I am glad that you are doing well. The statistics are in your favor!
Thanks for the follow-up.
This was my post. It was concerning a serious condition, as opposed to some of the things I 've seen here since becoming familiar with the forum. I just wanted to express my disappointment with the lack of any reply whatsoever from the doctor. It has been over a month, and I obviously no longer expect one. Rob616
Yes, you are correct, I have gotten behind in my answers. I am catching up, however.
I do not find your thick walled bladder with a diverticulum and a dilated ureteral orifice totally unique. Your bladder has been compensating adequately for the obstruction created by your prostate until the drug made it impossible to empty. Now that your bladder has recompensated, you might actually be able to empty using an alpha blocker such as Uroxatral or Flomax, but I would not recommend doing that in the long term as you are skating on the edge of decompensating again. I would recommend that you have a prostatectomy and then be followed for adequacy of emptying and urinary tract infections. If you are not emptying or have recurrent infections, then I think that you should have a fluoroscopic voiding cystourethrogram to see if you have urinary reflux into the dilated ureter or are not adequately emptying the diverticulum. At that point your urologist can make a decision regarding a ureteral reimplant (or possibly having a Deflux implant, such as we often do in children) and/or a bladder diverticulectomy (removal of your bladder diverticulum).
The immediate problem is getting rid of the prostatic obstruction, the rest can be treated later, and they ultimately may not need any treatment.
Thank you, Dr. Liroff, for your reply! In the meantime, and after consulting with colleagues at Vanderbilt & Emory, my urologist did decide to go ahead and deal with the obstruction. (His caution had been a fear of it resulting in permanent incontinence.) On 12/30, I had the PVP surgery. He said the prostate was larger than it had shown to be on the CT scan AND that my bladder looked better than before. Today I had my post-op visit for a voiding trial. Good results, and I came home without a catheter...after 2 months with one! So far so good, as I have urinated almost normally the last several hours! He gave me Uroxatral to take over the next 3 weeks, at which time I'll see him again. To the extent that he and I may have to talk about any future surgery, I'll find your suggestions concerning cystourethrogram, urinary reflux, ureteral reimplant, Deflux implant, and bladder diverticulectomy very helpful! I'll research those in the coming days to be ready for those conversations. But as you suggested, perhaps further surgery will not be necessary...hopefully!! Thanks again! Rob616