is this a symptom?

Harry

What tests have you had,  PSA, a biopsy perhaps ?

Apart from the initial slow flow your urine production sound familiar. 

Thanks Chris

Edited by member 29 Jun 2020 at 07:41  | Reason: Not specified

Thanks Andy, that does seem to fit the slight issue I am noticing which was causing me slight concern and something I had not heard of before.

Yes, my bladder does feel as if it empties completely, its just a very slow process sometimes first thing on a morning. So slow in fact, that when I am still half asleep, I find it so much easier to just sit down for the performance.

I'm already scheduled to have the regular PSA level checks annually. Dates and values I can access in my online patient record. My last check gave the following results:

Serum prostate specific antigen level (XabAM) 6.6 ug/L [< 5]
Above high reference limit
PSA: age-related reference ranges in use, values as recommended
by the Prostate Cancer Risk Management Programme
Total PSA : Siemens Centaur methodology

I have a phone call due this afternoon, from the kidney consultant who arranged for the stent. If I remember to ask, I will ask about the emptying my full bladder first thing, then having the need to go a second time an hour later - as if urine is backing up in my kidneys.

Edited by member 29 Jun 2020 at 14:51  | Reason: Not specified

Your hypothalamas monitor's your body's hydration levels. When the interstitial water level between cells starts getting low, it releases antidiuretic hormone. This is picked up by the kidneys, and tells them to recover the water from the urine, so your body doesn't lose so much water, preserving water in the body and making more concentrated urine instead.

During the day, your pituitary also steals some of the antidiuretic hormone, and then releases it overnight. This is intended to slow the rate of water loss into urine overnight, so you don't need to wake up and pee. Excess water is stored elsewhere in the body (blood, which is why blood pressure can raise over night, and as interstitial water between cells). After you wake, your pituitary stops releasing antidiuretic hormone, so this excess water is now excreted by the kidneys.

So your first pee when you wake up is usually quite concentrated, because the overnight antidiuretic hormone told the kidneys to recover the water from the urine, and then after you're awake, you can end up peeing again soon, much more diluted, as your kidneys get rid of that excess water they avoided losing overnight.

So what you describe in the form of peeing twice in quite quick succession when you wake up is quite normal, and shows your antidiuretic hormone mechanism is working well. It is something that deteriorates as we get older, and is one reason you can end up needing to get up to pee at night.

However, that isn't an excuse for any complacency with monitoring for prostate cancer. Your PSA is high, and the slowing of flow first thing could also be caused by growth of the prostate, BPH and/or cancer. It doesn't look to me like you've had an mpMRI scan for prostate cancer, which I would have expected given your symptoms.

Edited by member 30 Jun 2020 at 12:15  | Reason: Not specified

Ah, I assumed because you hadn't said. If the injection was inside an MRI scanner part way through the scan, then yes, you've had an mpMRI (multi-parametric). The injection is a Gadolinium contrast dye to show up blood vessels, which are more numerous and more haphazard in a tumor. (You can also have an mpMRI scan without an injection, but that's rarer.) If they didn't follow that with a biopsy, it's presumably because they didn't find anything which looked like cancer on the scan.