis showed elevated white blood cell count. I did have very mild pelvic pain, prostatitis was diagnosis (my thinking was non bacterial). After 10 days of antibiotic symptom came back within a month so I went for the dreaded cystoscopy of bladder. There is a history of bladder cancer in my family but I understand it generally is not hereditary unless you have same personal habits that may cause it (I don't) although I was a NYC firefighter in a busy area and that happens to be a risk factor. Thankfully my bladder was clear. The hardest part of that examination was the young female nurse holding on to me. During the exam Uro said I had a very vascular prostate and the blood was probably from a blood vessel rupturing. The blood happened one other time but in my research I may have found the remedy. Each time it happened I had a difficult bowel movement. A light went off in my head so I went to Dr. Google and my Grey's Anatomy copy and see the rectum is right next to the prostate. I added prunes to my morning routine and everything is fine now, no blood and pelvic pain gone.

So my next problem is knowing I will eventually need a procedure. I'm leaning toward a Prostate Artery Embolization as my first least invasive procedure. Will be having a consultation sometime this year with a good Intervention Radiologist in Boston who has done many of these procedures. Decisions decisions, nobody said this will be easy. I am thankful for the Mayo Clinic and everyone on this board. The knowledge and experiences here are invaluable for people like us. Together we'll deal with this male curse. Glad to be a part of the community.

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@bill5letsfixthis

Where did everyone go? I hope Steve from Ohio is doing well. My name is Bill and will soon be 69 y/o, a former athlete still very active cyclist (split seat), elliptical and moderate weight conditioning. Good overall health except….. I've had BPH for at least 3 years with some problems I'll talk about, I'm doing fairly well on Tamsulosin. I have been seriously researching other options as I know the future of this condition doesn't get any better on it's own.

My problem started with a retention incident of my own making, waited too long. I knew I had a problem so I took myself to the emergency room. Voided over 1000cc. Found a good Urologist that I vetted best I could at a urology group nearby. Did the usual exam and put me on Tamsulosin that immediately helped. I do void a decent amount with about 60cc or less remaining in bladder as ultrasound has shown. I usually sleep about 6 hours but don't drink anything about 2-3 hours before bedtime. I easily void about 12-14 oz in the morning, a little slow but usually within 1-1 1/2 minutes. I do have moderate pain upon starting the stream which could take about 10 seconds to start.

Here's my concern and problem. My prostate is 150 grams according to Uro's estimate. About 6 months ago I saw a little bright red blood before the stream started. Saw the Uro and urine analysis showed elevated white blood cell count. I did have very mild pelvic pain, prostatitis was diagnosis (my thinking was non bacterial). After 10 days of antibiotic symptom came back within a month so I went for the dreaded cystoscopy of bladder. There is a history of bladder cancer in my family but I understand it generally is not hereditary unless you have same personal habits that may cause it (I don't) although I was a NYC firefighter in a busy area and that happens to be a risk factor. Thankfully my bladder was clear. The hardest part of that examination was the young female nurse holding on to me. During the exam Uro said I had a very vascular prostate and the blood was probably from a blood vessel rupturing. The blood happened one other time but in my research I may have found the remedy. Each time it happened I had a difficult bowel movement. A light went off in my head so I went to Dr. Google and my Grey's Anatomy copy and see the rectum is right next to the prostate. I added prunes to my morning routine and everything is fine now, no blood and pelvic pain gone.

So my next problem is knowing I will eventually need a procedure. I'm leaning toward a Prostate Artery Embolization as my first least invasive procedure. Will be having a consultation sometime this year with a good Intervention Radiologist in Boston who has done many of these procedures. Decisions decisions, nobody said this will be easy. I am thankful for the Mayo Clinic and everyone on this board. The knowledge and experiences here are invaluable for people like us. Together we'll deal with this male curse. Glad to be a part of the community.

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Hi, @bill5letsfixthis. Looks like lots of similarities between us. Maybe my experience will be helpful to you. BPH was my main problem 12 years ago. After 5 years on Tamsulosin (Flomax), my urologist urged me to avoid the potential problems from long-term reliance on the drug. One reason: It was no longer effective. My urinary problem became more difficult, so we decided on a TURP (transurethral resection of prostate tissue). After removal of tissue, the cystoscope lit up a small papilloma in the bladder lining that had been hidden from view of imaging technology. It was removed immediately, and a follow-up cystoscope exam found a dozen more of those tumors, all superficial and not invading bladder muscle. We performed a TURB (bladder) and removed them, followed by a 5-week treatment with BCG solution to eliminate seeds of any other tumors. Since then, I have had periodic exams by cystoscope and found no more tumors. Once or twice a year, my urine turns pink from blood leaking into my bladder for a couple of days, but it's never been "frank" (undiluted) blood, and my urologist urged me to consider it non-critical. Three urologists, actually, all said leaky blood vessels in the prostate were not uncommon after a TURP. Unfortunately, BPH doesn't give up and continues to grow as the years pass by, so we're always checking for its intrusion into the bladder. Martin

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@predictable

Hi, @bill5letsfixthis. Looks like lots of similarities between us. Maybe my experience will be helpful to you. BPH was my main problem 12 years ago. After 5 years on Tamsulosin (Flomax), my urologist urged me to avoid the potential problems from long-term reliance on the drug. One reason: It was no longer effective. My urinary problem became more difficult, so we decided on a TURP (transurethral resection of prostate tissue). After removal of tissue, the cystoscope lit up a small papilloma in the bladder lining that had been hidden from view of imaging technology. It was removed immediately, and a follow-up cystoscope exam found a dozen more of those tumors, all superficial and not invading bladder muscle. We performed a TURB (bladder) and removed them, followed by a 5-week treatment with BCG solution to eliminate seeds of any other tumors. Since then, I have had periodic exams by cystoscope and found no more tumors. Once or twice a year, my urine turns pink from blood leaking into my bladder for a couple of days, but it's never been "frank" (undiluted) blood, and my urologist urged me to consider it non-critical. Three urologists, actually, all said leaky blood vessels in the prostate were not uncommon after a TURP. Unfortunately, BPH doesn't give up and continues to grow as the years pass by, so we're always checking for its intrusion into the bladder. Martin

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Thank you Martin for your reply and concern for me and everyone else you have helped on this forum. In reading some of your previous posts I was going to bring up your thoughts on my next visit to my doctor. My goal of course is to get off the Tamsulosin with a smaller prostate and I am resigning myself to the fact it will be a lifelong ordeal. I do believe I have a little time as I am as close to normal as I can expect to be and manage my prostate well enough to have a regular life (I know where all the good bathrooms are if I need to travel). I drink 2 liters of water a day and mostly work at home so voiding every 2-3 hours or so is fairly easy. Without all the pressure (no pun intended) that I need to go straight to the gold standards of TURP and HoLEP right away I am hoping I am on the right track by researching everything first. I have a number of friends on finasteride with side effects that are not acceptable to me. My doc offered it to me but I declined as I felt Tamsulosin was working for now. My Dad had a TURP in I think 1989 which basically ruined his life but my doc assures me the advances have come a long way. My doc thought a Urolift would be suitable as extra clips could be used for the large prostate but the Urolift people say no, so that's out. The PAE interests me, I just need more info.

I've never seen any pink urine, just those 3 times of a little blood at very beginning of stream, but I will bring up the papilloma question, thank you for stressing that. I have a question for you. You mention blood leaking into your bladder, but am I correct to say leaking blood from the prostate will go directly into urethra? Or, can it go into the bladder as well? The prostate intruding into the bladder from what you say would be a major concern for me with a large prostate. Thanks, Bill

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