Bladder spasms

[Ali1980]

Anybody have experience with painful bladder spasms? Dad’s prostate is so big and he has so much pressure and debilitating spasms. He’s a new dx so he’s waiting for treatment to start. Surgery not an option at this point. He straight caths and I’ve told him about trying kegels. What else can he do while we’re waiting for this damn thing to shrink?

[Tall_Allen]

Kegels - why? They are used to artificially stop the stream, which is the opposite of his problem. There are about a dozen medications for bladder spasms. His urologist probably has samples he can try to find one that works best for him. Has he discussed Turp, HoLEP, etc to open up the flow? What's his Dx?

[Ali1980]

Well I read that the kegels might help but maybe not so much in his situation huh? All we know at this time is he has stage4, Gleason9. Mets to lots of places in the pelvic cavity. No bone Mets as of yet. Starting adt and taxotere next week. I know he’s been trying several meds for the spasms, not sure of the names. What do you think about belladonna/opioid suppositories? Will the adt shrink the tumor enough to allow for him to pee without cathing? Sorry, we are new to this😫

[Racer26]

Could not urinate urologist said it was tract infection from swelled prostate gave me a prescription after a week of just barely dribbling I went back and said this isn't working he gave me a differ prescription , by this time I was up all night burning and straining trying to go every 15 minutes and putting cold packs on my crotch for the pain I was pushing so hard my rectum was having spasms , by the 3rd week my angle were swelling and I developed a 103 fever I called urologist and he was on vacation and was told to go to emergency and was immediately catharized sent home with a catheter bag . Slept on and off for 2 days what a relief. Started self cathing when needed and don't let yourself go through what I did. Cath immediately Hope this helps

[kaptank]

Welcome to the club no one wants to join! I find the collective knowledge of our group invaluable. Kegels are probably not that useful when you have an internal catheter. They will simply be working against the plastic tube. Unfortunately some people (I am one of them) have a sensitive bladder that spasms when insulted by a foreign object like a catheter. The bladder is a very powerful muscle and when it spasms you really know it. Your urologist can probably do a measurement of bladder pressure to check this but I am guessing he has figured it out. There are now drugs and patches that soothe and settle the bladder down a bit. I use oxybutenin, an old and cheap drug that has the side effect of a dry mouth. Oxybutenin skin patches don't do this but I have found them less effective than the pills. There are a number of newer drugs with less side effects that work well for some people. As Tall Allen suggests, try to find the one that works best for him. I would not recomend trying the suppositories you mention without a urologist's advice. I assume the first priority is to shrink the cancer and then to open up the urethra to get a good flow. TURP referred to by TA is often called a rebore. These days often done with a laser.

Best wishes and hang in there.

[Ali1980]

Thank you so much for your response, this group is such a wonderful resource. I will tell him about the oxybutenin for sure. Hopefully once he starts his treatments he will have some relief. I’ve read about the TURP, May be a good option down the line.

[Sxrxrnr1 in reply to Ali1980]

How many milliliters of urine are typically released when undergoing catherization. Is it the high hundreds or low hundreds or less?

There are other conditions that can cause painful bladder spasms besides a man’s prostate. Ask any woman who experiences same,,,most of whom having no prostate. In women this is treated as uncommonly frequent urination or pain in this general area.

Have you considered your diet as a cause. Most Urologist completely overlook this as they never get beyond the prostate and Bph as the prime target and treat men no further then for this.

There is a disorder called interstitial Cystitis(roughly inflamed bladder walls) that can certainly cause problems as you described. It is often triggered or exacerbated by acidic foods such as wines, lemons, pomegranates, or any of an uncountable number of substances,,,or by spicy foods,,,,think black pepper, wasabi, hot sauces,,,,the list is endless.

Basically the disorder can be caused by having the protective lining of the bladder compromised in some manner. This allows these foodstuffs to irritate the bladder,,,sending spasm signals to the brain,,,the brain being remote and a bit stupid sees these spasms as a full bladder signal,,,when in fact the bladder may be far below its innate capacity. You can have a strong painful urge to urinate, however the bladder may in fact could be empty,,,,or the spasms themselves could prevent the relaxation to allow the sphincter valves to open

There is a endoscopy like procedure where a urologist will insert a video probe up your urethra and view your bladder lining to determine if there are fissures or other compromises in its protective lining.

Additionally what can prove interesting is to have an ultrasound scan of your bladder when in pain or spasm to find if it is nearly full or empty,,,,which can prove very helpful in a proper diagnosis. If only a few milliliter of urine are found,,,likely not your prostate as the cause. A man’s bladder can hold roughly 500 to 1,000 milliliter of urine. If a scan shows only say 400,,,,then likely not a prostate problem.

Constipation could be another problem. A colon that is packed tight with feces, could be tightly compressing your prostate,,,,thereby squeezing down your urethra. Rare, but as they say,,,stuff happens.

Find a competent urologist and have a full workout of your bladder,,,,your prostate problem could be your bladder. They are out there,,,however not a whole lot up on this issue,,,as again, a man with a peeing problem is merely cast in the prostate bit bucket,,,,and is advised accordingly.

What is your prostate size. Have you been fully explored for bacterial or viral infections of the bladder and prostate.

And of course previously suggested medications could help,,,Flomax, Hytrin, etc May help relieve spasm by relaxing the sphincters allowing the free flow of urine.

I suspect that much detective diagnostic work remains.

Additionally I would print this off and carry it into the your Urologist for comment.