Visit To Urologist

[diaperpt]

Last summer, my primary care doc prescribed generic for Flomax for me. I get up multi-times at night, frequent urges and then only dribble, little to no control of flow once it's started. Because I dribble so much, I've taken to sitting down to urinate. As I sit, I'm even losing a sense of when I'm peeing. I also often have a sense of not fully emptying my bladder. This summer, I used the Flomax for several days until I decided getting sleep was more important than any good effects from the med. I was awake just about all night. I told my primary care doc that I'd rather suffer from not taking the med than from taking it. He offered no alternative.

I also saw my urologist over the summer (other reasons) and he said that he could prescribe something else which wouldn't have that side-effect. In looking online just a bit and from what I've heard from some people here, there may be worse side effects than the benefits might be. I have an appt with my urologist this Wed and want to ask about all options - what are possible side effects of each type of drug, will the helpfulness of the med continue or tend to fade over periods of use, and what are my options if side effects are such that we don't find a suitable med.

What are your thoughts and experiences with various meds for this problem? If you have any suggestions for what to ask my urologist or how to approach it, I'd appreciate your opinions. I'm a little apprehensive about many of the negative side-effects I've heard about. I'm not thinking he's going to say that diapers are anywhere on his approved list of options and I won't push it. Any thoughts on what other options you've heard of or explored yourself?

Thanks for any helpful comments you might have.

[LuvsGurl]

A lot of newer drugs scare me. It seems with everything on the market these days the side effects are worse than the problem being treated.

Diapers are typically seen by the medical community as a temporary fix while a better solution is found. But if you are experiencing problems with the drugs I don't really see any other choice. You'd probably be better off checking with your insurance company to see if they cover disposable or reusable incontinence garments. It may be a cost you have to pay out-of-pocket.

[WetDad]

Any thoughts on what other options you've heard of or explored yourself?

Thanks for any helpful comments you might have.

My PCP talked to me about a number of different drugs, suggesting that I try anything beside my diapers. Nice guy, still a personal friend, but I wanted a second opinion. The urologist said I had prostate issues, and a simple out patient procedure would fix it. His take on the meds was quite lengthy- each one had a different set of side effects and a very low probability of actually working... He agreed that other than surgery, the side effects of diapers was the lowest.

Oh yeah- I had the surgery. Painful till I recovered, but it helped. Not a complete cure though, as the side effects of my anti-depressants still give me incon issues at times.

[Guest munchkitten]

I have spironolactone which is a duretic, but doesn't make you go too often (every 2 hours, but I never wake up to go at night.) plus it's been out forever, lowers your blood pressure, and is 4 bucks at walmart.

[diaperkevin]

I take Flomax daily. Was on a higher dose but there was an unwanted side effect, and the larger dose didn't seem to help that much more.

I am taking it because my prostate is abnormally large for a man of my age. I also have incomplete emptying of my bladder. It seems to help a little, but not all that much.

Haven't had a problem with any side effects other than just one.

[babylin]

I had the surgery, diaperpt. The "gold standard" operation is a trans urethra resection of the prostate, TURP. Doctor goes in thru your urethra and snips out a section of prostate thus relieving strangulation of the urethra. A good chance of developing incontinence is possible.

Four years ago I had a less troublesome (consequences/side effects) operation called a TUIP, where instead of cutting out a section, the doctor simply cuts the strangulating prostate at the muscle that empties the bladder thus allowing the bladder to empty naturally. Much less incontinence.

The real long term complication is strangulation if you do nothing and blockage occurs. Painful, I'm told.

I do not remember any drug that actually shrinks an enlarged prostate..and they all have side effects. Worse, you take pills for years without real improvement.

Diapers are a coping mechanism that is very conservative with minimal side effects (rash) and allows you time to evaluate options further.

One key factor is "What is your PSA count?"

Let your urologist do a full workup and then decide the best procedure for you.

Best of luck!

HAPPINESS IS WEARING COTTON DIAPERS

[Dill_Pickle]

I had the surgery, diaperpt. The "gold standard" operation is a trans urethra resection of the prostate, TURP. Doctor goes in thru your urethra and snips out a section of prostate thus relieving strangulation of the urethra. A good chance of developing incontinence is possible.

Four years ago I had a less troublesome (consequences/side effects) operation called a TUIP, where instead of cutting out a section, the doctor simply cuts the strangulating prostate at the muscle that empties the bladder thus allowing the bladder to empty naturally. Much less incontinence.

