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Old 05-03-2013, 03:50 PM   #16
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Re: Very High Urine Post Void Residual – Why? What to do?

yeah,,, I would call this a milestone,, you can now empty your bladder,,, keep the bladder empty and it will shrink.
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Old 05-05-2013, 05:22 AM   #17
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Re: Very High Urine Post Void Residual – Why? What to do?

albedo,, I am wondering if you have any discomfort
while urinating ??
I still have some burning or some kind of urethral pain or bladder neck, mild
when urinating, its been about 10 weeks now since my bladder neck incision.
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Old 05-05-2013, 10:44 AM   #18
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Re: Very High Urine Post Void Residual – Why? What to do?

@bhp02. No, not really. But also the doctor was asking last week (at 3 months from the TURP) hence it might still be possible. Keep taking it easy and drinking, everyone react differently and 10 weeks is also not that long.

 
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Old 05-11-2013, 12:25 AM   #19
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Re: Very High Urine Post Void Residual – Why? What to do?

The "why" of this thread has not been touched: why people end with such a high residual in a similar condition as mine (no particular nocturia, flow quite normal, small prostate, PSA elevation quite normal)? I only detected the very high PVR because of testing. What is it: bad BPH? Stress? The chronic attitude for decades to refrain to urinate even when you feel the urge because you are doing other things? (actually you are always doing other things!) A matter of education? I recollect events where I refrained to almost pain after drinking a lot following a kidney stone event long ago. All of this...?

Last edited by albedo1; 05-11-2013 at 12:26 AM.

 
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Old 05-11-2013, 04:40 AM   #20
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Re: Very High Urine Post Void Residual – Why? What to do?

in your case, your bladder has been stretched too long.
As I mentioned the bladder cannot contract completely when it is
too large as the detrusor muscles are over stretched.

This is also why its easier to have more retention if you have a full bladder
before peeing than peeing with 1/2 full bladder.
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Old 05-11-2013, 06:29 AM   #21
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Re: Very High Urine Post Void Residual – Why? What to do?

Quote:
Originally Posted by albedo1 View Post
...The chronic attitude for decades to refrain to urinate even when you feel the urge because you are doing other things? (actually you are always doing other things!) A matter of education? I recollect events where I refrained to almost pain after drinking a lot following a kidney stone event long ago. All of this...?


Say you were normal young man of 20, with no kidney or BPH problems.
Say you decide to hold your urine until 500 ml to 1000 ml all the time.
You will create permanent damage to the muscles of the bladder
as they will be over stretched for years, they will have scar tissue,
unable to function properly, until one day they cannot squeeze all the
urine out of the bladder when you go pee.

You can damage your bladder by holding too long. Once a day
when you are asleep is enough to hold to 500 ml -600 ml.
But if you do this all the time when you are awake, you are asking for
problems as you get older because our bladders lose elasticity with age.
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Old 06-07-2013, 02:34 PM   #22
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Re: Very High Urine Post Void Residual – Why? What to do?

bph02, thank you. This looks logical. I searched but could not find studies on reversibility which is of interest to me. It looks logical but where is the medical evidence TURP might entirely reverse the PVR problem? If I can find some statistics I could better justify my TURP decision. However, even without that evidence at least I think I removed an obstacle and even if I cannot arrive to void entirely (I think I can make now 50-60%) at least by taking some time and maneuvering I arrive to void it all and reduce the risk to further damage the bladder. And if I arrive to repeat frequently the full voiding I hope to continue improving. I think I arrive to do it max 3x per day.

Last edited by albedo1; 06-07-2013 at 02:35 PM. Reason: spelling

 
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Old 06-07-2013, 06:03 PM   #23
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Re: Very High Urine Post Void Residual – Why? What to do?

as we get older, the bladder cannot expand and shrink as well.
I do not know how reversible your situation is.
I think it is partially reversible but you may have retention problems, though
a smaller problem than without turp.

What do you think caused your retention problems in the first place ??
before the turp ??
when did you first start to have retention ??
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Old 06-08-2013, 12:52 AM   #24
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Re: Very High Urine Post Void Residual – Why? What to do?

