Possible prostate issues or bladder problem?

[advancebooking]

Ive got an appt booked with a urology dr in a few weeks but thought I would discuss issues here as I could learn something. 

 

Over a month ago I had a hernia laproscopic repair done. It was successful and now back to full strength. Only thing I noticed was a slight dull pain in my right testicle. This week no weird feeling there at all for the first time. 

 

Prior to surgery they made me have a check up with urology dr. He did the finger test and said I have mild enlargement of the prostate. Same as last few yrs actually. I get it checked once a year. 

 

Last week I had an afternoon nap and woke up and saw that I had accidentally dribbled some urine on my boxer shorts. 

 

I frequently wake up at 5am with kind of uncomfortable full bladder. I was going to say painful but unsure if its the correct word. I would stand over the toilet urinating for a long time. Sometimes I cant really feel it coming out. Hard to describe or remember at that hour of the morning actually. 

 

Im only concerned now as Ive never had dribble on the boxer shorts before. 

 

Based on the above info what testing do you think should be done, if any? Whats the gold standard for testing ones prostate with minor symptoms? Or should I be looking to check my bladder?

 

thanks

 

 

[jojothai]

11 minutes ago, advancebooking said:

Based on the above info what testing do you think should be done, if any? Whats the gold standard for testing ones prostate with minor symptoms? Or should I be looking to check my bladder?

 

thanks

 

 

Advice for what the urologist should want to do is in the following. The two tests 1 and 2 for bladder function are what in my experience is normal. Not had test no 3 yet

 

"If you have unusual urges to urinate, your health care provider will check to make sure that you don't have an infection or blood in your urine. Your provider may also want to make sure that you're emptying your bladder completely when you urinate."

Your provider will look for clues that might also indicate contributing factors. Your appointment will likely include a:

Medical history
Physical exam, which may include a rectal exam and a pelvic exam in women
Urine sample to test for infection, traces of blood or other abnormalities
Focused neurological exam that may identify sensory issues or reflex problems
Tests of bladder function
Your provider may recommend tests to assess how well your bladder is functioning and its ability to empty steadily and completely (urodynamic tests). These tests usually require a referral to a specialist, but testing may not be necessary to make a diagnosis or begin treatment. Urodynamic tests include:

1. Measuring urine left in the bladder. This test is important if there's concern about your ability to empty your bladder completely when you urinate. Remaining urine in the bladder (post-void residual urine) may cause symptoms identical to those of an overactive bladder.

To measure residual urine after you have voided, your doctor may request an ultrasound scan of your bladder. The ultrasound scan translates sound waves into an image, showing how much urine is left in your bladder after you urinate. In some cases, a thin tube (catheter) is passed through the urethra and into your bladder to drain the remaining urine, which can then be measured.

2. Measuring urine flow rate. To measure the volume and speed of your voiding, you may be asked to urinate into a device (uroflowmeter). A uroflowmeter catches and measures the urine, and translates the data into a graph of changes in your flow rate.
3.Testing bladder pressures. Cystometry is a test that measures pressure in your bladder and in the surrounding region as your bladder fills. During this test, your doctor uses a thin tube (catheter) to fill your bladder slowly with warm fluid. Another catheter with a pressure-measuring sensor is placed in the rectum or, for women, inthe vagina. The sensor tells how much pressure your bladder has to exert to empty completely.

This procedure can identify whether you have involuntary muscle contractions or a stiff bladder that's not able to store urine under low pressure.

Your doctor will review the results of any tests with you and suggest a treatment strategy.

[advancebooking]

1 hour ago, jojothai said:

Advice for what the urologist should want to do is in the following. The two tests 1 and 2 for bladder function are what in my experience is normal. Not had test no 3 yet

 

"If you have unusual urges to urinate, your health care provider will check to make sure that you don't have an infection or blood in your urine. Your provider may also want to make sure that you're emptying your bladder completely when you urinate."

Your provider will look for clues that might also indicate contributing factors. Your appointment will likely include a:

Medical history
Physical exam, which may include a rectal exam and a pelvic exam in women
Urine sample to test for infection, traces of blood or other abnormalities
Focused neurological exam that may identify sensory issues or reflex problems
Tests of bladder function
Your provider may recommend tests to assess how well your bladder is functioning and its ability to empty steadily and completely (urodynamic tests). These tests usually require a referral to a specialist, but testing may not be necessary to make a diagnosis or begin treatment. Urodynamic tests include:

1. Measuring urine left in the bladder. This test is important if there's concern about your ability to empty your bladder completely when you urinate. Remaining urine in the bladder (post-void residual urine) may cause symptoms identical to those of an overactive bladder.

