slow urination after seeds

Good morning all.

I had my seed implant (66 palladium 103 pellets) on February 1. Removed catheter two days later per instructions. I hate catheters. Took the scheduled meds as directed (antibiotic for 7 days, ibuprofen as needed, still on flomax daily).

After catheter removal, urination seemed normal, clear, and with just a slight burning.

But two days ago (one week after implant) I noticed a distinct reduction in urine flow. I can still urinate, but the stream is much weaker than before the implant, and "emptying" takes longer. I understand it's due to the radiation effects on the prostate. Once urination starts it keeps going until I'm empty; no stops and starts.

But of course I'm worried that it's a "warning" of impending doom (i.e. eventual inability to urinate).

I'm still taking .4mg Flomax capsule daily.

I have to admit, other than this slow urination, I don't feel any negative effects at all, other than a slight tension in my lower abdomen.

Has anyone else experienced this urinary "slow down"? My doctor says it's normal, but of course I'm concerned it might get worse. This has been about the same for three days now. I can certainly live with it like it is, but the psychological "worry" of a possible 3 a.m. race to the ER keeps me on edge.

I realize every guy is different, but would appreciate hearing how others have experienced and dealt with this after seed implant.

To worry, or not to worry. That is the question.

Thanks.
Tom in CT
(original diagnosis October 10: T1c, Gleason 3+3, PSA 4.8, 4 of 12 positive samples.)

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24 replies. Join the discussion

Greetings,

I had my brachy on 3/30/10 (coming up on one year), readings similar to yours, age 54. I recall having to begin tamsulosin (Flomax generic, same daily dosage) within a couple of days due to short and frequent urination. The first few weeks (the first month) was perhaps the worst for me for frequent urination, having to get up twice each night. After the first month things seemed to gradually settle down.

At six months I began to wean myself off the tamsulosin and discontinued it at nine months. At this point I've noticed some "soft" urination, especially first thing in the morning, but nothing serious.

Good luck!

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I'm in the exact same boat as you, except they pulled the catheter before I left the OR. I experienced really painful burning for a few days, but it gradually subsided at the end of a week. BTW, I'm 83.

I had the BT done on 3/30/11, about four moths ago, and from the getgo, the stream was much weaker. I started Flomax a month before the surgery. I actually timed it, and it takes between 1-2 minutes to empty the bladder. That may not seem long, but if you are standing up, it seems forever. I just sit down now and wait it out. Somebody wrote on another thread that it got embarrassing to stand at a urinal and have two or three people on either side come and go. :)

I also called the radiation oncologist and the urologist, and both told me this was perfectly normal.

Like you, I have no other symptoms, so i guess we should be grateful. Some of the possible side effects are scary, so we should be grateful, I guess.

Don't worry.

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I had BT Dec 2010. I'm 68. First month burning and slow stream with frequent trips with Flomax once a day. 2nd month getting slightly better slowly.
Really not so bad but one has to be not in a hurry to fully unload. I tried missing a flomax a couple of times hoping that I could wean off of it but that did not work out well-at least at this time. Hopefully weaning will happen in the not to distant
future. Based on the similarity of these comments, it sounds like these symptoms are par for the course.
All the best to my fellow travelers.

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Thanks gentlemen. Even tho' the doctors told me to expect this, it really helps to hear from guys actually familiar with the situation themselves. As I had the seed procedure on February 1, I guess I'll have to live with this for a minimum of at least three more weeks.

Say, down in the lower abdomen, I have a "tight" feeling. My doctor says that's the result of (1) the placement of the seeds, and (2) the radiation doing its job.

How do you guys deal with that tightness? It's not really pain, but the discomfort makes it very difficult to sleep. Did you just tough it out, or take ibuprofen, or ...?

Thanks.
Tom in CT

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Hi Tom,
Thanks for starting your first Discussion. I just logged on and was about to start one just like it until I saw yours. Your 2nd Discussion and now this one have also been helpful. I don't mean to post a "non-topic" post but it was the simplest way to thank you since the other posts are closed to Replies.

I'm where you were at with your first Discussion. I am going to see Dr. Gordon Grado on 3/1 who has done over 8,000 BT procedures. He was kind enough to call me at home for quite some time after my Medical Ongologist, Dr. Nicholas Vogelsang referred me. Clearly, he strongly believes that BT is the right decision.

I am also going to balance that with one more consult with a daVinci RP surgeon, (who will also clearly believe that RP is the right decision), and who has done over 1,000 procedures (another Dr. Vogelsang recommendation). I asked a close friend (orthopedic surgeon) who has performed over 8,000 surgies how much it mattered if the daVinci RP surgeon has performed 400 or over 1,000. He said he thought he was "good" after 4,000 surgies but now he chuckles because he recognizes that he is better at "the little stuff" after 8,000.

