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Cant pee

User
Posted 15 Sep 2022 at 18:39

so after my prostate was removed and I  had the in-dwelling catheter. However each time its been removed i cant pee. I have had 2 bladder neck surgeries and now self catheterising. Doc thinking its a sphincter problem now..

Recently the doc has suggested 2 meds so I was wondering about others experiences pf these and at what doses.

I am on Tamulosin in  the morning and Amitryptaline at night. A couple of days in and no obvious benefits so far.

Any thoughts?

 

cheers 

 

Dave

User
Posted 16 Sep 2022 at 11:09

Thanks Chris

Yes i was advised that although i dont have a prostate the drugs might help- doc did say it was an experiment. Not sure what dilatation involves- never been suggested. Issue seems to be the over enthusiastic muscles...

User
Posted 15 Sep 2022 at 19:56
I have been prescribed amitriptyline for nerve pain (not PCa related) it is also used for depression and anxiety. Don't think it will help you pee Dave.

Cheers

Bill

User
Posted 15 Sep 2022 at 22:32

Originally Posted by: Online Community Member
Dave, I am not a pharmacist but I thought tamusolin worked by relaxing the prostate,and you haven't got one.

It's used in this case if they suspect there might still be some smooth muscle of the original bladder neck or prostate left constricting the urethra.

User
Posted 15 Sep 2022 at 22:58
Both drugs can relax the bladder muscles
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 16 Sep 2022 at 14:50

Dave, Google, cook s curve dilators, so you can see what is used.

In my case they used the camera to insert a guide wire through the very small hole into the bladder they then pull the camera out but leave the guide wire in. They then pass the smallest dilator over the guide wire and through the stricture, this stretches the stricture without cutting into it. The dilator is removed and the next size is passed over the guide wire. This process is repeated size by size until the biggest one has been used and the opening has been stretched. The camera is then passed over the guide wire and into the bladder to inspect the bladder.

Most of my procedures were done under GA but on one occasion I had it done in clinic without any anesthetic or pain relief. Not in my top ten of favourite activities but I would do it again if required.

I did wonder what happens if tamusolin relaxes the smooth and the bladder muscles. Do you self cath at regular intervals or when the brain / bladder says you need urinate. Does the urine come out of the catheter with force or just dribble out ,have you ever checked the flow rate from the catheter. 

I can't remember if you have had a urodynamics test or not. That should establish whether the bladder is producing enough pressure to get past the obstruction. Or if the issue is with the  sphincter or sphincters depending on what you have left. 

Hopefully the drugs might have a beneficial effect.

Thanks Chris 

User
Posted 17 Sep 2022 at 18:42

Dave , I went to see a professor at the Christie in Manchester,one of the Mr there is now also a professor. My home consultant said the prof is considered top of his game and said it is sometimes a good idea to get another opinion out of area. My GP did a referral on the NHS and it was only a few weeks to get the appointment,but it was all pre COVID. 

They were very accommodating, my cystoscopy and incision were done under GA on a Monday morning but they admitted me Sunday afternoon to avoid early morning traveling or hotel stays .

Thanks Chris 

 

 

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User
Posted 15 Sep 2022 at 19:31

Dave, I am not a pharmacist but I thought tamusolin worked by relaxing the prostate,and you haven't got one. 

We have probably covered this before, my flow normally slowed to a dribble over a three month period. On one occasion I went into retention 12 hours after a dilatation, that then required another dilatation 72 hours later. I had around twelve attempts to sort my stricture.

Thanks Chris 

 

 

User
Posted 15 Sep 2022 at 19:56
I have been prescribed amitriptyline for nerve pain (not PCa related) it is also used for depression and anxiety. Don't think it will help you pee Dave.

Cheers

Bill

User
Posted 15 Sep 2022 at 22:32

Originally Posted by: Online Community Member
Dave, I am not a pharmacist but I thought tamusolin worked by relaxing the prostate,and you haven't got one.

It's used in this case if they suspect there might still be some smooth muscle of the original bladder neck or prostate left constricting the urethra.

User
Posted 15 Sep 2022 at 22:58
Both drugs can relax the bladder muscles
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 16 Sep 2022 at 11:09

Thanks Chris

Yes i was advised that although i dont have a prostate the drugs might help- doc did say it was an experiment. Not sure what dilatation involves- never been suggested. Issue seems to be the over enthusiastic muscles...

User
Posted 16 Sep 2022 at 14:50

Dave, Google, cook s curve dilators, so you can see what is used.

In my case they used the camera to insert a guide wire through the very small hole into the bladder they then pull the camera out but leave the guide wire in. They then pass the smallest dilator over the guide wire and through the stricture, this stretches the stricture without cutting into it. The dilator is removed and the next size is passed over the guide wire. This process is repeated size by size until the biggest one has been used and the opening has been stretched. The camera is then passed over the guide wire and into the bladder to inspect the bladder.

Most of my procedures were done under GA but on one occasion I had it done in clinic without any anesthetic or pain relief. Not in my top ten of favourite activities but I would do it again if required.

I did wonder what happens if tamusolin relaxes the smooth and the bladder muscles. Do you self cath at regular intervals or when the brain / bladder says you need urinate. Does the urine come out of the catheter with force or just dribble out ,have you ever checked the flow rate from the catheter. 

I can't remember if you have had a urodynamics test or not. That should establish whether the bladder is producing enough pressure to get past the obstruction. Or if the issue is with the  sphincter or sphincters depending on what you have left. 

Hopefully the drugs might have a beneficial effect.

Thanks Chris 

User
Posted 17 Sep 2022 at 13:39

Thanks Chris

Urine comes out with some force- not a dribble- am doing it about every 3 hours when i get pains.. not checked flow rate..

not had urodynamics thing either.. am thinking of a provate consultation just for another opinion..

 

Dave

User
Posted 17 Sep 2022 at 18:42

Dave , I went to see a professor at the Christie in Manchester,one of the Mr there is now also a professor. My home consultant said the prof is considered top of his game and said it is sometimes a good idea to get another opinion out of area. My GP did a referral on the NHS and it was only a few weeks to get the appointment,but it was all pre COVID. 

They were very accommodating, my cystoscopy and incision were done under GA on a Monday morning but they admitted me Sunday afternoon to avoid early morning traveling or hotel stays .

Thanks Chris 

 

 

User
Posted 02 Dec 2022 at 21:07

Hi folks-

 

I had my urodynamic assessment cancelled because i have UTI.

I have had antibiotics but they didnt seem to work. Just had same meds prescribed again 

any one else had UTI that was hard to shift?

 

cheers

 

Dave

 

User
Posted 03 Dec 2022 at 09:42

Dave , did they grow a culture from a urine sample, the culture result is used to determine which is the right antibiotic for the type of infection. 

 

Thanks Chris 

User
Posted 05 Dec 2022 at 10:36

yes Chris- they did that.

i dont know maybe i just needs an extra a blast of the same meds. Problem is i didnt have any noticeable symptoms so will have to get another test to be sure..

 

Dave

User
Posted 23 Jan 2023 at 18:43

I am still waiting for a urodynamic assessment for suspected 

detrusor external sphincter dyssynergia

 

anyone else heard of this?!

 

Cheers

 

Dave

 
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