Urine Retention & Voiding/Bladder Dysfunction

Posted by terwifwoods @terwifwoods, Oct 21, 2021

Hello,

Over a month ago, I went into the ER with a distended bladder. Thankfully, my kidney function is good. After seven days on a foley catheter, I started self-catheterization, which continues. I can only empty approximately half of my bladder with a weak stream. I have seen up and down progress with my ability to urinate and empty.

After further visits and a cytoscopy, I was told my external urethral sphincter is very tight and I had bladder hypertrophy. My current doctor gave me grim news stating there was a low probability of my bladder recovering and I may have to catheter the rest of my life.

Prior to this, I was a very physically active forty some year old and over twenty years into a career where I would not be able to work based on having to cath. My career is physically and emotionally demanding. I have been doing pelvic floor exercises, meditation and mindfulness, frequent deep breathing exercises, and of course prayer. I am also on Flomax, but I am not sure if it is effective. I have noticed more constipation.

I am seeking a 2nd doctor's opinion, but can anyone offer any other options they have used to relax the external urethral sphincter/pelvic floor muscles? Or in general, anything you have done to increase urination and self-voiding?

Interested in more discussions like this? Go to the Kidney & Bladder group.

I am at the Mayo Clinic in Rochester, MN for urinary problems. They prescribed Pelvic Floor Physical Therapy for me, and that seems to help. I am able to relax my Kegels fully, and can initiate urinating just by an appropriate way of breathing. You might want to look into this, too.

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@lindes

I am at the Mayo Clinic in Rochester, MN for urinary problems. They prescribed Pelvic Floor Physical Therapy for me, and that seems to help. I am able to relax my Kegels fully, and can initiate urinating just by an appropriate way of breathing. You might want to look into this, too.

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Ok, thank you @lindes. I have been doing pelvic floor exercises/stretching for about a month. I do them at least twice a day, including stretching my hips, legs, and lower back. I have not noticed a difference yet. I have also utilized deep breathing. Do you have a realistic time frame as far as how long it may take to relax that area? 3-6 months? Longer, shorter?

I am looking for a sense of hope. My current urologist said there was a high probability I would have to catheter the rest of my life. I would like to defy those odds. I am an otherwise healthy forty some year old male.

Do most male patients who do pelvic floor exercises respond to them and actually loosen or relax that area?

Any other procedures or things I can do to loosen that area at home?

My doctor recommended placing a foley cath back in for at least a month to let the muscles and bladder relax. Think its worth a try?

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@terwifwoods

Ok, thank you @lindes. I have been doing pelvic floor exercises/stretching for about a month. I do them at least twice a day, including stretching my hips, legs, and lower back. I have not noticed a difference yet. I have also utilized deep breathing. Do you have a realistic time frame as far as how long it may take to relax that area? 3-6 months? Longer, shorter?

I am looking for a sense of hope. My current urologist said there was a high probability I would have to catheter the rest of my life. I would like to defy those odds. I am an otherwise healthy forty some year old male.

Do most male patients who do pelvic floor exercises respond to them and actually loosen or relax that area?

Any other procedures or things I can do to loosen that area at home?

My doctor recommended placing a foley cath back in for at least a month to let the muscles and bladder relax. Think its worth a try?

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I cringe each time when I hear of long term applications of Foley cath. It is almost impossible to prevent a bladder infection with those (my medical specialty is infection control & prevention). The male pelvic floor is very similar to the female pelvic floor, and I assume that the phys therapy is not much different either (I am female). It took me about 18 sessions (45 minutes each, twice a week), to be able to empty my bladder down to a table spoon amount of urine. I also learned to initiate urination as soon as there was enough liquid inside the bladder.
I know that pelvic floor control is for most men a book with 7 seals, because they don't need it as much as females do, and because most urologists are guys, it might not even be on their radar screen.

Linde

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@lindes

I cringe each time when I hear of long term applications of Foley cath. It is almost impossible to prevent a bladder infection with those (my medical specialty is infection control & prevention). The male pelvic floor is very similar to the female pelvic floor, and I assume that the phys therapy is not much different either (I am female). It took me about 18 sessions (45 minutes each, twice a week), to be able to empty my bladder down to a table spoon amount of urine. I also learned to initiate urination as soon as there was enough liquid inside the bladder.
I know that pelvic floor control is for most men a book with 7 seals, because they don't need it as much as females do, and because most urologists are guys, it might not even be on their radar screen.

Linde

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Ok thank you. Do you think having a Foley catheter for one month would be beneficial and allow the external urethral sphincter and bladder to relax or reset so to speak?

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@terwifwoods

Ok thank you. Do you think having a Foley catheter for one month would be beneficial and allow the external urethral sphincter and bladder to relax or reset so to speak?

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I am not a urologist, and can't answer this. You should consider to get a second opinion. From the infection prevention side, I don't see it as beneficial.

