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Medical Forum / Diseases and Disorders / Prostate BPH / September 2005Symptoms Much Worse At Night
I started having urinary problems about seven years ago. About 3 l/2 years ago, I began to have "almost" acute urinary retentions at night (almost completely blocked but going away in an hour or an hour and a half). A month ago, I had my first AUR and catheterization. All of the "almosts" and the AUR occured at night. I am always ok during the daytime, except for frequency. Is this experience typical? Does it suggest any kind of syndrome in particular? >I started having urinary problems about seven years ago. About 3 l/2 >years ago, I began to have "almost" acute urinary retentions at night [quoted text clipped - 6 lines] >Is this experience typical? Does it suggest any kind of syndrome in >particular? I have had similar experiences. My problem is that my flow becomes slow when my bladder is nearly full, and flow stops altogether when it is too full. Very nasty... in other words, when I need to pee the most, I can't pee at all. In the first years I had retention only during the day, caused by such things as having to drink 4 glasses of water for an ultrasound. These days my problems are more at night... probably because I have developed some degree of urgency that ensures I pee in time when I'm awake (and I defy the radiologists by not drinking all that water before ultrasounds), and because my bladder size has become less. That latter fact means I get up two or three times during the night... but because I'm asleep, I might get up a bit too late, when my bladder is over-full. Then peeing is very difficult or (occasionally) impossible. When I'm critically full, typically I can (with great effort) produce a few cc's but can't sustain flow. So it stops after maybe 5-10 ccs. Then I temporarily feel great relief and no need to pee any more... even though I'm still critically full, with an aching bladder. I have to wait about 5 min before I can produce another batch, hopefully with more volume than before. In this way, with each 5-min session, I can increase the flow stepwise and rescue myself. This requires about 20-45 minutes total. Sometimes I just can't produce enough in these intervals to equal the inflow from the kidneys... and then I go into complete retention, unable to produce even a drop. So then it is time to go to emerg for a catheter. But my experiences there have been bad... each time having to wait 2 hours or so for relief. By then I have more than 1 liter in my bladder, and it is so over-stretched that the capillary blood vessels are bleeding and there is risk of permanent damage. Nowadays I do self-catheterization (against the advice of my first uro) ... no waiting and much less stress. If you want to do this, better ask your uro about it or do it at your own risk. My prostate is ~150 cc. I take Flomax and it has helped quite a bit to reduce the incidence of retention. Ed >>I started having urinary problems about seven years ago. About 3 l/2 >>years ago, I began to have "almost" acute urinary retentions at night [quoted text clipped - 49 lines] > > Ed Ed...I have had many ultrasounds in my life (usually at my request - only takes the nurse 5 minutes), and I have never drank water before them. I drink water for the urine flow test, not the ultrasound. I am curious about this. Your uro's must have a different approach. I can kind of see the logic, but not totally. The ultrasound checks how much urine is in your bladder immediately after you have urinated or voided, to see how much urine you are retaining (for whatever reason - usually a blockage of some sort). I don't necessarily see why you need to drink water first (I guess to insure you have urine in your bladder, assuming your kidneys are working okay). In other words you don't need to drink water first to do the ultrasound. Whether you drink first or you don't drink first, if you void yourself before the test your bladder should be empty, or close to empty. Do you see my point. Like I said, I have never drank the water first. I find this interesting and welcome your comments back on what your uro's logic is for drinking the water. Thanks...Pete >> In the first years I had retention only during the day, caused by such >> things as having to drink 4 glasses of water for an ultrasound. [quoted text clipped - 17 lines] >interesting and welcome your comments back on what your uro's logic is for >drinking the water. Thanks...Pete Pete, Those ultrasounds were done in connection with prostate biopsies. As I understand it, the water is needed to help assess the condition of the bladder. The bladder examination is done before voiding. Of course the primary use of the ultrasound is to guide the needle into the prostate, and the water is not needed for that. In fact, you void before the biopsy part of the procedure. Since I know that my bladder is probably in satisfactory shape, I now omit the water to avoid acute retention. Ed >>> In the first years I had retention only during the day, caused by such >>> things as having to drink 4 glasses of water for an ultrasound. [quoted text clipped - 35 lines] > > Ed Ed...I haven't had the biopsies you are talking about (other than the samples they took during my TURP, which almost ruined me and did not help). Would you please explain a little more. Are you having a rectal ultrasound for the biopsy, and where do they insert the needle from, and are you awake. And you mention the bladder exam is done before voiding (is that another ultrasound with the roller ball and lubricant on your belly - I'm