Forlorn hope 2009-11-16 12:44:40
I contacted my uro’s secretary to see when my cystoscopy might be taking
place – the months are ticking by since September when I was hospitalised
with acute retention – and after taking down my file she said that they had
decided that a uro-dynamics test would be more useful at this time.
Unfortunately my uro doesn’t do these so I’ve been passed to another
specialist’s waiting list and warned I could be facing a long wait. Not
surprised – this is the UK after all.
I’m still self catheterising and still retaining about 150 – 200ml, and
without these tests still have no idea whether the retention is caused by
obstruction or ‘floppy bladder,’ akthough I suffer the usual BPH symptoms
and take Flomax.
Anyone else had one of these? (uro-dynamics test) I don’t recall seeing it
discussed on the NG.
Artie 2009-11-16 12:44:43
Yes. My Uro called it a CMG. I didn’t find that it was too uncomfortable.
Next to a Cysto it’s a walk in the park. What it entails is a thin catheter
is inserted into the bladder which is used to fill the bladder with water.
Another catheter is inserted into the r***** to measure pressure. The
bladder is slowly filled and you’re asked to let the doctor know when you
first feel a feeling to urinate. You’re then asked to let them know when you
would normally need to urinate, but could wait. Then when it is urgent and
you would normally interrupt what you are doing to urinate. Then when it
becomes very urgent, pee-pee dance. I never got beyond the first feeling to
urinate. My bladder held 750ml without a problem and the water bag was
empty. I’m told by my Uro that the first feeling is usually around 150ml.
With the other stages following not to far behind. At this point you’re
asked to void into a Uro-Flow meter. The urine flow and r***** pressures are
recorded. After voiding either a catheter is used to void the remainder for
measurement, or an ultrasound is done. My doctor did an ultrasound. My
problem turned out to be a weak bladder that was probably brought on by a 25
year old back injury. My prostate blockage was minimal, but paired with a
weak bladder was causing me problems. I had a PVP done January 22nd and am
very pleased with the results.
Forlorn hope 2009-11-16 12:44:53
Thanks for replying. That’s definitely the same test as I was told that a
catheter would be inserted in the r***** to measure pressure, while my
bladder was filled. It’s interesting to read what the actual test
I suspect my result will be similar to yours. When I was called for a flow
test in January they asked me to drink a lot of water ‘until I was bursting’
before peeing into the flow meter. I voided 540ml but an ultrascan showed
340ml left in the bladder.
I have similar results at home if I’ve had two or three pints of beer. (I
measure what I retain when doing ISC, which I’ve been instructed to do once
per day before bed.)
I was very interested to hear that you went for a PVP. I was told after a
digital examination that my prostate seemed small, and my PSA test was ok,
so I have been concerned that if my problem was mainly a weak bladder then a
PVP would not help and I would be performing ISC for the rest of my days.
However, as I said before, I do have the usual BPH problems of hesitancy,
weak stream etc., so I guess there must also be some obstruction.
I read in one of your earlier posts that you had been living with retention
of about 300ml and that PVP had reduced that to about 50ml, (has that
continued?) so your posts have given me some hope. It may be worth digging
into my limited funds to go privately for this uro-dynamic test, in order to
speed things up a bit.
Thanks again for an interesting post
Andy 2009-11-16 12:45:01
When my regular Urologist told me that it is time for the
TURP procedure, I seeked a second opinion from a doctor
who stopped doing TURP 3 years ago.
After a few questions about my symptoms, a DRE and urine
lab test he suggested PVP. He said the cystoscopy will
be performed during the PVP procedure.
No other urological tests were suggested (except the
pre-admission EKG and lab blood test)
I had the PVP done on 1-12-05 and doing great.
Magna149 2009-11-16 12:45:11
folorn hope what part of the uk are you from? I may be able to
recommend a clinic for a urodynamics test.
Artie 2009-11-16 12:45:19
Sounds a lot like me. My last PSA was .93 and a DRE also showed that my
prostate was small. My first Uro said that my problem was due to a large
median lobe that was pressed up into the bladder. He wanted to do a TURP.
When I asked about laser he went into a tirade about microwave and if I
don’t do the right thing (TURP) then I should do nothing at all. That was my
cue to move on. I waited until PVP was available closer to me, so I did go
back to him a few more times. Each time I asked him about laser, he had the
same reaction, but at least I got my prescription for Flowmax. My new Uro,
Dr. Sinha, put me on a fast track, since my medical insurance is currently
in jeopardy (layoff). He found minimal enlargement of the side lobes and no
enlargement of the median lobe. He told me quite honestly that after seeing
the results of my CMG that he couldn’t guarantee what amount of relief a PVP
would provide. I decided to go through with it anyway. In my case I made the
right decision. Flow is very good. Sometimes scary. I feel empty after
voiding. No incontinence. Urgency is getting much better. There is some
retro, or something, since volume is definitely down; and it is different
than Flowmax induced retro. I did verify with the doctor, that he did not do
any work on the median lobe or near the bladder neck. I don’t know what is
causing the retro, but in my case, a very amicable trade.
Forlorn hope 2009-11-16 12:45:34
I live in the North East but would be prepared to travel if the waiting time
is too long here.
Magna149 2009-11-21 04:54:28
Hi Flororn Hope
I’m in SE so probably too far for you to travel. BTW how old are you?
Re symptoms do you get frequency and/or urgency and what is “floppy
bladder” I’ve never heard of that?
Forlorn hope 2009-11-21 04:54:31
I’m 58. Until the end of August last year I didn’t know I had a prostate
problem, then two days after a walking holiday in the Dolomites I got an
acute urinary infection which led to retention despite immediate antibiotic
treatment. I was catheterised for a month, because after the first attempt
at removal of the catheter I was retaining about 600ml. At the end of a
month I was still retaining about 500ml, and I was shown how to perform ISC.
At first I did this 4 times daily, then three times, twice and now once and
retention is usually between 100 and 200ml. I don’t get feelings of acute
urgency, but do of frequency, I guess because I’m never properly emptying my
bladder. When I do void I have hesitancy and the stream is weak. I have
been told to take Flomax and this helps, I tried not taking it for a few
days and it had an adverse effect on my stream.
Floppy bladder syndrome is a bladder that has been stretched through long
term retention and the detrusor muscles have lost the ability to contract
sufficiently to expel all the urine. This can apparently be permanent, or
the muscles can return to function of their own volition.
What I need to find out, and what is proving so difficult to find out in our
overburdened health system, is why I am retaining this urine. Is it
obstruction by the prostate or a stretched bladder – or both? My own guess
is that I have had a long term worsening obstruction by the prostate and
retention has slowly increased, probably over two or three years, until this
walking holiday when a combination of unseasonal cold in the mountains and a
couple of days of dehydration has triggered a urnine infection and brought
everything to a head.
Obviously I am hoping that the problem is entirely caused by obstruction and
that a PVP would allow everything to return to ‘normal’.
Thanks for your interest Magna.