OT? Male urine hydraulics.

I hope this isn't too far OT. It is about hydraulics and I think that's of interest here.

But it's about male urine hydraulics. And I need some advice before I try to talk to the doctor again. I've learned one needs to be informed when talking to a doctor.

Until 2 months ago, I could pee normally, one single stream going just where I pointed it, except once every 6 months or so, the sides of the opening were stuck together for a minute or so, but that was so rare it was no problem.

But recently, I had blood in my urine and the urologist sent a scope up my urethra to look inside my bladder, then on another day something else to do a bladder biopsy (negative), and 10 days after that, a laser to zap a bladder stone, almost as big as a golf ball. .

Between the 2nd and last procedure I had 3 different catheters, and after the last procedure, abother thicker, stiffer one with a bigger channel inside, to allow any remaining little particles from the stone to come out. Everything is fine now, no more blood, except now I almost always pee in 2 or 3 streams going in all directions and it makes a mess if I'm standing up.

In response to this problem, the doctor thought I need a smaller prostate, either with a stronger drug or a laser-sapping (this time the prostate itself, not the bladder stone (which is gone).

But the prostate is several inches from the opening, at the end. Wouldn't any turbulence caused by a narrow opening due to a enlarged prostate(*) even itself out before the exit point, even if we understated the distance as 3 or 2 inches), and doesn't that mean the obstruction is quite close to the opening?????

And not where the prostate is. After all, I was peeing normally until the day before the 2nd procedure, and even though the outside catheter surface is smooth, I can't help thinking it messed something up near the exit point, maybe when one of the four were coming out.

*(which is probably no more enlarged than it was 14 days earlier, before the 2nd procuedure) )

Background. The tube leading to the opening is called the urethra, but the tube ends (or starts) where the prostate is, and from there up to the bladder, there is no tube just a space made by the lobes of the prostate. At least this is approximately right, and it's why it's possible to zap the prostate with a laser without cutting through the urethra, or needing to sew it back up.

I don't mind posted replies, in fact they are better because other people reply to them,, but if anyone wants to email, remove the extra r's after onlooker. There should be only one.

Reply to
Onlooker
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Did you ask the doc why that was happening (sticking together)? Inflammation? Discharge? Any meds or other medical issues going on?

Smile...be happy that bugger was not in your kidney :o)

The larger urinary catheters might make strong men faint on seeing one in place :o) There is a balloon at the top that is inflated after insertion and which holds the catheter in place (unless you have dementia and want to just yank the thing out...happens regularly). Balloon is usually 5 cc or 30 cc...30cc the norm after prostate removal.

Did the doc look up there after the last catheter removal to be sure no stone fragments remain?

This is the only present problem? If so, hold on and see how things go. Most surgeons will sell stuff the patient is willing to buy and the stuff is often not the "cure". Do read up on prostate problems in legitimate scientific/medical resources. One complication of prostate removal is incontinence...don't know the statistics, but it is something I would not want to risk for some other minor issue. (Sitting down is better than leaking all the time...I know because I'm not a prostate owner)

You have had a lot of traffic up the old tube...swelling, inflammation, possibly some stretching. Unless there is some medical reason not to do so, drink a lot of fluids, including cranberry juice.

Well, you are close....the urethra goes from the bladder to the outlet (you know where that is). The prostate encircles the urethra at the base of the bladder (think "doughnut hole"); that's why the plumbing doesn't work so well when the prostate enlarges. Can't do transurethral prostate removal without nipping through that section of the urethra....

Reply to
Norminn

I think your instincts are good. To me, it sounds more like a "nozzle" problem much closer to the outside world and not at all like a restricted flow problem originating more proximally in the prostatic urethra. Maybe there's a small tag of skin or scar tissue (possibly produced from stone fragment or instrument trauma) either very close to the outside world or even at the meatus that is producing the spray. If your prostate were enlarged and constricting the urethra, it would restrict urine flow, which would likely reduce flow turbulence. In fact, I wonder if having prostatic surgery would exacerbate your symptoms by increasing turbulance. As someone else has mentioned, there are potentially unpleasant and undesirable side effects that can happen with prostate surgery and personally, I'd rather live with a spray problem than have prostatic surgery on account of that particular symptom alone. If you can't get a logical, clear explanation from your urologist how restricted urine flow from an enlarged prostate causes your symptom, time to get a second opinion.

