Sudden Onset of Urge Incontinence

Posted by e39driver @e39driver, Aug 13 6:51am

I have BPH (was told it was a large one) and had a TURP in 2015. I considered it successful (compared to my prior condition) though I still got up about 2x per night to urinate.

Fast-forward to June, 2020, with no warning or change in any other health conditions, I experienced the following:
– blood in urine (with small clumps) for 36 hrs straight
– a couple of days of no blood in the urine
– then, another 30 hrs straight of blood in the urine
– then, sporadic blood in urine for a week
– then, no blood in urine since the beginning of July (and to this day)
– however, cessation of blood in urine was accompanied by multiple bouts of urge incontinence per day (and continues to the present time)
– also, now getting up every 2 hrs (or less) at night to urinate.

Previous to this, I might have a bout of urge incontinence once every 2-3 weeks and could generally control it with a Kagel move. Now, my ability to control my urge incontinence is almost non-existent. Now wearing extra-absorbent pads in my underwear.

Lastly, my urine flow through all of the above has been good, so do not think it is associated with my prostate – rather something with the bladder.

Was able to see my urologist in mid-July (quite difficult due to Covid-19), who ordered a CT scan of my abdomen, with a follow-up visit on Aug 26th. He did not speculate what the source of my problem was.

Any insight from forum members would be appreciated.

Good morning e39driver (@e39driver), we share some similarities in our past experiences, right up to the first of this month. I'll spell those out presently, but want to say hurrah that you're scheduled for a personal conversation with a urologist in less than two weeks. You'll spend the time until then racking up questions to ask at that time –in-person or on-video live.

I too have BPH and had a golf-ball size piece of my prostate removed in a TURP 11 years ago. Since then I have had episodes of blood in my urine (occasionally with a few small clots), but never "frank" bleeding — that is, heavy red blood in place of urine. Instead, I get pink urine in these episodes of two or three days about once every three months. My urologists have told me that the TURP probably exposed some blood vessels by removing tissue that previously reinforced them, and given my general high blood pressure, occasional thin bleeding is not unusual. If the blood is not frank, they say, don't consider it an emergency worthy of a trip to the hospital.

Getting up two or three times each night to urinate is common for me, and I don't take that as an urgent problem either. Urge incontinence was a main problem before my TURP; it disappeared afterwards, until early this year when it became apparent that my prostate was expanding again into my bladder, which is functionally impaired by my hypertension medication and tends to feel the urge when urine occupies less of the bladder volume than before.

I'm due for my now-annual cystoscopy later this month so my whole situation will get a fresh review. In 20 of those over the past 10 years, we have seen no damage to the bladder lining, leading to the suspicion that the bleeding is probably attributable to the prostate, not the bladder. My nephrologist also ruled out my kidneys as the source of blood a few years ago, and I'll ask my urologist about that possibility now.

Good luck with your own urologist visit ahead. We may have more similarities to discuss after I see mine as well. Meantime, can we provide any further information now that you think might be helpful in crafting your questions for the doctor? Martin

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Martin,

Thank you, for your reply. I will report back after my next urologist visit.

As noted in my original post, my flow appears to be normal (for my history and age) and did not change with the onset of urge incontinence. This is why I thought my prostate might not be the culprit?

Ken

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@e39driver

Martin,

Thank you, for your reply. I will report back after my next urologist visit.

As noted in my original post, my flow appears to be normal (for my history and age) and did not change with the onset of urge incontinence. This is why I thought my prostate might not be the culprit?

Ken

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Had a follow up visit with my urologist where he did a cystoscopy. This showed some scar tissue and inflammation, but nothing else significant. The CT scan also came back clear. He diagnosed it as an infection and prescribed bactrim, but also sent a sample to the lab to make sure it was the correct antibiotic for the infection. I've been on it for a few days now and things are getting better every day; so, I think my problem is solved.

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@e39driver

Had a follow up visit with my urologist where he did a cystoscopy. This showed some scar tissue and inflammation, but nothing else significant. The CT scan also came back clear. He diagnosed it as an infection and prescribed bactrim, but also sent a sample to the lab to make sure it was the correct antibiotic for the infection. I've been on it for a few days now and things are getting better every day; so, I think my problem is solved.

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Thanks for taking the time to report back. Fingers crossed that this is the solution.

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