Had A Urodynamics Procedure Today

WARNING: Specific (but tasteful) discussion of male urinary tract stuff​

I've been having urological issues for a while.

A CT Scan 3 years or so ago for an unrelated issue showed a bladder stone, and that discovery put me on this roller coaster. In the process of seeing a urologist to get the stone remediated, other tests show that I'm retaining a lot of urine...my bladder remains over 1/2 full even after going to the bathroom. I've know I had issues, but chalked it up to "old guy stuff" I'd rather just live with than potentially get butchered on the table over. The recommendation has been to start self-catheterizing to salvage my remaining bladder function. I've yet to be able to consummate the deal.

The doctor that removed my bladder stone (at a different practice than the one I'm currently seeing) told me that he did not see anything to indicate my prostate might be a causal issue. So because I've yet to self-cath, my routine doctor recommended that I have a urodynamics test done to definitively pinpoint the problem. I had that done this morning. They confirmed that I have weak bladder muscles and that no procedure can fix it, and the choice is to self-catheterize now, or wait until I can't go at all on my own and have a permanent catheter (which is chock-full of infection risks, in addition to the other obvious downsides.) Another risk is developing kidney issues if my bladder fills and the urine should back up. I also run the risk of forming more bladder stones.

I was catheterized 3 times as part of the procedure today and don't know if I can do that to myself...and he used a numbing gel! The test was a very unpleasant experience that lasted over an hour. I almost no-showed them, but I needed to know for certain what the problem is and what my options are..turns out I got exactly one option.

I've read articles about male self-cathing, and I found one brief thread on one forum. The articles I read and the doctors' discussions are almost infuriating in the way they downplay the true experience of this. Reading condescending "You Totally Got This!" articles as though I'm a kid does not help, and it ain't the reality of the experience. I get that they don't want to scare people off, but they lie (or at least diminish) in the process. There's no place I've found for a brutally honest discussion. The one brief thread on one discussion board I found indicates that self-cath experiences for men are all over the place, and that most (but not all) eventually "get used to it." I don't see how that is possible.

The flip side to this is the early mortality rate I've mentioned for males in my family (in their 50s), and I've had all sorts of scans and tests over the past few years that all led to positive outcomes. Other than this, at 66 years old, I have no medical issues. (And since I've been outside working on firewood storage and stacking cords of wood the past week or so, I've dropped 8 pounds.) I should be grateful that this is all I've got going on. And I am. But that's an intellectual exercise, not the reality of this looming several-times-a-day act of torture and self abuse with no end in sight. It's just hanging over my head...

*sigh*

 

I have had that done to me once and it was extremely traumatic, so I know what you're talking about. I can't imagine doing that to myself.

 

It's crazy.

I have never had a never-ending health thing. Did you find that vid where you gotta confirm your age to watch? The crossed-leg comments are spot-on.

I'm concerned that I won't find a way to do this. At least the doctor today was one I could talk to...but even he inferred that the issue is 90% wrapping your head around it. Yeh. Right.

I figured you would understand some of the condescending articles out there. It's like reading those recipes where it's obvious that the author never actually made the dish. You gotta wonder why they bother putting pen to paper in the first place.

 

Heck, talk all about yourself as much as you like. Regarding the doctors: up until now, the underlying cause has been nothing but supposition. Here are the highlights on that urodynamics test, under a Spoiler click for those who don't wish to inadvertently see them.

Spoiler: Click to see urodynamics test details

-They lay you on a table and take an image of your bladder to check for stones (my only stone had already been removed, no more are forming.)
-Then they sit you up with another camera pointed right at your crotch
-They stick a tube up your rectum to monitor the pressure you apply
-They attach electrode sensors to your belly measure bladder muscle activity
-They drain your bladder
-They insert another tube that's used to fill your bladder with saline solution
--The Inlet tube has a pressure sensor on the end of it
--The saline solution has a chemical in in that can be tracked by the crotch camera
--They keep track of the amount In

They slowly pump the liquid in until you tell them you really gotta pee. This takes a while. The table you're sitting on has you hovering over a plastic toilet thing that measures volume and flow rate. They stop pumping in liquid and you pee with the tubes still in you. This entire time the doctor is monitoring all the metrics on a computer monitor (I could see it from my vantage point.) It's maybe 6 measurements with a horizontal line for each one...bladder pressure, rectum pressure, amount of liquid out, rate of liquid out, electrical muscle activity. Then they measure (and scan) the residual amount left.

Based on the bladder pressure and the rate of discharge, they can tell if there's any obstruction in between. And based on bladder pressure and flow rate, they can tell how strong/weak the muscle is. (Kegel exercises will strengthen the sphincter to remedy leakage, but nothing can exercise the actual muscle surrounding the bladder.) So those tests indicate two things for me:
-My prostate is contributing maybe 2% towards the inability to completely void
-The weak bladder muscle is contributing 98% towards the inability to completely void

After I was done they pulled the tubes from inside me and let me go into the bathroom to see if I could empty more. Then they see how much is left and catheterize again if it's a significant volume (it was for me.) I will say it was weird when I walked out, because I'm at the point my bladder needs to be pretty full before I can even go to the bathroom. It's always over 1/2 full, so does not take much time to top off but I never drain it anywhere near Empty. It has not been completely empty for well over 10 years. So it was maybe 6 hours after I left the appointment before I could pee to any extent. That benefit is the one thing that might motivate me to bite the bullet and do what needs to be done.

I had this test done because it removes all doctor subjectivity from the equation. These are quantitative measurements being taken by sensors and computers. So I trust this diagnosis. And this doctor was a regular guy I chatted with the entire time, so it was an extended interactive conversation and not just a diagnosis followed by a shove out the door.

I really hate this stuff. My anxiety level spikes every time I have an appointment with these guys because it's never good news. I'm hoping the more I "talk" about it, the more I'll lower my resistance and just do what I've got to do. I can't really think about it right now, though...I'm still sore from today's ordeal.

 

I think we would all be disappointed if she hadn't thrown something like that on the table, huh?

I'm sorry about your grandfather. And I understand. The catheter is the immediate horrific reality, while the alternative is tomorrow's concept.

I need to follow your advice and find a group. I've been fruitlessly searching on "self-cath forums," but not on "support group."

 

Thanks, Don.

If I may ask, how did you adapt? It sounds like you "got used to it." Did the experience change for you? How?

My issue is that there is no immediate crisis. As I told the doctor, this has been my state for well over 10 years. While that's a good thing, it leaves room for procrastination (which is my middle name).

 

Thanks, Lon.