TUMT and Overactive Bladder

[Bigdaddy1]

I had the TUMT procedure earlier this year. I have had several episodes of not being able to make it to the bathroom and have also wet the bed several times. My doctor gave me Enablex and the episodes stopped. I stopped taking Enablex and the bedwetting and not making it to the bathroom happened again. The doctor started me on Vesicore and again the episodes stopped. Have you ever heard of this happening after TUMT? I had the TUMT so that I could stop taking Flomax.

[Bigdaddy1]

Two months ago, I had a flow study and a cystoscopy. The flow study showed that there was some type of blockage. The cystoscopy showed that the area flowing through my prostate was blocked. I was shown this on a monitor as I was cystoscoped. Six weeks ago I had a TURP to releave this problem. I also discontinued the Vesicare. I have still had three episodes of bedwetting since the procedure. I am still very sore six weeks out of the surgery. My urine flow is great but I have a strong urge as I feel as though I have full bladder but not that much urine comes out. My urologist said this is all normal after TURP. I did have an infection and was given an antibiotic. Do you have any suggestions to keep from soiling the bed or sofa?

[Bigdaddy1]

Thanks for your response. What would you consider my options for this problem? How could I find out for sure what is causing this. Night before last, I woke up and I had started urinating and was able to stop and make it to the bathroom. This is one of the worst things that has ever happened to me. I don't want to end up wearing diapers.

Again, thanks for your help!

[HeinrikMD]

Hi,

The presence of the obstruction may have prevented the problem in the bladder from becoming symptomatic. The muscles that hold urine in the bladder are able to perform their function up to a certain pressure that the expanding bladder generates against it. The presence of an obstruction would increase this pressure. Hence, it would be easy to imagine that relieving the obstruction would lower the overall pressure that can be raised against the pressure to void urine, so the result would be spillage.

[Bigdaddy1]

But the overactive bladder problem started after the TUMT procedure. This never happened before.

[HeinrikMD]

Hi,

The short answer is yes.
I am considering the possibility that there are two problems. One is a problem with the prostate which is increased in size and is causing obstruction in flow. The other problem is on the bladder, which may be unable to maintain holding urine, so occasionally you wet the bed. It is simpler to think that the root of the problem would be the obstruction of flow, and so removal of the obstruction would solve everything.
The Flomax is aimed at reducing the size of the prostate. The same can be said with the TUMT. If symptoms of obstruction have been relieved, then the treatment is deemed successful.
But even in the absence of the obstruction, if the bladder is failing in its function, there would still be symptoms.
Enlargement of the prostate is so common that a situation like yours, in which there may be a problem overlapping with the bladder would confound things.

[Bigdaddy1]

Are you saying the TUMT probably doesn't have anything to do with the overactive bladder?

[HeinrikMD]

Hi,

I understand the frustration of getting an outcome that is the opposite of your expectations.

While removing the obstruction makes a lot of sense, one of the problems is that the bladder may also havev some problems by itself independent of the prostate. Hence, there may be no improvement afforded by the procedure indeed. The bladder has a natural sensescence, making it less able to determine how much urine is present. So even in the absence of prostatic disease, there may still be problems with voiding.