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A week after ART - burning sensation and couldn't P

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Posted 3/23/2019 8:03 AM (GMT -5)
Well, my ART sessions ended 3/15 relatively uneventful.

A few days later, urine flow diminished, then almost completely stopped 3/21 - Thursday. Extremely painful. Couldn't sit down or go at all except for a few drops. Was getting a burning feeling as well.

Stopped by the Uro office and saw the nurse practitioner who prescribed FlowMax. My wife insisted we go to the ER. Foley was inserted - 600ML of urine and I was released. They did do blood work and urine sample - but came back good - no kidney issues or high WBC. The catheter did hurt a bit going in but it did go in without an issue and the balloon inflated.

My next appointment is Tuesday 3/26 with the Uro who did my RALP and they'll remove the Foley. I've been taking the FlowMax, 0.4MG 1x a day at bedtime.

Are there some specific questions that may be helpful to ask Uro on Tuesday to get to the root cause of the issue?

It could just be post-ART inflammation that resolves with continuing with the FlowMax. Or it could be a stricture that needs further treatment.

Thanks!
Posted 3/23/2019 2:10 PM (GMT -5)
Most likely it’s post-radiation “obstructive voiding symptoms” (OVS). A common side effect in the first month after radiation and usually resolves fairly quickly. Although Flomax mainly affects prostate cells, it also can help relieve stricture in the bladder neck.
Here’s a study: https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4118163/#!po=38.3333
Good luck!
Posted 3/25/2019 9:55 AM (GMT -5)
Thanks for the link Saipan Paradise. Will listen to what Uro says about it
Posted 3/26/2019 11:04 AM (GMT -5)
For pain you can use Phenazopypyridine or Aleve both available over the counter.
Posted 3/26/2019 8:30 PM (GMT -5)
Thanks three 5's and a jack - I picked up some Aleve and Advil after the Uro appointment today

They had me come in at 830am to have catheter removed - all went well and my stream has returned to normal. Urgency still seems to be an issue I'll monitor for now. They did have me come back late afternoon to do urinalysis - all clear there. Nurse did the scan after I voided and it came back with only 7 ml residual. So good there for now.
Continue 0.4 mg of FlowMax for now.

Side note, it was my 60th birthday so as the nurse said - the only present I have is to remove the catheter. It was a good present!
Posted 3/27/2019 11:33 AM (GMT -5)
GG1273
Try taking your flomax about 2 hrs before bed time, That's what I was told ....
Posted 3/27/2019 12:01 PM (GMT -5)
Getting the cath out IS a great present. 60 seems pretty significant to me. Not much room left for pretending. 🙂 I’m about a year out from mine. Happy Birthday!
Posted 3/29/2019 7:42 PM (GMT -5)
thanks for the tip MG, I've been walking it back about 1/2 hour each night to 8pm and doing okay with it

Now that the catheter has been out for a few days, stream is still strong and some of the urgency has abated!
Posted 4/7/2019 1:22 PM (GMT -5)
Almost 2 weeks since catheter came out and no retention issues

Still taking 0.4 FlowMax - evening. First few nights, wet in the morning. I switched over to Depends Pull Ups for a week and back off to guards now

I'm meeting with the RO on Weds, follow up appointment 1 month after ART finished. He had suggested getting the follow up uPSA 2 months after finishing ART - so mid-May. Uro, who took out the catheter / started FlowMax, said 3 months so I'll probably split the time difference.
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