Bladder symptoms

I'm a 74 yr old male with a history urinary tract infections; have had a TURP, PC (8yrs ago) and a TUIP in Jan, 2005.  Last PSA in June, 05 was <0.10.

Since early November have experienced a very low grade pain (or awareness) in my bladder, whether full or empty. This is constant and feels as though my whole bladder lining is irritated, as in a mild stomach ache.  Have had this same condition 1-2 times per year for the last 10 years, but it normally stopped after 4-5 weeks.  (This incident is now into its 10th week).  Urine specimen is negative.  Have performed periodic self-caths with the following results:  5/05   150cc/40cc retained
          6//05  190cc/45cc retained

After "awareness" started in Nov, retentions were:
           11/05  340/100cc
           12/05   240/90cc

Have been taking high doses of niacin (1250mg) per day for some time and wonder if that could be having an accumulative effect on my bladder lining?  Have stopped taking for a week, but has had no effect on the bladder.  Any ideas?   (I do have an appointment with my urologist on Jan 25th, but would like to some ideas before I meet with him.

**** 940

[Kevin Pho, MD]

I am not aware of niacin having an effect on the bladder lining.  

Having urodynamic studies to evaluate bladder function can be considered.  This can include the following tests:

* Cystometry (or cystometrogram) evaluates bladder function by measuring pressure and volume of fluid in the bladder during filling, storage, and voiding.

* Uroflowmetry measures the rate of urine flow.

* Urethral pressure profile tests urethral function.

* Leak point pressure determines the bladder or abdominal pressure when leakage occurs due to increased abdominal pressure (Valsalva or cough) to assess urethral resistance.

If there is concern about the bladder lining, you can consider interstitial cystitis, which can be evaluated with a cystoscopy as well as a potassium sensitivity test.

These options can be discussed with your personal physician or urologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b

[j857]

A related discussion, stricture was started.