I just completed a laser TURP for BPH - removing about 50% of a 125 CC Prostate. 6 days post op we removed the catheter (after injecting about 350cc) and the DR said - go pee. I could not void anything. We waited 4 hrs, still nothing... DR advises bladder muscle is non responsive. Inserted new (smaller thank God) catheter for 10 days when we will repeat the removal process. My question is, if this happens again, is there a drug or a procedure or something that can stimulate the detrusor muscle to squeeze? Or, do you believe I might have an issue that the sphincters are not opening? Any drug or procedure for this? He also said he may need to go back in and vaporize more prostate tissue - thoughts here?
Hello! I thought I would write you about my own experience with LUTS (lower urinary tract symptoms) in the hope that my experience will help.
I am currently 56 years old, in general good health, live in Los Angeles CA, and have undergone several surgeries at UCLA Medical Center.
I first experienced urinary retention at age 45, when extreme bladder pain sent me to my first urologist. After an ultrasound, he discovered that I was retaining and cathed me for the first time. Traumatising! It was discovered that I had 1000 ml of urine trapped in my bladder. The release was staggering!
The doctor expected that my urination would return to normal after this draining. But within a few months I underwent a TUIP at UCLA. It was not effective. I then underwent a second TUIP — also not effective. During this period, I used intermittent catheterization.
I finally underwent a TURP. These three surgeries took place over the course of 1.5 years. The TURP surgery resolved my condition, and I began urinating normally. I enjoyed normal urination for 10 years, forgetting completely about this phase of pain, confusion and fear.
Then two years ago, at age 54, I began retaining again. Reading about Greenlight Laser, I opted to undergo a PVP at UCLA. It was unsuccessful. I then decided to undergo a TURP, also unsuccessful, as post-surgical scarring resulted in blockage. I subsequently underwent another TURP with a focus on clearing the bladder neck. The final TURP surgery worked for several months, but recently I have begun retaining again. I am even having difficulty inserting an intermittent catheter and am at my wits end!
This has all been quite the ride, I can tell you that. I have several opinions on the condition and the various procedures I have undergone.
Greenlight Laser PVP is not the technological triumph their vast marketing juggernaut is designed to lead one to believe. I say, go for the TURP. There is no difference to you, the patient, between any of these three surgeries. The timing is the same. The recovery is the same. Trust me, I've had them all.
The emotional issues around this condition are the worst of it — not the surgeries. Today, urological surgery is no picnic, but it's not horrible.
What IS horrible is the psychological anguish of needing to urinate, yet not being able - several times per day, day after day, week, month, year. Chinese Torture? This is it.
What I have come to believe is that the balance between the detrusor strength of the bladder vs the closing/gripping strength of the muscles in the bladder neck are the issue, and should be the focus.
Bladder detrusor strength is something we have little control over. It weakens over time. To date, there is no surgery or medication or exercise that will strengthen a weak detrusor muscle.
However, we do have some control over the strength of the muscles in the bladder neck. These are the muscles we consciously tighten when attempting to "hold back" before urinating. They are also the muscles that spasm and grip during orgasm.
Something one seldom hears discussed on any forum or in any literature is the effect of sex and orgasm on this condition. In modern culture, people like to imagine that sexual behavior is an expression of health and vigor, and should never be criticized or inhibited in any manner.
But I have come to believe that the orgasm can strengthen the muscles of the bladder neck, and regular orgasmic sex or masturbation, in some individuals, can render these muscles tighter and tighter. When we combine a strong, tight bladder neck with a weakened bladder, we're in for trouble later in life.
I have a great deal more to say and am open to discussion. I will also try to leave my email address, but I'm not sure if it is possible here. I can be reached privately at ********
Best of luck to all with this condition. I believe the solutions are out there — but they are not easy to come by.
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