To measure residual urine after you have voided, your doctor may request an ultrasound scan of your bladder. The ultrasound scan translates sound waves into an image, showing how much urine is left in your bladder after you urinate. In some cases, a thin tube (catheter) is passed through the urethra and into your bladder to drain the remaining urine, which can then be measured.

2. Measuring urine flow rate. To measure the volume and speed of your voiding, you may be asked to urinate into a device (uroflowmeter). A uroflowmeter catches and measures the urine, and translates the data into a graph of changes in your flow rate.
3.Testing bladder pressures. Cystometry is a test that measures pressure in your bladder and in the surrounding region as your bladder fills. During this test, your doctor uses a thin tube (catheter) to fill your bladder slowly with warm fluid. Another catheter with a pressure-measuring sensor is placed in the rectum or, for women, inthe vagina. The sensor tells how much pressure your bladder has to exert to empty completely.

This procedure can identify whether you have involuntary muscle contractions or a stiff bladder that's not able to store urine under low pressure.

Your doctor will review the results of any tests with you and suggest a treatment strategy.

What sort of specialist would test for 1 and 2. Is it Urology?  I could not tolerate n.o 3

[Sheryl]

9 hours ago, advancebooking said:

What sort of specialist would test for 1 and 2. Is it Urology?  I could not tolerate n.o 3

Urologist will check prostate size and dhspe (rectal exam) , get urine tested for infection and do a PSA.

 

Urodynamic tests are unlikely to be needed in your case. 

 

 

[jojothai]

11 hours ago, advancebooking said:

What sort of specialist would test for 1 and 2. Is it Urology?  I could not tolerate n.o 3

Yes, a urologist.
The problem of an enlarged prostate is referred to as benign prostatic hyperplasia or BPH.
Sheryl has helped to clarify what is normally done.
I have had tests 1 and 2  a couple of times, easy to do.

Sheryl noted about checking for any infection.
Note that if urine is remaining in the bladder, any infection you may get will not clear readily.
The first time i went to a urologist for the problem, I had an infection that would not clear by antibiotics.
The urologist prescribed the appropriate medication to use for the BPH, tamsulosin it works by relaxing the muscles in the prostate and the bladder. This eased the problem and antibiotics then cleared the infection.

[swm59nj]

I have a significantly large prostrate for a number of years.  I never had dribble or testicular discomfort. But everyone is different  I have PSA, urine testing, ultrasound, digital exam, as required.  But that doesn’t mean you need these tests.  And unless someone on here has medical training such as doctor or nurse. They are not qualified to suggest what type of testing you should have. 
The urologist will treat and test as necessary.  According to your symptoms and medical history. Then if you still aren’t sure. I would see another urologist for a second opinion. 

[blazes]

I read recently (forget where) that 62% of German men pee sitting down.  No idea why.  But I tried it out myself and, mirabile dictu, I found  that I felt somehow "better" after performing that (normally) feminine feat.

I will be seeing my urologist in September and will ask him about this.  It occurs to me (though it  sounds like a conspiracy theory) that this method of urinating may be good for your general health. 

 

Maybe why, statistically, women live longer than men?!!!

[Gandtee]

25 minutes ago, blazes said:

I read recently (forget where) that 62% of German men pee sitting down.  No idea why.  But I tried it out myself and, mirabile dictu, I found  that I felt somehow "better" after performing that (normally) feminine feat.

I will be seeing my urologist in September and will ask him about this.  It occurs to me (though it  sounds like a conspiracy theory) that this method of urinating may be good for your general health. 

 

Maybe why, statistically, women live longer than men?!!!

I don't know about living longer, but I've been sitting down to urinate for a few years now. At 89 it's tiring standing up for ages to pee???? in the middle of the night it's safer and yes, I slightly dribble during the night. I just take it as a sign of old age and live with it. Just like a vehicle, things wear out and leak as they get older. At my age I just live with it and am thankful that I am in relatively good health. If I were twenty years younger I think my attitude would have been different. 

[Expat68]

After surgery (I had a TURPS) your pelvic muscles are weakened, not a expert but if you start doing Kergal exercises daily I am pretty sure you will return to normal 

[Dazinoz]

On 7/25/2023 at 8:30 PM, advancebooking said:

Based on the above info what testing do you think should be done, if any?