The real long term complication is strangulation if you do nothing and blockage occurs. Painful, I'm told.

I do not remember any drug that actually shrinks an enlarged prostate..and they all have side effects. Worse, you take pills for years without real improvement.

Diapers are a coping mechanism that is very conservative with minimal side effects (rash) and allows you time to evaluate options further.

One key factor is "What is your PSA count?"

Let your urologist do a full workup and then decide the best procedure for you.

Best of luck!

HAPPINESS IS WEARING COTTON DIAPERS

Having lost my dad to prostate cancer, the question to be asked is what is my long-term prognosis. In my dad's case, he had it treated a decade or so ago, and then it recurred....and metastased to his bones. At that point, there were 10 months left, it went to his bones, and he eventually died of anemia.

Oh, and not being able to pee is a medical emergency. Having a difficult time will do damage if untreated; lots of stories of guys having to get a foley put in to return their bladders to normal size.

[sarah_ab]

interestingly enough... flomax has been found to help break up kidney stones..

i know this because a few weeks ago when i inexplicably ended up with a kidney stone... the doctor prescribed me some so it would break up and pass quicker... but i only took it for 3 days, so not long enough to experience side effects....

[diaperpt]

Thanks for the comments. My PCP and urologist have been watching carefully. My PCP has sent me to my urologist when my PSA has changed or gone up. This summer it was because my PCP had concern about the size of my prostate. My urologist wasn't too concerned - this was when I mentioned to him that I'd tried the generic for flomax.

I know my problem isn't huge and I've been assured I show no signs of cancer. This is more just an aggravation. I have mixed feelings because I don't really want to have to wear diapers all the time, but having a problem would legitimize me having to wear. I certainly don't want to cause a problem. I'm more just curious about the side effects of some of the other meds that might be prescribed and I will ask my urologist. I just wondered what others had experienced.

If there are other thoughts, I'd appreciate hearing them as well. Again, thanks to those who did respond.

[Cons32]

My PCP talked to me about a number of different drugs, suggesting that I try anything beside my diapers. Nice guy, still a personal friend, but I wanted a second opinion. The urologist said I had prostate issues, and a simple out patient procedure would fix it. His take on the meds was quite lengthy- each one had a different set of side effects and a very low probability of actually working... He agreed that other than surgery, the side effects of diapers was the lowest.

Oh yeah- I had the surgery. Painful till I recovered, but it helped. Not a complete cure though, as the side effects of my anti-depressants still give me incon issues at times.

What med are you taking for the incon as a side effect? I have trouble sleeping, so they want to try an anti-depressant, but I was hesitant about it. If I can take one, and it lets me "need" to wear diapers, its a plus. Is the side effect just at night, or all the time? They were also thinking of putting me on ADHD meds to see if that helped me to sleep. Anyone know of any I can recommend to the Dr., that may help me wet in my sleep?

[Mischa]

oxybutynin didnt work for me after two and a half months, so I said "drop the meds and just double the script for the diapers, the pills aren't doing anything except making me queasy."

[Bettypooh]

....I have mixed feelings because I don't really want to have to wear diapers all the time, but having a problem would legitimize me having to wear....

I was the opposite Like so many others who are just coming to terms with being DL, I thought incontinence would legitimize my wearing and make it easy Then my always weak bladder began leaking more than I could control, so I began wearing 24/7 It took a lot of getting used to mentally, always watching where others were looking at when looking at me, and always super-conscious of what I was wearing Now it doesn't matter and nobody has noticed a thing I have the "excuse" I always wanted, but I now realize that I don't "need an excuse" like I thought I did- I can wear just because I want to I would like the option of not wearing, but really, it's not a big deal anymore. I am lucky that my minimal leakage allows me to use the most discreet protection- and I'm glad of that- but now that I've gone everywhere and done everything wearing a bulky cloth diaper and still nobody noticed, it is a non-issue

I think you'll find it much the same. Wearing diapers isn't always desired or fun for everyone, but it doesn't really have as great an affect on your life as you think it might. And if you have to wear then let that help you get used to it mentally There's no point in worrying about the things you cannot change All that will do is add to your stress and blood pressure Just be sensible, aim for discretion, and refuse to feel any shame for the things you have no control over And if you can find a way to make it more enjoyable, give that a try- it will go a long way to making you feel better about it all.

Bettypooh

[diaperpt]

Bettypooh, not only do I love your emoticons, you always show great wisdom in your responses.

I'm back from the urologist. He said that he hadn't heard of Flomax causing sleeplessness but he did believe me - and it was true.