Reply to
Peter

Yes, and his answer was that it was the enlarged prostate.

There has not been any discharge ever, and no inflammation I could see. The only med I'm taking is Vitamin D and generic Flowmax - Tamsulosin. And I keep forgetting one or two days a week. It's been 11 weeks since the last procedure, and I had been waiing for this stream problem would go away.

The Flomax, he said, keeps the prostate from growing, but that's all. The stronger drug, Adovart iirc, is what they use to make it get smaller, but it has side effects on some people.

I may have had kdiney stones. I'm not sure.

I read that that could damage the exit of the bladder.

Well, the first two of mine fell out on theirs own. After the 2nd procedure, the biopsy, I couldn't urinate at all, and after about 16 hours, I went to the emergency room Sat. morning around 2AM. They put me in the hospital. Around 7 Sunday morning, the catheter fell out and neither the nurse nor some other person who came around could figure out why. The non-nurse said that there were some new catheters without balloons, and the nurse nodded. But later the urologist said that the sharp corners on the stone had punctured the balloon. (there are catheters without balloons, but they are meant for sel-insiertion and only for a few minutes, to urinate, and then take it out.) The nurse threw the catheter in the trash and I dug it out and looked at it, and didn't notice even a punctured balloon, but I didn't know yet that there were balloons and didn't look for one, and a) it might have been like a belt around the top, and b) I told the urologist about this, so he would look for any latex scraps in my bladder. He nodded.

The urologist also told me over the phone how to remove the catheter, by using scissors to cut off the stub tube that they had attached a water-filled syringe to, to inflate the balloon. I did that with the last two of them, and after the (clean) water sprayed ou, through the little cut I made at first, the catheter fell out a minute later.

No. I went to the office but he just talked to me.

It's been 11 weeks, and there's been no change in the last 6 to 10 weeks. I have an appointment with him in December, 6 or 7 months after the last time I saw him. He didn't seem eager to do anything else, but that would depend on my symptoms. The need to urinate more frequently may be coming back. It's hard to say. When I'm ou for a long time, which is not so often, I can go 5 hours or the last time 4, without a bahroom, but when I'm home, I go much more often, upt to once an hour. Better than the every 10 minutes it was the week before the 2nd procedure

Yes, I know you'r e not. Perhaps you can get one on ebay.

Are you sure? The urologist said specifically that the urethra starts just below the prostate, and that is why the urethra is not in the way for any laser "zapping",( my word. I forget what word he used. And I don't think he referred to "lobes" of the prostate.)

Reply to
<NONONOmisc07

I think instead of a doctor, you need to see a rabbi...

:-)

Mark

Reply to
Mark

I don't have a lot of experience in this department. Decided to read the mail, and comment when I could agree with someone. This is such a moment. Peter has the right idea.

I'm suspecting urethra damage, near the exit point.

Christopher A. Young Learn more about Jesus

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I think your instincts are good. To me, it sounds more like a "nozzle" problem much closer to the outside world and not at all like a restricted flow problem originating more proximally in the prostatic urethra. Maybe there's a small tag of skin or scar tissue (possibly produced from stone fragment or instrument trauma) either very close to the outside world or even at the meatus that is producing the spray. If your prostate were enlarged and constricting the urethra, it would restrict urine flow, which would likely reduce flow turbulence. In fact, I wonder if having prostatic surgery would exacerbate your symptoms by increasing turbulance. As someone else has mentioned, there are potentially unpleasant and undesirable side effects that can happen with prostate surgery and personally, I'd rather live with a spray problem than have prostatic surgery on account of that particular symptom alone. If you can't get a logical, clear explanation from your urologist how restricted urine flow from an enlarged prostate causes your symptom, time to get a second opinion.

Reply to
Stormin Mormon

Most specialists have nurses working in their offices, and oftentimes the nurse is more accessible. The OP should make a phone call, ask for the nurse, and pose the question. If no satisfactory answer, then I'd try to get a second opinion from a reliable doc...some family docs will address questions like that more readily than specialists. Anyone facing non-emergency procedures should try to research the problem, treatment options, complications, etc. There is so much info available on the net, a basic anatomy lesson is a good idea as well.