Great place to ask medical advice. Suggest a real doctor not self proclaimed experts on here.

[nickmondo]

if your prostrate tests are pretty much normal, i would put it down to the hernia.  was it Inguinal?  Direct or Indirect?  because the side effects during recovery are many, including discomfort in your meat and veg.

[dlclark97]

On 7/25/2023 at 9:53 PM, advancebooking said:

What sort of specialist would test for 1 and 2. Is it Urology?  I could not tolerate n.o 3

Why could you not tolerate test 3?  Is it the thought of the catheter being inserted in your penis?  I agree, if you have never had it done while you are awake before, it seems to be something many men fear.  FEAR NOT!  It is not a big deal.  A few years back I had prostate issues but was unable to have surgery (a Terp procedure) at that particular time.  I was given a prescription for catheters and a nurse showed me how to insert them.  I used a catheter every night for several months before going to bed to completely empty the bladder.  There was no discomfort at all in doing this.  FEAR NOT!

[blazes]

1 hour ago, Expat68 said:

After surgery (I had a TURPS) your pelvic muscles are weakened, not a expert but if you start doing Kergal exercises daily I am pretty sure you will return to normal 

You mean Kegel surely???

Edited July 27, 2023 by blazes

[Expat68]

3 minutes ago, blazes said:

You mean Kegel surely???

Sorry yes

[sirineou]

On 7/25/2023 at 8:30 PM, advancebooking said:

I frequently wake up at 5am with kind of uncomfortable full bladder. I was going to say painful but unsure if its the correct word. I would stand over the toilet urinating for a long time. Sometimes I cant really feel it coming out. Hard to describe or remember at that hour of the morning actually

Take the below for what it's worth , which might be nothing m but that was my experience.

I had the issue of getting up to urinate several time with similar feelings as you mentioned, and then not being able to fall asleep again for a while. 

In washing some doctors talk about the issue on  YouTube  vitamine B1 complex was suggested to decrease urination regency. ( B1  deficiency can Coues urination issues)

In addition by sister who is a nurse practitioner back n the US suggested m Magnesium in the evening and half hour before I go to sleep Melatonin and Benadryl ( Diphenhydramine) . I sleep like a baby(8-9 hrs) and only get up to urinate one time,  I have also noticed fewer urination during the day. 

The B1 complex (vitamin B1,  B2,  B6 ), takes about one month to have any noticeable affect. 

Talk to your doctor to see if it is right for you.It has worked wonders for me 

 

[NanLaew]

57 minutes ago, Dazinoz said:

Great place to ask medical advice. Suggest a real doctor not self proclaimed experts on here.

Yet here you are, trawling the Health & Medicine forum and giving advice.

[Dazinoz]

6 minutes ago, NanLaew said:

Yet here you are, trawling the Health & Medicine forum and giving advice.

Amazing how some people think.

[NanLaew]

I recently had a USG KUB (kidney, urethra, bladder ultrasound) procedure to identify a slightly high RBC count in a urinalysis. The urologist identified a single kidney stone so I will modify my diet and get a follow-up in 3 months time. Another urologist refused to do the USG KUB and insisted that a CT scan would be his first choice for making a diagnosis. Funnily enough, it was the cheaper government hospital urologist  who was insisting on the more expensive CT scan whereas the more expensive private hospital urologist was happy with the lower cost ultrasound for a primary investigation.

 

Posting this for the OP as it seems the ultrasound may be adequate for a 'first look' with CT scan follow up if merited?

 

On another note, I am 66 and have been siting to pee for decades and I am still not German.

[NanLaew]

Just now, Dazinoz said:

Amazing how some people think.

Yes, isn't it?

[bkk6060]

Actually, a one time dribble sounds like no big deal.  I don think the hernia has anything to do with it.

And, if you are geting up at 5am and peeing a lot, that sounds not terrible as Prostate issues can usually cause frequent urgency and minimal urine disposed.

I would take Sheryls advice and possibly add an ultrasound.

Some think I am trying to be funny, but I am a firm believer in frequent ejaculation as it relates to Prostate problems.  Search it, plenty of articles supporting this.

[Rimmer]

A troll post and a reply have been removed

[KannikaP]

24 minutes ago, bkk6060 said:

Some think I am trying to be funny, but I am a firm believer in frequent ejaculation as it relates to Prostate problems

I have mildly enlarged Prostate, 60 ml I think. For about a year my ejaculate has disappeared, either with the Mrs or self induced. The orgasm is still there.

