Has any one had the Urolift procedure after radiation

[rogerwegner]

I am going to have the Urolift done next week to try and help with my urinary problems. I can not empty my bladder without self-catheterizing every 6 hours and I still have to get up the urinate small amounts six times a night.

[Don_1213]

Talk about a timely post - yesterday my urologist suggested we might consider Urolift to address my old-man symptoms (weak stream, urgency, nocturia (never knew that was a word, I think I have it right - peeing at night..) Had the same problems before PCa was diagnosed, but Flomax 2x/daily seemed to put it right. Now Flomax doesn't seem to be doing much, and adding Finasteride hasn't helped a bunch. I'm not to the self-catheterization point - yet, but it is a real pain as it is. Whenever I get up from sitting it's off to the bathroom as quickly as I can.

I'm subscribing to this thread. I spent some time reading studies, looking on the web, and found nothing on Urolift after radiation treatments - but I guess it's done if your urologist and mine are both suggesting it.

It's most successful in 80cc and smaller prostates. It has been done on 100cc ones, but less successful.

[larry_dammit]

I had been on flomax for years ,saw my urologist and he put me on self catheter regiment, I tried it for 2 a day then 3 a day without the flomax. I was uncomfortable all the time and having infections. I decided to go back on the flomax and back off to twice a day on the catheter. Much better , I can sleep all night most nights and the discomfort is back to minimal . Just saying. 😊. Keep up the fight warrior 🙏🙏🙏

[Deadstick]

Hi Roger,

Did your doc check the performance if your bladder? If your bladder is "atonic" meaning that you have a weak or poor detrusor muscle function, you might not get much relief from Urolift. Urolift basically moves the prostate lobes away from the urethra but does little to improve bladder function. The only way to really tell what's going on is to do a urodynamic study. And yes, as others have said, Urolift may work better for smaller prostates. Radiation can damage your bladder neck and sphincter as well so you might want to ask your docs about these other factors.

Good luck to you...

[rogerwegner in reply to Deadstick]

Hi, he did tell me that my bladder maybe atonic. But he said it might help me make it through the night without getting up 12 times. I do need the sleep. If this does not work ,then I am looking at a suprapubic catheter and wearing a leg bag everywhere during the day and a bag to hang off the bed at night. That does not sound good, so I am really hoping for this to help

[Don_1213 in reply to Deadstick]

Again - talk about timing - tomorrow at 1:30PM I'm getting the urodynamic study. I'll fill in on what's found and how it's done.

And just as a sidenote - one of the websites I found comparing treatment for urgency/weak-stream covered Urolift, and the MD/urologist conducting the talk was responsive to comments. I asked him if he had any knowledge of using Urolift after having radiation treatment for PCa - and his response was "Yes, he felt it was a useful tool, and there have been good results in these cases.." Nice of him to reply! And it gives me a bit of reassurance my urologist isn't talking out of his..

[rogerwegner in reply to Don_1213]

I am having mine done tomorrow at 8:30. Here's hoping that we get some relief. I think mine is on the extreme side because I have seeds as well as beam radiation. Good luck !

[Don_1213 in reply to rogerwegner]

Anxiously awaiting results..

[rogerwegner in reply to Don_1213]

I am very anxious to have some relief from the blockage

[Mufj in reply to Don_1213]

Had urodynamics done this summer not a pleasant procedure but tolerable. Goid idea to get if having urinary problems cause bladder can contribute

[Don_1213]

I promised to report on the Urodynamic Study. It was somewhat curtailed since the very nice Nurse-Practioner (I suspect she'd been an MD in the Ukraine) couldn't get a catheter to the bladder. The urethra narrowed so much at the prostate that she was afraid of doing damage. She tried 3 different diameter ones.

So the flow studies are incomplete - but it identified where the restriction is. She felt a cystoscope under sedation is the next step. I see the urologist in a week. Meanwhile, peeing a bit of blood (not awful) and some discomfort (not awful - but there..)

This is a link to the video I mentioned - the subject is - Who shouldn't get a Urolift:

youtu.be/egaSpywR7Tk(Not working as expected?) - the presenter MD did reply to my question about after PCa radiation treatment..

[WildRose6]

My hubby had the UroLift implant performed by Dr. Reznicek. It has provided quite a bit of relief for urgency and emptying problems. If he hadn't had it he'd likely need to be permanently catheterized by now.

He still has difficulty but overall, things are much improved with the UroLift.

The procedure went smoothly, the only problem was my hubby didn't want a post-procedure cath but the procedure caused some clotting and the next morning he told me he couldn't empty his bladder, so we raced to the clinic for an emergency Foley cath. He kept it in all weekend and was able to have it removed a coupe of days later.

So, if the doc recommends a catheter post-procedure it might be a good idea to listen

[rogerwegner in reply to WildRose6]

I had the procedure this morning and I went home with no foley catheter and so far I am urinating very often during the day light hours with no pain. I have decided to cath every 3 hours tonight and see how that goes. I don't know about the cannabis. I will see how the weekend goes. I do not have a lot of pain so far, Thanks for your help,

[WildRose6 in reply to rogerwegner]

Good luck, hope it helps!

[Don_1213 in reply to rogerwegner]

Roger - please keep us up to date on progress.. which hopefully will all be positive. I think the Urodynamics test scared my prostate - last night was the 4th night in a row of undisturbed sleep (for about 7 hours - then it was a bit urgent, but not awful). I also find the normal daytime urgency is less and the stream is getting a bit better.

