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1 Year Post IMRT Urinary problems

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Posted 5/22/2023 2:03 PM (GMT -5)
Stats in signature.
Completed IMRT 5/13/2022 and started coming off of Lupron in November (see T numbers below).

about a month ago I started having pretty bad problems with urgency, like all the time, and very little flow. I've never had a lot of pressure and flow anyway. Pain and burning during urination. Uro (NP) put me on Myrbetriq. A few weeks on that provided some relief but still a lot of pain and burning when I urinate. Ultrasound indicates I'm voiding well. Uro then prescribed Flowmax and said if that doesn't help I need a Cystoscope. I've been on Flowmax a week tomorrow and haven't really noticed any difference.

Any thoughts as to what's going on here? Anybody had a Cystoscope for this kinda thing? Doesn't sound fun at all. Would like to just be normal again, but wouldn't we all I suppose.
Posted 5/22/2023 4:04 PM (GMT -5)
You are right, it is not any fun. However, it is doable. I remember my father and I discussing his urologist, and realized we saw the same person. I asked my father if he liked the Dr. and he replied that it was difficult to say something nice about a person that put a wire up his penis five different times. At that point I had never had a cystoscopy, but later on I recalled my father's words, and they rang true.

If you have tried a couple different meds, then it might be time for another approach. Keep us posted.
Michael
Posted 5/22/2023 4:57 PM (GMT -5)
did you try saw palmetto? i have taken it for the past few years
Posted 5/22/2023 6:53 PM (GMT -5)
I had minimal voiding problems prior to RALP. Post op my flow was slower and urgency/nocturia was an issue. Didn't make physiologic sense without a prostate. I had been continent with exercises. My urologist did an in office flexible fiberoptic cystoscopy to be sure that I did not have a stricture. Really not that bad. Everything was normal. All of the oral medications did not improve my urgency much. Flomax made me more incontinent. I am currently getting Botox injections every 4-5 months. Works pretty well. Better urgency but I have some straining to void. My urologist thinks that the Botox injections are easier for him to do and more effective with a rigid cystoscope when I am asleep in the OR. 5 minute procedure.
Posted 5/22/2023 9:30 PM (GMT -5)
BB I am a little over a year and a half off of IMRT and two months off of ADT. As soon as I went off ADT I noticed some retention when urinating and urgency. A sonogram showed I was not emptying completely. My Uro also put me Myrbetriq. It worked immediately after the first dose. I was told to take it for a month or two and see if it worked. I got off Myrbetriq after one month and so far no reoccurrence. So I skipped my appointment for the Cystoscope. I did ask if the symptoms were due to the RA and he said most likely that was the case. I hope you can find some relief going forward.
Jack
Posted 5/22/2023 10:35 PM (GMT -5)
Four years ago I had salvage radiation (SRT) after my PSA had been become detectable again. Since then, it has become steadily more difficult to empty my bladder (start and stop, weak flow). Last month, I had a flow test and cystoscope, which showed scar tissue (bladder outlet obstruction). At the time of the radiation, I was warned this was a possible side effect. So I am scheduled next month for an outpatient procedure to remove the scar tissue ( with a type of cystoscope).
The cystoscope last month was really not that bad. I watched the procedure on the tv monitor to keep my mind occupied. It was really not bad, just uncomfortable. For the scope next month, I will be knocked out.
Posted 5/23/2023 10:46 AM (GMT -5)
Thanks for all the response, guys. I'm learning that my experience is not that uncommon. I naturally would prefer to avoid the 'scope but we'll see what the next week or two holds.
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