He talked about the different drugs and did also talk about that TURP which babylin mentioned. He gave it an alternate name of 'roto-rooter', which doesn't sound real accurate according to babylin's description. He said, though, that Flomax and other drugs of its type are somewhat diagnostic as well since they do chemically what the TURP does.

Since the Flomax did work, he seemed to think I do have some obstruction. He suggested starting conservative and gave me a couple week's worth of samples of 'Rapaflo' (a name which even he couldn't keep a straight face saying!). If it helps the bladder issues, it will confirm a blockage. If it gives side effects, I'll stop it and we'll go from there.

Take one a day with a meal - so I came home, had a sandwich and a bunch of water and my first pill. Almost immediately, I felt a little light-headed - not super dizzy or disoriented - but I'd say a little fuzzy. If this is what this drug is going to do to me, I don't think I can take it.

Bettypooh, I do understand what you are saying about wishing incontinence for yourself. I'm not really there. I also know you are right even in saying that if you get started, there isn't much turning back. My mixed feelings come from the fact that my wife discovered my diapers about 10 months ago and thought I'd given them up as per her 'demands' at the time. I had for several months but couldn't stay away. Just last week, I had to admit that I've been wearing again. She wasn't happy and said she can't accept the diapers, but we are working on our relationship overall and I am hopeful that we can work things out. Where diapers fall in all this is still a huge question, but we've made huge progress from 'either the diapers go or you go!' She said last week she should have known I wouldn't be able to just walk away from wearing. While she said she can't accept them, she says she does love me and does want to grow old with me (we each want to grow old only because its better than the other option...).

Now, I don't want incontinence in order to be able to wear diapers. I'm working on that side of things with my wife as I feel I can.

I'm legitimately having trouble with urinating - I can barely make it through a 45 minute drive most days and I'm getting up 5/6 times per night just to dribble. I would VERY much like to get this taken care of. To the extent that my wife knows I'm having this difficulty and working with the urologist on the issue, that is a good thing.

IF these drugs don't work for me (and right now I'm not confident with this Rapaflow), I'll go back to my urologist and ask for options - still other drugs, the TURP, which he didn't discuss in detail (particularly nothing about potential continence issues as a result). I'll worry about that if and when I get there.

The only thing I can say about these problems coinciding with my love of diapers is that while I don't want to be incon, IF it does happen at least I'm not opposed to using diapers. I don't think I'd want to try other options. Yes, I'm very sure that being incon is NOT convenient. Your points, Bettypooh, are very valid and I do agree with you (at least from this side of continence!)

I feel very, very fortunate that this is an issue of aggravation rather than a serious health concern - I do not have cancer and that is a wonderful thing. It is absolutely a luxury to be talking about a relatively common and relatively minor condition.

[sarah_ab]

if you take a medication orally it will take at the least 20 min to start working so if you felt dizzy immediately after swallowing it .... maybe it was vodka not water you were srinking???

but seriously it would have taken some time for you body to metabolize the pill especially with a full stomach....

[Bettypooh]

if you take a medication orally it will take at the least 20 min to start working so if you felt dizzy immediately after swallowing it .... maybe it was vodka not water you were srinking???

but seriously it would have taken some time for you body to metabolize the pill especially with a full stomach....

Sarah's right- it's called "titration"- the time it takes for a substance to enter the bloodstream in enough quantity to have an effect I do hope you can get your problems worked out in both regards (medical and home) TBH, I haven't had any tests so I am going on a educated self-diagnosis of my own bladder problems, but they key in very well with a lifetime's experience It's possible I have more problems than I know of but since I can't afford to get them treated if I have them it doesn't really matter I'm NOT going to worry about it and make my already too-high stress levels worse Life will do what it does and so will I

Bettypooh

[Dill_Pickle]

I feel very, very fortunate that this is an issue of aggravation rather than a serious health concern - I do not have cancer and that is a wonderful thing. It is absolutely a luxury to be talking about a relatively common and relatively minor condition.

Yup, but if you have to dribble frequently, has the urologist checked to see how big your bladder is or if it is emptying completely? Back pressure on your kidneys makes them not work.

I'm starting to wonder what standard of care you are getting from the urologist....

I'll also mention that a few weeks back I played with an external catheter and leg bag and wore one for about three weeks....it did an extremely good job of keeping my diaper in bed dry....you might want to think about one while this gets resolved. You don't need a prescription for it, just to know what it is and ask at a surgical supply store.