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I am 80 and a healthy male. Diagnosed with bladder cancer last February. The cancer was removed successfully however it was high-grade and I am undergoing observation and BCG treatments. My bladder was greatly distended due to an enlarged prostate and not being able to empty completely. I am now using catheters and would love regain normal function. I have seen three different Urlogist none of them Have recommended Physical therapy/exercises. Would like to hear from any men who have successfully recovered function with exercises. If you’re out there please give me as much info as possible. Thanks for any replies.

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@dan80

I am 80 and a healthy male. Diagnosed with bladder cancer last February. The cancer was removed successfully however it was high-grade and I am undergoing observation and BCG treatments. My bladder was greatly distended due to an enlarged prostate and not being able to empty completely. I am now using catheters and would love regain normal function. I have seen three different Urlogist none of them Have recommended Physical therapy/exercises. Would like to hear from any men who have successfully recovered function with exercises. If you’re out there please give me as much info as possible. Thanks for any replies.

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@terwifwoods, @dan80, @lindes, and all other 'bladder- babies'…I'm a Mayo
Jacksonville patient and see a gyno-urologist there to help me with some of the same issues you seem to be having. I'm not sure that specialty is a good match for you, as a man….but I do know…urologist is for you. I do know Mayo has a good department to help us. And, the newest treatments as well.

I strongly suggest you see more than one urologist especially since you have some serious life-changing issues. I also have found seeing a specialist at a major research hospital, or university teaching hospital or such is a very good direction to get the best info. I live in Jacksonville, Florida, so it was logical for me to visit Mayo. It's been the best decision I've ever made!

I do know catheters can and often do lead to infections, no fun. I also had physical exercise sessions for pelvic floor dysfunction. That, my friend, you need to discuss with your urologist whom you trust to know the newest and best for you. I found it helpful for me until she used a tens unit too strong and too long and I had some discomfort for days. Haven't been back. but that's due to some new problems in other specialties that took my focus. I do think therapy can really help and may be part of the way for you to improve.

Again, strongly recommend you get a second opinion and from a doctor in a teaching or large facility.
Blessings on your journey. May you find the answers and professionals to guide you to better health.
Elizabeth

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@dan80

I am 80 and a healthy male. Diagnosed with bladder cancer last February. The cancer was removed successfully however it was high-grade and I am undergoing observation and BCG treatments. My bladder was greatly distended due to an enlarged prostate and not being able to empty completely. I am now using catheters and would love regain normal function. I have seen three different Urlogist none of them Have recommended Physical therapy/exercises. Would like to hear from any men who have successfully recovered function with exercises. If you’re out there please give me as much info as possible. Thanks for any replies.

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Hi, Daniel (@dan80). Your situation and mine were very similar, except that my bladder cancer was perhaps not as high grade as yours. It involved a dozen or so pedestal-type papillary tumors that sprouted on the lining of my bladder but never got the chance to grow into the bladder muscle. They were removed in a TURB procedure, and I had five weekly BCG treatments to prevent further tumors. This was several years ago, and the treatments worked; annual cystoscopes of my bladder show no further tumors.

The tumors were discovered after a TURP that removed a golf-ball size amount of prostate tissue. That operation ended serious bladder function problems, but in recent months, my bladder has once again pressed in on my urethra, interfering with my urges to empty my bladder (and get a full night's sleep without interruption). As with you, my series of three urologists have not added physical therapy and exercise to our plan for better urine excretion, and my exercise program has not helped my growing problem. I'd endorse the advice from Elizabeth (@ess77) to get a second opinion from another urologist or two AND find a large medical center (state university or Mayo) for relief from your conditions. Martin

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Thanks I will keep looking for help. Appreciate any other patient for sharing what ever treatment or exercise or procedures that may have been helpful.

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@terwifwoods and @dan80, I thought you might be interested in videos that Mayo Clinic made about pelvic floor therapy.

This animated video depicts normal pelvic floor function vs pelvic floor dyssynergia. Describes the goal of pelvic floor training in the Mayo Clinic Evacuation Disorders Program.

Niki Cookson explains further.

In this video, Dawn Underwood explains what to expect at an appointment at Mayo Clinic. This might be helpful to know what to expect and what questions to ask no matter where you get treatment.

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Thank you for the replies. I obtained a second opinion from an experienced urologist, who at minimum, gave me more hope for recovery than the first. My bladder will recover, but not fully. There are more questions than answers, and both urologists agree a urodynamic test will provide more information. I have a pelvic floor therapist who I trust, who has expressed sincere confidence I can heal. The common answer I get regarding pelvic floor therapy for men is some see progress in several weeks, and other see progress in 3-6 months.

Has any men out there seen progress with pelvic floor therapy, or used any other methods to relax their urethral sphincter muscle?

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