Quote:
Originally Posted by bhp02 View Post
....
What do you think caused your retention problems in the first place ??
before the turp ??
when did you first start to have retention ??
I probably developed the high PVR say 7-10 years back. The first time I measured it was likely in the order of 150-200ml already and started to control (I was then in my late forties), so maybe it increased of 60-70ml each year and likely worsened as prostate size increased obstruction (but remember, at my TURP the my prostate was normally at 13 gr). I likely had a bad lifestyle habit to refrain to go due, I do not know what, maybe stress at work, being busy all the time, laziness, whatever. As I had a kidney stone event long ago I regularly drinked water and recollect painful events, saying being stuck in traffic jam and not going. There is a large part of responsibility and bad education and behaviors, I guess. I hope this help others not doing the same. Anyway I am happy of my TURP at 57, I am clean from PCa for the time being (TURP will not reduce risks), accepted the only size effect I have so far (retrograde) as a trade off with worsening my bladder condition, will soon start a physiotherapy to learn how to relax pelvic muscles (doing now the Cradθ maneuver I incidentally rediscovered, feel very light each time after that !), continue drinking and eating well, supplement for prostate health, take a specific medication (distigmine bromide) at least till my new check up in October, exercise moderately and hope to have healthy life till the end as I enjoy it and have a lot to do.

Thank you bhp02 for your interest.

Last edited by albedo1; 06-08-2013 at 12:54 AM. Reason: spelling

 
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Old 06-08-2013, 02:17 PM   #25
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Re: Very High Urine Post Void Residual – Why? What to do?

Hello Albedo1,

I was reviewing your remarks and noted Crede voiding. Another method is Valsalva, in which you sit down and void by pressing as though you are having a bowel movement. These two methods used to be encouraged but have fallen out of favor with professionals as they increase the bladder pressure and possibly promoting refluxing through the ureters into the kidneys. (CIC is fast, clean and doesn't interfere with the body's natural functions.) I saw where your current voiding removed 50% more than pre-TURP but still at a un-recommended level of residual.

Good luck and hope your toughest days are behind you.

 
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Old 06-12-2013, 05:38 PM   #26
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Re: Very High Urine Post Void Residual – Why? What to do?

albeido, any reason why your urologist did not recommend intermittent catherization ??
If you can void everything out on the second attempt, you would not need to
do catheter...
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Old 06-14-2013, 05:53 AM   #27
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Re: Very High Urine Post Void Residual – Why? What to do?

Two urologists have not recommended it my case (infection risks, no neurogenic bladder condition, ...) and I went to TURP. I now got a Rx for for some physiotherapy to better learn how to relax the pelvic floor muscles but will also recheck for SCIC if no results. I have a good doctor for that and few people here (e.g. Millard) seems very prone on it. By forum policy I cannot post here the link but have a very interesting study on a prospective randomized trial comparing TURP and CIC in case of chronic urinary retention.

 
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Old 06-14-2013, 05:10 PM   #28
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Re: Very High Urine Post Void Residual – Why? What to do?

i was referring to the use of cathetar after your turp.
it will help to drain the bladder completely, that is , if you cannot
pee it out your self on subsequent attempts.
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Old 06-22-2013, 04:41 AM   #29
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Re: Very High Urine Post Void Residual – Why? What to do?

To further (try to) reply both bhp02 and Millard:

1. I specifically asked my urologist for a bladder physio and got a prescription for a number of sessions I will do. He explicitly dismissed SCIC in my case for risks of infection and must admit I did not push further the discussion as I do not see it positively myself (see 2). I was given a doctor contact name for SCIC as she seems in favor of it but never met her, which I will surely do.

2. The issue I have in mind is: is SCIC good in my condition based on practicality or clinical relevance? I mean, if by my process I am able w/o much efforts (note I am not doing Valsava but simply the movement which I discovered with some delicate stimulation (e.g. simply touching the top skin region of the penis) and w/o any mechanical pressure on bladder (was doing it but found it unnecessary)) to fully void the PVR, why not continuing? SCIC will be faster but to the expense of a true unnatural way, putting stuff in my urethra and bladder and risks associated. Is there any clinical relevance of SCIC vs a process which looks to me more natural. If we want to achieve a shrinkage of the bladder both might be equally effective, so why not using what looks to me a more natural method? During my process I bend my body, stimulate as described and apply a gentle strain. Would the gentle strain be causative of damage? I cannot imagine a reflux back to kidneys as the easiest urine path would be through urethra now that prostate obstruction has been removed. However, looks like Millard has a point as my gentle strain might indeed increase bladder pressure, but would that be in itself damaging if the effect is to void the PVR? Moreover, I would expect that pressure will decrease with time as bladder will (hopefully) shrink and recover better functionality.

Confusing right? Anyway I will get to discuss this with a real doctor and see what she says after presenting my case.

Very much appreciated both your comments!

Last edited by albedo1; 06-23-2013 at 01:19 AM.

 
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Old 06-22-2013, 06:00 PM   #30
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Re: Very High Urine Post Void Residual – Why? What to do?

If you can fully void the bladder yourself, there is no need for catheter.
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