rphguy said...
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4. My prostate "channel" is opened up, but a very small portion of the prostate is pressing on my urethra right at the bladder sphincter. I've read where GG had problems with having success when this type thing was the problem. I think Martin Victor reported this to us.
This makes sense when I heard it because prior to PAE, when I'd push the catheter I would feel resistance for a length of space as I slowly inserted it. Now, I feel no resistance at all until just before it enters the bladder. I have notice this situation for weeks. I feel it push thru that spot and urine flows immediately.
My uro has told me to not be discouraged. Possibly I'm still inflamed from the infection and it may resolve itself.
But, he also said from what he's read that it could take months anyway for me to see full results, especially with the situation with my prostate being different.
He further told me to give it at least 6 months before I make any decisions to do anything else at all.
That's all I know for now.
I haven't posted in a couple of months, for some reason I wasn't notified of new posts. It's been 13 months since my Greenlight surgery and there have been no changes for the past 6 months so this is basically it.
It took about
9 weeks for the trauma of the greenlight 180 xps watt laser and the subsequent UTI and catheterizations I got to calm down, and I experienced 4 good months of bph symptom relief. Then at the six month mark all of my bph symptoms returned to wipe out more than half the gains, and I've been there ever since. At the six month mark my urologist removed some scar tissue at the point where the urethra joins the prostate at the external sphincter. This is different than the internal sphincter which is at the bladder neck. My urologist recommended self cathing every two weeks to keep the channel
open, which he recommended a couple of days ago decrease to once a month. (I became adept at cathing prior to the Greenlight).
I also feel resistence at both the external and internal sphincters when I cath. I think it's normal to have resistence at the bladder mouth. I also get blood in the cath and in the bowl for the first couple of voids after cathing.
Regarding PVR, my PVR was 400 ml before the Greenlight. Since the GL it has been a maximum of 250 ml.
Before the GL my uro said PVR should be 50 ml. But now he says around 200 ml is fine, and a lot less than the 400 ml it was.
When I void I usually get a decent stream for a few seconds then it stops, but there's still a lot of pressure and burning and I have to wait. I noticed that if I manipulate my body, lean sideways to the left and right, rock sideways, sometimes lean forward on my toes, etc. the stream will restart, first as dribbles, then eventually as a thin stream to completion. It takes a good 2 to 3 minutes. By the end of the stream the pressure and burning are gone. I consider it calisthenics, but it does work for me. I use a urinal by my bed and I've become adept at leaning, waiting and using the urinal in the dark and getting back to sleep pretty quickly.
I void often, but have since my 30's and I'm 66. I go 4 to 5 times a night and 3 to 4 times the first hour I'm up, then once every hour or two during the day. The GL improved my maximum time between visits from 45 minutes to 2 hours.
My PSA is 6.5, down from 6.9 prior to the GL. My uro said that's fine. All my other tests are pretty good except for protein in my urine which I have also had since my 30's. I don't take any meds but Micardis HCT for blood pressure. The diuretic actually helps. It's seems the more volume I have, the easier it is to void.
The flomax had no positive effect on me after the GL.
I had my second 6 month follow up with my uro a couple of days ago and he advised me to live with my condition. He said he doesn't think another procedure would help and it could cause harm. He says he took out 70g. of my 120 g. prostate and went as far as he could in the lobe that protrudes into my bladder.
I can actually feel this lobe when I cath because an inch past the bladder mouth the cath stops and bounces back - that is the lobe. But since there's an inch clearance for urine to flow, the uro says this is not a problem.
The one thing that puzzles me in all of these posts is that people have gotten relief of bph symptoms by procedures that have reduced the size of the prostate. But in my case my prostate went from 120g. to 50g. in two hours! Thats a 58% reduction in size, or a 70% improvement in size above 20g. None of the procedures offer this amount of reduction, yet my improvement in bph symptoms was modest at best.
P.S. I also wanted to add that the hydrophilic caths (coloplast speedi cath) which are packed in saline and are self lubricating are much easier to use than the ones you need to lubricate. I found the 14FR size is stiff enough to get past the external and internal sphincters without folding and compressing. I'm presently using the 16 FR to shave off any scar tissue that might form. There's usually some drops of blood and a small plug of rolled up tissue inside of the cath, when all the urine has drained from it.
I also want to add that I void a couple of times before cathing (the anxiety of cathing makes me go more than once) and I let the urine drain from the cath into a one liter urinal with ml markings. I find my PVR changes from time to time. In the last couple of months it's been as high a 250ml but as low as 50ml. Last week it was 140 ml. If you think about
it we produce about
100 ml an hour, so most people have more than 400 ml in there bladder at some point during the day. Some people void 800 ml or more, so they had 800 ml before voiding.
Post Edited (Bob_NJ) : 8/9/2013 3:53:35 PM (GMT-6)