I am aware of the sensitivity of this issue but it needs to be addressed. I have coined the term "Uringency" to combine the two symptoms of retention and urgency which I have been dealing with for a long time.
I'm a 68 yo male with moderate BPH and PD 15 years duration. I frequently have difficulty with initial flow and emptying. It is usually much worse at night. I have been seen by a urologist and he put me on flowmax which made my hypotension worse.... I couldn't kneel at the side of my bed to use hand held urinal without passing out.
I currently manage my pm symptoms by not drinking anything more than needed to swallow my medication after 5pm. I think that this might make me dehydrated so I drink copious amounts of water in the morning. I still don't feel well most of the time but this could be just the progression of the PD.
My question is has anyone had similar symptoms and if so any solutions?
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etterus
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My 82 yr old dad had surgery last year for an enlarged prostrate because his bladder was not emptying. The doctor first put him on Flomax & it did nothing. They then did a laser surgery to clean the prostrate out for better flow. He said it was the best thing he ever did. I'm not sure if you have the same thing but it sounds like a possibility. Hope this helps.
My husband had the same debilitating reaction to Flomax. Our urologist prescribed Cialis for my husbands enlarged prostate. He can empty his bladder, but it takes a little while, but the hypotension is almost totally gone. He says he can live with a slow stream since he can get out of bed and function.
We did have to have the urologist justify the Cialis to our prescription provider.
Not drinking enough water on a regular will make you dizzy and fall. Have you tried a drug like generic Detrol LA? It works, and you can drink a reasonable amount of liquids before going to bed. I discovered i can cut my capsules in two (carefully from one capsule to two) into empty capsules, and it saves a lot of money and works just as well.
Oh yes, that is exactly what is happening to my husband, makes going anywhere very difficult, he has just been prescribed Mirabegron, only two days ago, so dont know if its helping yet, if not he will then see an Urologist, but the neuro did say it's typical for PD
Further to the above, not drinking enough in 24 hours is not the answer and do you know if the urine has a very unpleasent smell to it? we know it is not an infection causing the smell.
My husband also had issues emptying his bladder. He had laser surgery removing scar tissue and he is as good as new. I am happy to say everything is flowing quite well again. Well worth checking into. Good Luck!
Hi Etterus. My sympathies are with you. My symptoms change from day to day. Some nights I urinate up to 8 times, others only once or twice. The flow in the evening can be quite annoyingly slow and difficult to aim. I have now decided to sit like the girls, it's easier than all that trouble.
There does not appear to be anything that I do that is unusual, but around once a month I have this night urination problem. it takes a few days to come back to normal again.
This other problem of needing to suddenly urinate makes life difficult, but there is always the expensive option, of wearing an adult nappy (Diaper). I have one in reserve but have not yet taken the plunge to put it on. I prefer to empty my bladder before leaving home on a trip to the shops and on arrival going to the gents before doing anything else. I don't go too far from a toilet without first seeing if I need to urinate. With air travel I keep a very close eye on my needs. The early-morning line outside the toilet is the worst so I stand in line before I need to use the toilet. It's a pain but it beats wetting my pants.
My dad and my husband's urologist told us that the prostrate continues to grow as men age and eventually if you live long enough you will need surgery to reduce the prostate. (Look up "TURP" on the internet) The intermediate step is to use Cialis to help with the symptoms. Cialis or a generic form is the only ED drug that helps due to the specific way it works.
It is really important to keep on top of this (watch creatine and BUN levels in your blood work up) because if the bladder does not empty properly, the urine backwashes over the kidneys and can damage the kidneys leading to chronic kidney disease and dialysis. It doesn't take long for the kidneys to be damaged so be very proactive.
Don't let anyone tell you it is just part of being a PWP or just part of getting old. The urologist calls it being part of the "man's club" and no male escapes! LOL
We went through this with my 81 year old dad a few years ago. He had the surgery and continues to have healthy kidneys - no symptoms now so a huge boost to quality of life. The surgery was not a big deal. His numbers did go up significantly as his symptoms worsened, but by getting good medical treatment in time he was able to avoid damage.
I for one am really glad you posted this because it is an important topic. The urologist took time out to talk to my sister and me after my dad's surgery to tell us to encourage the males in our life to not be embarrassed about talking about their symptoms and getting help (he suggested we drag them into the office if need be) - this is not really a "benign" condition and ignoring it is dangerous.