If I had to guess - it might be the finesteride since I'm also experiencing nipple tenderness and some apparent growth, and nothing else I'm on has that as a side-effect (gymnowhateveritis.. ie - man boobs.)

I see my usually non-responsive urologist on Tuesday and will see what I can pry out of him besides pronouncements and grunts.

[rogerwegner in reply to Don_1213]

Well I had the urolift 2 days ago and I am feeling much better. I am getting more control of my urine flow. I have much less retention of urine. I am down to 150 cc from an average of 325 cc just 2 days ago. If this keeps up I may stop the self cathing every 6 hours. Funny that you should mention the breast tenderness. Mine has returned after a lapse of 13 years, I think that the apalutamide has driven the testosterone so low that my estrogen is getting the upper hand, The Doctor said that it might taper off so we are giving it a while to settle down. I am really happy that I had the procedure done in the office and not in the hospital. It was very quick and painless. I was on my way in about an hour and fifteen minutes

[WildRose6]

Also to consider--if your state allows medical/legal cannabis it might be worth trying that. Hubby uses an edible before bedtime and it usually means the difference between getting up 1 or 2 times during the night instead of 3-4.

[Don_1213]

So I'm going on 6 nights now with at least 6 hours of undisturbed sleep each night. I normally go to sleep late (2AM) and get out of bed around 9AM. This morning the wife's alarm woke me up at 8:30, so I got out of bed, pee'd, and went back to bed until 9:15AM.

That's been pretty typical. I also don't have to go RIGHT now whenever I stand up from sitting, and have gone 2-2..5 hours during the day not going at all. And when I was in a position to observe my pee'ing (mirror in the urologist's office bathroom today) - the stream isn't bad at all. Not teenage piss up a stick, but reasonable. Also feel I'm fully emptying the bladder each time.

So the question is - cystoscopy? The urologist wants to do it to see if there is some radiation-induced restriction that is causing problems. He doesn't seem to accept that it's gotten MUCH better over the past 8 days (since it was scared by the aborted uroflow-study of a week ago.) He thinks maybe there is something he might be able to clear while he's poking around in there.

My inclination is - leave well enough alone.. and see if things continue to improve. He responds that it might suddenly change (why?) and I'll end up in the emergency room getting it catherized. Of course the cystoscopy would be done by him at the private surgery center with anesthetic (groggy kind - I'm used to it from stents installations). Costly test IMHO. Medicare will pay of course so I shouldn't be concerned, but I am if it's an unnecessary test.

Right now - my plan is - go another week before deciding.

> If things stay the same - perhaps have it done, while things are much better, it would be nice to get off the flow enhancing drugs. If I have it done - make sure he has the urolift handy and ready to use if that's what's needed, so I don't have to go through this twice.

> If things continue to improve - forgeddaboutit. Don't screw with a working thing.

> If things degrade again - then it's off to the cystoscopy post-haste/pronto (he said they're scheduling 4-6 weeks out..)

Anyone see any flaws to that plan? Anyone with cystoscopy experiences to relate?

[rogerwegner in reply to Don_1213]

My experience with csytoscopy is interesting. I had the first while I was on Warfarin and I bled quite a bit. Things did loosen up a bit but I was already scheduled for the Urolift and I went with it after stopping my warfarin for 5 days. There was no bleeding with the process even though the Urolift uses the same diameter catheter. Every day things keep getting better. I am sleeping for 6 hours at a time ,there is much less urinating both day and night and no urge incontinence. It is so nice to stand up with out having to suddenly urinate.

[Don_1213]

Roger - great for you! Your report is really encouraging! Are you still on any pee drugs?

I'm getting closer to deciding. Apparently, the damage the attempted study last week hasn't entirely healed - saw a bit of pink in some pee tonight. I'll be keeping an eye on it.. closely. I am on 81mg aspirin and Plavix for the 5 stents the cardio guys have been having fun installing, so I imagine that increases the tendency to bleed (as it does with my nose..) My cardiologist (who is also a long-time good friend) is in the hospital - infection from some back surgery he had done, so I can't ask him. I guess I'll have to ask his understudy.

[rogerwegner in reply to Don_1213]

I will bet that it is the plavix. I even bled from my ear while on plavix. I am still on tamsulosin. It is also for my blood pressure.. I also have stents in my heart, in the LAD and the RCA. If I were not on the tamsulosin they would have me on something else. Good luck with the blood thinners,

[rogerwegner]

I am giving an update on my journey with Urolift. The urine still was getting cloudy when the antibiotics ran out. Well they ran one more urinalysis last week and it showed Kebsiella in large quantities and it is multi-drug resistant. So now I am going to see an infectious disease specialist and they stated me on a triple regime of fosfomcyin. One packet in water every other day for three times. The first druggist was out and he said it was not covered by Humana and it would be $300. The next druggist had one dose and has to order the other two, but he said with the Good Rx coupon they are $25 each. I may be switching druggists soon. Apparently I I have a complicated UTI, and it might be into my kidney's. So my complaint of a continuing back ache was not being listened to. I just seem like an endless side show. I am going to see a radiation oncologist next month, my breasts have become very tender from the ongoing lupron and apalutamide. My testosterone is so low that my estrogen is taking over. I have defintely have crossed some sort of divide.