[BabyChris121675]

I've dealt with urologists before and I didn't exactly like being poked and prodded around my privates. I have been reccomeneded to see a urologist but I won't. To me, it's a waste of time and I don't trust medicines all that much. I have had bad experiences with anti-depressants and ADHD meds that made me suicidal in high school.

I decided years ago that diapers are the best, viable option for me. Not medicine. I don't care for side-effects, I have an active life and I would rather keep that going, thank you very much. I play softball, I go out with friends and I enjoy life to it's fullest and I do it with diapers and not medicines.

To me, diapers are the best option for me.

BabyChris121675

[diaperpt]

Ah, the blessings of posting online like this... its so difficult to write accurately enough for people to understand what you intend to get across and so easy to write something which is difficult to understand! It isn't the fault of those who've tried to be helpful here, but maybe at least partly my fault in not being clear.

sarah...let me go check...I thought it was water I took the pill with...maybe it was vodka.

No, when I say immediately I meant by that right from the first pill. Not instants after taking it. And I'm not going to assume anything from just one dose. Right now I'm eating a bigger breakfast than I'd normally eat and have taken the pill. I will try to give this med a solid chance before writing it off for any side-effects. It certainly isn't right to judge based on one dose. But I will say also it was wonderful last night! I only got up twice (or was it 3 times) during the night - its been quite a while since that's happened!

I do want to give this med a chance.

I am also somewhat concerned that I NOT be so afraid of the possible side-effects that I imagine them. Give it time. Give it a chance. Don't judge on the basis of only a couple days. I have an appt again at the end of April. I can always stop the med if I feel I need to, but I am going to try to give it a fair shot.

Dill_Pickle, your comments are very valid. But when I say I dribble, it isn't in between trips to the bathroom. When I get there, there has been no 'stream' so to speak. That is what I meant by dribbles. I'll get to the bathroom, sit and dribble for a while. I don't feel empty, so I sit a little more and then I get more dribbles. Once in a great while, there may be yet another time of dribbles. Once I've judged that I'm 'done' and leave the bathroom, I'm OK - no spontaneous, surprise dribbles. I have NOT been having accidents, although while I've been wearing a diaper while driving the hour to work or back, I've been thankful that I can just let go instead of trying to struggle to make the whole trip. Now, if I try to make it all the way home when I'm feeling lots of pressure - and then keep driving and driving - I'm sure I could make myself have an accident...but then is that really an accident?

I try to describe completely and accurately to my doctors, but this may not come across clearly here.

I realize also that when we read other people's posts, we relate to it through our own experiences (how else could we??). Dill_Pickle, I will say that I do think I'm getting reasonable care from my urologist. BabyChris121675, I can understand and appreciate your feelings as well, but I haven't had those same experiences. It is horrible that you had such bad times with meds and you've now got every right to be afraid.

Dill, the doctor's position is that the generic for Flomax and now this Rapaflow are each meds which will back up the idea that I do have some blockage - they are somewhat diagnositic in themselves. IF the meds take care of it satisfactorily - without side effects - then the basic problem is solved. I will have to be meticulous -as with any doctor - in telling him how the med is working. If I get to sleep through the night except for getting up once or maybe twice, that's one issue. If when I get to the bathroom, I get more flow - closer to a stream rather than drips and dribbles, that's another issue. If I go to the bathroom fewer times during the day, if I still feel full after I'm done...all these are seperate pieces I need to be able to describe to him so he can make a decent diagnosis. If I get side-effects I can't deal with OR if the meds only partially resolve the problems, then we've got to regroup and try something else.

BabyChris, my own experience with antidepressants has been good. The one's I've used and am using now are in fact helpful to me. That doesn't mean that I think you ought to reconsider them. Not at all. Your experience warrants your concerns and you are probably doing just the right thing for you. I am somewhat concerned about drugs and I do NOT like the fact that my cabinet is getting filled more and more by meds I'm taking for various reasons. And yes, if any of these meds start interfering with things I consider important to me, I'll look for the next option.

This is a helpful thread, I think, for many of us. Your comments bring in your own experiences and I think that's good for others who are only reading. There is no one person's experience that tells the whole story. In my case, I've begun to get some understanding and sympathy, empathy, whatever from my wife over the situation even as we deal with our relationship overall and her intense dislike of my interest in diapers. I'm trying to keep these two issues seperate.