Is this something to worry about

[wwest5829]

6 hours ago, blazes said:

I read recently (forget where) that 62% of German men pee sitting down.  No idea why.  But I tried it out myself and, mirabile dictu, I found  that I felt somehow "better" after performing that (normally) feminine feat.

I will be seeing my urologist in September and will ask him about this.  It occurs to me (though it  sounds like a conspiracy theory) that this method of urinating may be good for your general health. 

 

Maybe why, statistically, women live longer than men?!!!

My motivation for this is having owned motorhomes for 30 years and having two Sons. Sometimes the standing aim is off. Easier just to sit and drain.

[connda]

How old are you.  Once your prostate enlarges, yep, you dribble.  Then join the club. 
It's just a fact of life for a significant number of men.  Why?  I don't think that any one has ever explained the mechanics no less a way to keep it from happening. 

But you'll find lot's of support here.  Welcome to Club Dribble.    You're among friends! 

[Gandtee]

1 hour ago, connda said:

How old are you.  Once your prostate enlarges, yep, you dribble.  Then join the club. 
It's just a fact of life for a significant number of men.  Why?  I don't think that any one has ever explained the mechanics no less a way to keep it from happening. 

But you'll find lot's of support here.  Welcome to Club Dribble.    You're among friends! 

Like the London song. 'Where ever I go I carry my poe. And a little piece of tissue paper.'????

[Dirk Z]

7 hours ago, Dazinoz said:

Great place to ask medical advice. Suggest a real doctor not self proclaimed experts on here.

Could not agree more. Please let this not be a market place of medical opinions and experiences. They belong in a doctor's office (says this MD).

[Rumpelstilskin]

On 7/25/2023 at 8:30 PM, advancebooking said:

Ive got an appt booked with a urology dr in a few weeks but thought I would discuss issues here as I could learn something. 

 

Over a month ago I had a hernia laproscopic repair done. It was successful and now back to full strength. Only thing I noticed was a slight dull pain in my right testicle. This week no weird feeling there at all for the first time. 

 

Prior to surgery they made me have a check up with urology dr. He did the finger test and said I have mild enlargement of the prostate. Same as last few yrs actually. I get it checked once a year. 

 

Last week I had an afternoon nap and woke up and saw that I had accidentally dribbled some urine on my boxer shorts. 

 

I frequently wake up at 5am with kind of uncomfortable full bladder. I was going to say painful but unsure if its the correct word. I would stand over the toilet urinating for a long time. Sometimes I cant really feel it coming out. Hard to describe or remember at that hour of the morning actually. 

 

Im only concerned now as Ive never had dribble on the boxer shorts before. 

 

Based on the above info what testing do you think should be done, if any? Whats the gold standard for testing ones prostate with minor symptoms? Or should I be looking to check my bladder?

 

thanks

 

 

Lots of good advice from other BHP vets. Recommend both saw palmetto and stinging nettle root powder. Take either 1 or both; always order 2 bottles because one you start....you won't want to be without. 

[kokopelli]

Yes, why stand when you can sit, relax and let it drain out of you especially at 5 AM!  That is the way Muslim men do it as part of their religious practice..

[radiochaser]

20 hours ago, KannikaP said:

I have mildly enlarged Prostate, 60 ml I think. For about a year my ejaculate has disappeared, either with the Mrs or self induced. The orgasm is still there.

Is this something to worry about

If you were given medication for the enlarged prostate, that could be the cause of the missing ejaculate.   The same thing happened to me.  When I asked the doctor about it, he confirmed that the medication would do that. 

The ejaculate returned when I stopped taking that medication.  If I recall correctly, the medication was to help with difficult urination, the reduced flow due to the enlarged prostate.   
Regarding the reduced flow.   I am now on 5 mm of tadalafil once daily for that.   It  does help, making it easier to urinate.   

Edited July 28, 2023 by radiochaser

[radiochaser]

34 minutes ago, radiochaser said:

If you were given medication for the enlarged prostate, that could be the cause of the missing ejaculate.   The same thing happened to me.  When I asked the doctor about it, he confirmed that the medication would do that. 

The ejaculate returned when I stopped taking that medication.  If I recall correctly, the medication was to help with difficult urination, the reduced flow due to the enlarged prostate.   
Regarding the reduced flow.   I am now on 5 mm of tadalafil once daily for that.   It  does help, making it easier to urinate.   

That should be 5 mg, not 5 mm!