Reply to
Norminn

That's encouraging, a split stream may be temporary interference from zipper. Much cheaper than a prostate removal, or other surgery. Easier to treat, also. Lower copayment.

Christopher A. Young Learn more about Jesus

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Be careful, lots of docs suck at diagnosis. :( cheers Bob

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Splitting of the urinary stream is very common. It occurs when there exists an area of relative narrowing of the urinary canal (urethra). This may occur anywhere in the urethra from the neck of the bladder to the opening of the urethra at the end of the penis (meatus). The most common causes are an enlarged or swollen prostate gland, urethral strictures or meatal stenosis. Another frequent cause is in those men who remove their penis through the unzippered fly, void and then put the penis back. Often, the space is not adequate for total free flow as the lower (bottom) edge of the fly can actually push on the urethra causing urine to be trapped. This phenomenon can be totally avoided by dropping your trousers and then urinating in the standing or sitting position. When the urinary bladder is full (such as from a diuretic or delaying the desire to void) or if one voluntarily strains to void, the pressure of the stream can be increased and the stream is often more full and forceful without the split.

To determine the etiology and potential seriousness of a split stream requires consultation with a urologist. A urinalysis, observation of the voided stream and uroflowmetrometry (to determine if the force of the stream is normal) are generally done. If there is a question about the ability of the bladder to empty properly, a determination of the residual urine can be done either by a bladder ultrasound or catheterization. Sometimes, a cystoscopic examination is also necessary to determine the cause of the problem. Many patients with split streams require no specific treatment. However, significant restriction of the urine flow, residual urine, or infection are indications for treatment. The latter, of course, depends on the underlying etiology.

Reply to
Stormin Mormon

I'm remembering, a year or so when I had a pinched nerve in my arm. A friend of mine, (an orthopedic surgeon) suggested I take ibuprophen, several times a day for several days. The thought being that ibu has anti-inflamtory properties. Seemed to help. It also helped to remove the source of the trouble, quit pinching the nerve.

A man with a localized inflamation of tissue such as urethra wall might get some relief of inflmation, using ibuprophen for several days.

Of course, consult your own doctor, and check with the MD who knows you personally, and knows what medications you presently take. I am neither a doctor, nor have I met the OP in person.

Christopher A. Young Learn more about Jesus

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Between the 2nd and last procedure I had 3 different catheters, and after the last procedure, abother thicker, stiffer one with a bigger channel inside, to allow any remaining little particles from the stone to come out. Everything is fine now, no more blood, except now I almost always pee in 2 or 3 streams going in all directions and it makes a mess if I'm standing up.

Reply to
Stormin Mormon

All I take is tamsulosin (Flomax) and Vitamin D. So I'm doing pretty well for 65. I think my older brother was t aking nothing when he was my age.

I was prescribed the tamsulosin 16 months ago, but ended up not taking it after 2 months, so at the biopsy this April, the anesthesiologist asked me what drugs I was taking and I didn't think Vitamin D counted and I said "Nnothing", and what I was allergic to, and I said "Nothing", and he said I was the first patient he ever had like that.

Thanks to all who gave helpful advice.

The phrase "scar tissue" was something I should have thought of but didn't. I will wai a little longer maybe until the December appointment, , and ask him again while using the words scar tissue.

I will read some more, and by coincidence, I just talked to a guy who has the same internist as I and a urologist who gave him the same choice, between laser zapping and Adovart. He has to decide sooner than I do.

Reply to
<NONONOmisc07

wrote in news: snipped-for-privacy@4ax.com:

I agree that most likely there is some scar tissue near the orifice that gives the OP his trouble.

I am now on 2 tamsulosin/day plus 1 finasteride (I think Proscar is a cousin of Avodart. So far so good, and the added benefit is support for suffering Big Pharma ...

Reply to
Han

You do sound exceptional, and in a good way. One friend of mine takes only aspirin for aches, and nothing else. Wish I could do that.

Idle thought. I wonder if Flomax leads to bladder stones? That would be ironic, if the med you take for prostate, gives bladder problems.