I'm not going to beg for the TURP procedure and my doctor won't recommend it until we are convinced there are no meds that will help. I do NOT want to just let the situation continue wherein I need to run to the bathroom all day and get up a million times at night. I don't want to ignore any situation that might in fact lead to a more serious medical issue (and I'm confident my doctors are meticulous enough not to let that happen). IF meds do not work or have too many bad side-effects and then with or without the TURP, I begin to have leakage issues, I think I'd opt for diapers rather than any kind of cath and leg-bag. I'm not there yet, though, and I do hope not to have to rely on diapers (or cath...).

Even if I get to the point of a TURP, I'll probably be back here in a flash to get a broader perspective on that. I'm sure there have been both positive and negative experiences there. And what I suspect is that on this board, we'd hear more negative experiences...hence the need for diapers and the attraction to this particular site. Still, I've grown to respect opinions and experiences here.

Now, it's too late for today since I've already taken my pill, but maybe tomorrow I WILL try it with vodka...or maybe... or !!!

[diaperboyMKE]

a little OT, but still on the subject of drugs. I can't help but think that with the technology we have today, if there were enough demand for a drug that would cause you to lose control of your bladder, we'd have it by now. This is the entire reason why Viagra and Cialis exist, medically, being limp hasn't killed anyone, and while it IS very emotionally troubling for men who can't get it up, that's NOT why these drugs exist. The reason they exist is because there are a LOT of men who WANT the ability to get an erection (a GOOD erection) whenever they want. I'd be willing to bet that a HUGE majority of people who consume these drugs would have no problem getting or maintaining an erection on their own. Proving the fact that if there were enough people who wanted to be able to "regress" medically, the medical industry would respond by not only designing a pill to make you piss yourself, they'd also come up with a convincing enough reason that it's medically necessary to ensure that insurance companies would cover their product. BUT, unfortunately, we're such a minority that the $$demand$$ just isn't there. Sorry to get OT.

[Dill_Pickle]

Ah, the blessings of posting online like this... its so difficult to write accurately enough for people to understand what you intend to get across and so easy to write something which is difficult to understand! It isn't the fault of those who've tried to be helpful here, but maybe at least partly my fault in not being clear.

Dill_Pickle, your comments are very valid. But when I say I dribble, it isn't in between trips to the bathroom. When I get there, there has been no 'stream' so to speak. That is what I meant by dribbles. I'll get to the bathroom, sit and dribble for a while. I don't feel empty, so I sit a little more and then I get more dribbles. Once in a great while, there may be yet another time of dribbles. Once I've judged that I'm 'done' and leave the bathroom, I'm OK - no spontaneous, surprise dribbles. I have NOT been having accidents, although while I've been wearing a diaper while driving the hour to work or back, I've been thankful that I can just let go instead of trying to struggle to make the whole trip. Now, if I try to make it all the way home when I'm feeling lots of pressure - and then keep driving and driving - I'm sure I could make myself have an accident...but then is that really an accident?

Dill, the doctor's position is that the generic for Flomax and now this Rapaflow are each meds which will back up the idea that I do have some blockage - they are somewhat diagnositic in themselves. IF the meds take care of it satisfactorily - without side effects - then the basic problem is solved. I will have to be meticulous -as with any doctor - in telling him how the med is working. If I get to sleep through the night except for getting up once or maybe twice, that's one issue. If when I get to the bathroom, I get more flow - closer to a stream rather than drips and dribbles, that's another issue. If I go to the bathroom fewer times during the day, if I still feel full after I'm done...all these are seperate pieces I need to be able to describe to him so he can make a decent diagnosis. If I get side-effects I can't deal with OR if the meds only partially resolve the problems, then we've got to regroup and try something else.

<snip>

I think I'd opt for diapers rather than any kind of cath and leg-bag. I'm not there yet, though, and I do hope not to have to rely on diapers (or cath...).

My point, straightforwardly, is it really *does* sound like you are blocked....and that there should be some concern about the effect of the pressure on your kidneys. The Dr may be able to explain why this isn't a concern in your case.

The value of the cath (even an intermittent self-cath) is straightforward and two-fold: 1) You sleep through the night (not sleeping properly brings its own hazards), and 2) It can help relieve that kidney pressure I am worried about. Possibly your wife might accept it better, too.

As for the side effects, and I know I've said this before on this board: antidepressants I've been on have left me with a stiff belly from trying to pee for a few weeks until my body got used to them, and distributing the dose around the clock significantly lessened the standard effect of removing the ability to reach a sexual climax. Spreading the dose out may or may not help you, but is worth asking the Dr about and experimenting with.