My father's internist kept telling him that the symptoms were just part of getting old and he had to adjust to them. If it hadn't been for my nephew who was doing his residency at the time recognizing what was going on, my dad would not have gotten the treatment he needed.
Don't assume your internist, neurologist, or cardiologist is well versed on this problem and solution. We have a dear friend who now has kidney disease because the doctor didn't treat the symptoms seriously enough.
Good luck to you - God Bless
in reply to
TURP - Mayo Clinic
Transurethral resection of the prostate (TURP) is a surgery used to treat urinary problems due to an enlarged prostate.
A combined visual and surgical instrument (resectoscope) is inserted through the tip of your penis and into the tube that carries urine from your bladder (urethra). The prostate surrounds the urethra. Using the resectoscope, your doctor trims away excess prostate tissue that's blocking urine flow.
TURP is generally considered an option for men with moderate to severe urinary problems that haven't responded to medication. Traditionally, TURP has been considered the most effective treatment for an enlarged prostate.
However, a number of other, minimally invasive procedures are becoming more effective, due to improved techniques and surgical tools. These minimally invasive procedures generally cause fewer complications and have a quicker recovery period than TURP. The risk of bleeding is generally higher with TURP, so it might not be the best option for certain men who take blood-thinning medications.
Thanks to all... it is a very threatening situation, especially when traveling. You never know if you need to be catherized! I think I'm going to look into the ciialis approach first.
Ìt is extremely distressing!, the only advice is empty the bladder frequently and NEVER pass a bathroom without using it, otherwise consider pampers when going an event. The problem on reducing water intake is the increase on constipation which is horrible
If you are prescribed Flomax be very aware of the blood pressure affecting side effects. Smoothing out the urethia also causes the blood vessels to smooth out and cause the orthostatic hypotension resulting in lightheadedness and severe dizziness. A parkinsons' patients nightmare. These side effects may not be recognized among general physicians. Urologist are aware of this. After watching my husband suffering from this complication for several years(that was only resolved by a urologist), if you are have prostate issues, use a urologist.
My father who is 82 and a doctor is suffering from PD for last couple of years and from last year his urination is not in control and despite using diapers in the night it overflows and wets the bed. Will the laser surgery of prostrate help in his case and what is the name of the surgery and is it different that TURP mentioned earlier.
This can be a real problem as PD patients commonly get UTIs and good urinary health is important. My husband was put on Myristiq which certainly controlled the urinary problem but then he had difficulty managing edema. The upshot was that he got a UTI, probably from the retention of urine and went into sepsis, kidney failure. Although it was predicted, he didn't die from this but the trauma destroyed all but 20% of his heart function which did kill him. The doctors comment was that 'it wasn't supposed to work like that.' Note that the UTI issue is now mentioned in their advertising.
I have no solution, only a caution that if you used any med for urinary retention, get checked OFTEN for infection. This is probably not uncommon...I think Mohammed Ali died ultimately from the problems related to a UTI.
My condolences on the passing of your husband. My Mother is 87 with PD + Cauda Equina. She spends MANY, MANY hours a day in the bathroom due to incontinence and constipation issues. If that isn't terrible enough, she is now having more difficulty pulling herself up to wipe, etc. She has caregivers but is still modest. I'm so afraid of her falling and/or straining which is a common cause of stroke in older people. During the last year she has had chronic UTIs. Her doctor recommended self-catheterizing for just the reasons you gave above, namely to avoid kidney damage and possible sepsis. All very terrifying. She had tests done with a urologist and a neuro-urologist who feel that her urine retention is not bad enough to warrant putting her through any type of cath process. Instead, with the next UTI (they occur about 1x/month), they will prescribe a longer course of the antibiotic, perhaps one month. They also discussed Botox for the overactive bladder. Another suggestion was Mandelamine with 500mg of Vitamin C 2x/day.
From what I hear the 3 most common causes of death for us is pneumonia,UTIs and falls that break our hips that makes us bed bound. As a career physical therapist I always swore that I planned to "live hard, die young and have a good looking corpse ".... alas it's now too late! Thanks to all for your advice and comments.
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