Christopher A. Young Learn more about Jesus

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All I take is tamsulosin (Flomax) and Vitamin D. So I'm doing pretty well for 65. I think my older brother was t aking nothing when he was my age.

I was prescribed the tamsulosin 16 months ago, but ended up not taking it after 2 months, so at the biopsy this April, the anesthesiologist asked me what drugs I was taking and I didn't think Vitamin D counted and I said "Nnothing", and what I was allergic to, and I said "Nothing", and he said I was the first patient he ever had like that.

Thanks to all who gave helpful advice.

The phrase "scar tissue" was something I should have thought of but didn't. I will wai a little longer maybe until the December appointment, , and ask him again while using the words scar tissue.

I will read some more, and by coincidence, I just talked to a guy who has the same internist as I and a urologist who gave him the same choice, between laser zapping and Adovart. He has to decide sooner than I do.

Reply to
Stormin Mormon

Did you all know they did surgery for blader stones since 2800 years ago? 2800. Successful surgery, at least some of the time. Hippocrates mentions it in his oath, and doctors promised in his day to refer such surgery to a specialist. IIRC one of the speciallists had done this 50 or 100 times.

And things were done pretty much the same way until about 40 years ago, when ultrasound was invented. For stone breakup, not in place of x-rays, which I mention below.

So if theis were 42 years ago, it would have been abdominal surgery.

(See Nominn, I've been reading for a long time, but it's hard to find stuff about my question. I really found nothing that addressed the specific quesiton. That's why I asked here.

No evidence of that here. I only took the generic flomax two months of spring 2011, and then after the stone was zapped.

But the BPH constricted the urine flow, and probably left urine in my bladder all the time, and the urine has dissolved or floating solids that precipitate (if they are dissolved) or (if they are only floating) fall out. And that makes the stone.

There have a special little ultrasound machine that views and then calculates how much urine is in one's bladder -- they used it almost every time I went to his office --, and the doctor was happy that the last time there was basically nothing left in it after I peed. I think the maxium a 5'9" man can hold is 800 to 1000 ml, and when it gets to 1000, he's in pain and really needs a catheter. Numbers are appoximate.

I should have seen this coming. During the period when I peed every

30 or 60 minutes but vety little, I couldn't bring myself to flush the toilet every time (waste of water) and what happened is tan or dark yelowishl stuff stuck to the bowl below the water line that wouldn't come off with reguar toilelt bowl cleaner or a brush. I had to use acid-based toilet bowl cleaner, let it sit for 10 minutes, and apply it several times in a row one time when the toilet got bad. Whatever stuck to the toilet bowl is what made the stone in my bladder I think.

Home repair question: I thought the acid would pit the toilet making it even harder to clean all the time. Do you think it would do that? Hint: When clean, I felt the surface with my finger and it didn't feel pitted at all.

BTW, the doctor all but apologized for not seeing the stone April of

2011. He might have actually apologized but he wasn't sure if he missed it (which he found hard to believe(*) or if it grew (a lot?) faster than normal. In the latter case he had nothing to apologize for.
  • He had taken pictures of some bloody looking areas in my bladder, which must have been where the blood came from. He didn't give me a copy of those, but he gave me four pictures of my bladder stone. He put a golf ball next to it so I could tell how big it was. (Just kidding. I can't tell how big it was, but I believe him. It's actually hard to tel what the pictures are of)

IIRC, I saw something like that on the news in the last two weeks, No I read it. I remember. There are two kinds of prostate cancer, slow growing which almost everyone with prostate cancer has and can take 20 or 30 or more? years to kill you and you're usually dead from someting else first, and fast growing. IIRC, the pill that treats the slow growing cancer makes the fast growing worse. Something like that.

Reply to
<NONONOmisc07

Probably what he meant was that the laser beam will not be aimed at the urethra only area because the prostate is farther back. He'll still have to run the equipment up the urethra to get it to the site.

Reply to
Ashton Crusher

Your logic does make sense and I'd test it by waiting and maybe taking a pr ostate supplement while you wait. If it doesn?t get better with the suppl ement and or by healing, you can ask the doctor what it's all about and how an enlarged prostate could cause this kind of symptom. While you have time , read Super Beta Prostate supplement reviews and see if it's right for you .

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Reply to
jeffrey.eadie

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