confused - that was the ultrasound I was talking about for my retention tests only). So are you talking about two ultrasounds (i.e. one for the biopsy and one for the bladder exam)...Pete >>>> In the first years I had retention only during the day, caused by such >>>> things as having to drink 4 glasses of water for an ultrasound. [quoted text clipped - 46 lines] >So are you talking about two ultrasounds (i.e. one for the biopsy and one >for the bladder exam)...Pete Correct -- two separate ultrasounds, done in one session (with a 5-min recess in between for voiding). Ed >>I started having urinary problems about seven years ago. About 3 l/2 >>years ago, I began to have "almost" acute urinary retentions at night [quoted text clipped - 49 lines] > > Ed Ed...as a follow up to my other messages in the thread, I want you to know that my heart is with you on your problems. It sounds terrible. I have trouble coping with my prostatitis/bph (mostly prostatitis) and can not get any help, and live in 24/7 hell, and find it very difficult to deal with. Your problem sounds very serious. What do your uro's say is causing the retention problem you have. It doesn't sound like a urethral blockage (including the prostatic urethra), since that would show up on a cystoscopy, which I'm sure you've had. Is it a problem with your bladder muscles not contracting or what. I am very concerned and do care...Pete >>>I started having urinary problems about seven years ago. About 3 l/2 >>>years ago, I began to have "almost" acute urinary retentions at night [quoted text clipped - 60 lines] >which I'm sure you've had. Is it a problem with your bladder muscles not >contracting or what. I am very concerned and do care...Pete Oh, it's not that big a deal. I haven't had an episode of retention now for 10 months or so. Life is good. But I do manage my fluid intake carefully and do have some tricks for getting through the night. Ed >>>>I started having urinary problems about seven years ago. About 3 l/2 >>>>years ago, I began to have "almost" acute urinary retentions at night [quoted text clipped - 70 lines] > > Ed Ed...I apologize for caring. What you wrote sounded damn serious. You said you were going to emer room for caths and nowadays you are doing self caths, and now you are saying you are all right. Huh!!! What was causing the problem before, and how come all of a sudden it is all right. If you don't want to talk about it, okay...Pete >>>>>I started having urinary problems about seven years ago. About 3 l/2 >>>>>years ago, I began to have "almost" acute urinary retentions at night [quoted text clipped - 76 lines] >problem before, and how come all of a sudden it is all right. If you don't >want to talk about it, okay...Pete I had two or three instances of retention about a year ago... it was pretty bad at that time. Then I went on Flomax (and Proscar) and that helped quite a bit. Also about a year ago I rebelled against my first uro and self-catheterized when I had retention. Much better than going to emerg if emerg is slow because the volume in the bladder does not build up as much, so less damage to the bladder. My current uro has blessed my self-catheterization. With this new (for me) tool, I have more confidence that I will be able to deal with certain situations... imagine going into retention on a trans-atlantic flight, or out in the wilds, or in a strange country, etc. I still have symptoms, but have not had retention since then. (Did have a couple of close calls...) Ed >>>>>>I started having urinary problems about seven years ago. About 3 l/2 >>>>>>years ago, I began to have "almost" acute urinary retentions at night [quoted text clipped - 100 lines] > > Ed Ed...you still haven't explained what was causing your retention. It couldn't be bph or you wouldn't have gotten better (unless the flomax is helping and you are still taking it). You also mentioned "in the first years" in your first post, which indicates you have had the problem for a long time. Why did you have the biopsy - I'm assuming you don't have cancer. BTW, I would assume that your self cathing is quite painful. The catheter they put in me after my turp almost killed me and I only had it in for three days (tremendous feeling of urge all the time and unbearable). I measured the son of a bitch and it was 9/32 of an inch in diameter. I would hope yours is smaller. Who showed you how to do the self cath. I can't imagine living with a catheter full time (I guess they use a tube directly into your bladder for most of those situations - going through the penis would seem awful painful, and large risk of infection, etc). Please explain what was causing your original retention (e.g. bph or what) and why it has stopped (do you attribute it to the flomax or what). Pete >Ed...you still haven't explained what was causing your retention. It >couldn't be bph or you wouldn't have gotten better (unless the flomax is [quoted text clipped - 16 lines] > >Pete The docs wanted me to have a biopsy because my prostate was big and the PSA was high. I've had 4 or 5 now, and they all came back negative. The retention was caused by the BPH. Flomax is helping, and I'm still taking it. Self-cathing is yucky and feels weird but is not painful. At emerg they leave it in for an hour or two... when I do it, it only stays in for maybe 5 or 10 minutes. Once the bladder is empty I'm good to go, because the retention (in my case) was caused by being too full. I watched them cath me and that is basically how I learned... although I did a lot of reading too before trying it myself. Ed |
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