1rphguy,
Glad you have got past the diverticulum surgeries and have had improvement from the PAE.
It sounds like your bladder neck is the reason for your continued need for the meds, if your symptoms include a poor stream or difficulty urinating.
One thing to consider is that prostrate or bladder neck obstruction probably only causes night time urination if your PVR (post void residual is high).
With a high PVR, your bladder fills faster, and so signals that you need to urinate more often. Have you had your PVR checked with an ultrasound? Generally anything less than 50ml. is considered good. Prior to my first greenlight laser, it was at 400ml, and I was urinating every half hour or so all day long. After the second greenlight it was about
150-200ml and I was going 5 to 7 times a night. After my turp it went down to 32ml. and I still go 2 to 4 times a night.
I had a greenlight laser in mid 2012 to
open up the path in my prostate, a second greenlight laser at the end of 2013 to widen the bladder neck and remove bladder stones and stop spontaneous bleeding spots on the bladder neck and prostate, and a turp in mid 2015 to stop severe spontaneous bleeding of the prostate.
For the past year I have been taking dutasteride to stop the prostate from growing. It was still 203g. after my turp. But my urination stream and volume for the past year has been good, and my PVR a year ago was just 32ml. I need to get it checked again within the next month.
Regardless of a good stream, low PVR and no other meds like flomax or cialis, I still get up 2 to 4 times a night. The reason is that my bladder has a relatively low capacity, and signals me to urinate at 200 to 300mls.
My solution has been to keep a couple of 1 liter urinals in a basket by the side of my bed, and using the urinals in the dark sitting on the edge of my bed. I generally am back to sleep in minutes.
I think medical professionals are reluctant to discuss the many reasons for night time urination. They look to bph first, then to the bladder neck, and finally to the bladder. My experience is that these procedures generally work to help prevent retention, and improve the urine stream, but for night time urination, many are left with the problem because of low bladder capacity.
I've also been told that as we age, lying down at night can loosen up the kidneys and bladder and make us more prone to more frequent urination than during the day. After all, older women often get up at least once a night, and they have no prostate.
I am following this thread on GG and PAE in case my prostate continues to grow in spite of taking the dusteride. If the dutasteride keeps it from growing, I will likely just take it for as long as it continues to work.
1rphguy said...
I am at the 3.5 yr mark following PAE. (June 2013)
I had about 7 or 8 bladder diverticulum removed in October 2013. (awful surgery)
In May, 2013 I was self-cathing 3-4 times a day.
1 month after PAE I was only cathing once daily. Better, overall, but not where I needed to be.
After the Bladder surgery was healed over, I stopped cathing.
But, was unable to kick my meds to the curb.
In Jan 2014, I was taking Proscar, Flomax, and Cialis (for bladder neck); fortunately no ED.
I have since stopped the Proscar but any time I try to quit Cialis or Flomax my symptoms get worse.
At the 3.5 yr mark, I don't regret anything I have done in my treatment regimen.
My prostate measures 32 now as opposed to 53 back in 2013.
My PAE still measures only a 0.8 so that's great.
My night-time trips to bathroom varies.
4 nights a week I have none.
2 nights I get up once.
1 night I'll get up 2-3 times.
I find that I cannot ever drink coffee at all or my symptoms get worse really quick.\
I think if I could quit my one Dr.Pepper per day habit, I would be doing even better.
It seems there aren't many days that go by that I do not think about my urine flow, but I am doing OK.
I do have larger median lobe that could be slit that might make everything great.... but hesitant to do.
I am told my bladder neck is narrow, but won't have that worked on for fear of retrograde.
I do have varicocele, but my urologist says small on one side, large on the other. I have mild scrotal pain associated with that. 15 yrs ago i was told by a different uro that I had bi-lateral varioceles but not to worry about it.
I would like to have had the GG back in 2013 but they stopped seeing patients and wouldn't return my emails. My symptoms are such now that it's not bad enough to make me want to spend $25K on it.
I've considered getting a varicocele repair via I.R. but my urologist doesn't want me to, although he is ready to refer me if I decide to do it.
If I could get off either the flomax or the cialis daily, I would be ecstatic and call it 100% success. But, very regularly think about doing one more procedure to acquire that fabled complete healing I desire.
But, I am happy that I've had the success I've had.
Post Edited (Bob_NJ) : 12/9/2016 12:04:58 PM (GMT-7)