I find myself INCREASINGLY intrigued and open to BT - even though at first, while reading books, blogs, purchasing copies of research from online Journals, etc. (mostly about RP), I figured that RP might be the best way to go. I even read an entire book by a Doctor (Bradley Hennenfent) who obviously hates Urologists and hates RP.

After these final 2 consults, I will reflect, and make my decision.

Too bad the science for picking a treatment for Prostate Cancer isn't as certain as it is for Strep Throat. Hopefully it will be someday.

Anyway, thanks again for your starting your discussions.

Paul in LV
(Age 52, original diagnosis Nov 23, 2010: T1c, Gleason 3+3, PSA 3.3, 5 of 12 positive samples.)

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Hi Paul - welcome to the "family". Glad my earlier posts were helpful to you. You might want to start a new discussion on your research if you have further questions and findings you want to share.

Best wishes to you in the journey. When I presented my findings and decision to my GP, urologist, radiologist and surgeon contacts, they all said "Tom - no one does as much research on this as you". They obviously don't know about UStoo!.

In this discussion I'm hoping to hear from guys who have experienced the "tightness" I'm experiencing.

Tom in CT

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Hi Tom,
In regards to minimizing the uncomfortableness right after BT, I have a few thoughts.
Eat a neutral diet and take it easy on the spirits. I found that after I abused these rules
I paid for it later. I get the feeling that all that Doctoring and inspecting at the lower end
takes a month or two to normalize-seeds or not. I even bought some stool softener which I have not used
yet but have it on standby.

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You can up your Flowmax to twice per day and take high dose, 800mg of Ibupropin for a short period of time to see it that helps.
I experenced the same thing about 4 days out and it helped a lot.
JohnT

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Thanks again gentlemen. Since I got home, I've had only tea and juices to drink and bland "boiled dinners" to eat. But I'm sure there are some digestive issues going on, with the stress of the situation. I've had a mild IBS (noisy grinding bowel) for most of my life; this is definitely one of the more stressful times, that's for sure.

JohnT - it seems the "flow" problem is going to remain constant for a few weeks more. Just talked with my doctor and he says this is perfectly normal.

Regarding the abdominal discomfort, for me, it's the feeling two days after being kicked in the lower abdomen: you just feel a dull "tension" down there. I have the 600mg size ibuprofen tablet, but haven't been taking them at all due to the "stomach and bowel problem" warnings. Maybe I should just take one and see if I notice a difference in the abdominal discomfort.

Say, how long did you feel you needed that ibuprofen for the abdominal discomfort?

Thanks.
Tom in CT

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You can't take high dose ibubropin for more than 8 days. It reduces the swelling of the prostate due to the procedure. Upping Flowmaz to twice a day seems to work in relieving urinary symptoms. It takes about 3 or 5 days to see the effect. My symptoms lasted 4 weeks and 4-6 weeks are normal for PD 105. If you had Iodine 125 then it could last up to 12 weeks because of the difference in half life of the two isotopes.
JohnT

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Klondike - you mention the 1-2 minutes to "finish". How long did that last?

Just like clockwork, I hit my two week implant annivesary yesterday, and my urination is now *very* slow, slower than last week. Takes about 1.5 to 2 minutes to feel "empty", but I have to urinate about once an hour. Still taking in six to seven cups of liquid a day.

I had the Palladium 103 seeds on February 1, and immediately started on the Flomax .4mg capsule, 30 minutes after dinner.

Thanks.
Tom

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Nutmeg, it is still about the same after four months. Not that big a problem once I got used to it, and with reassurances from two docs that it is normal. For how long, nobody knows, but I begin to suspect it permanent.

Before the surgery, I had to get up twice a night for a long time, but i am 83, so I guess that is to be expected. Now, it still is mostly twice a night, but now and then three times. On the average, throughout the 24 hrs, I got about every three hours. The stream is weaker than before, but not that bad. At the end, sometimes I strain a bit and some more comes out.

It has now become routine for me, and does not bother me. If i have to go for a long drive, I void just before going and don't drink until back. I seldom drive anywhere more than three hours. As I exercise strenuously every other day, and live in the very dry Arizona desert, I drink 8-10 glass of water a day, so maybe that, along with the Flomax, helps
.

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Thanks Klondike. I hear you on the "frequent urination" thing.

When I feel the urge, the stream is very weak, and only about 1 or 2 ounces comes out, then the urge disappears. This happens 12-16 times a day (including 3 or 4 times between 11pm and 6am). I take in 6 to 8 cups of liquid per day.

My doctors say that as long as something is coming out, I don't have to worry about urinary retention. A few days ago the stream got even weaker, so yesterday I was told to start taking a .4mg Flomax in the morning after breakfast, in addition to the .4mg Flomax after dinner that I've been taking since the seed implant on Feb 1.

Do you notice the amount coming out seems to be "small"?

Thanks.
Tom in CT

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I had similar issues after seeding (I-125, 86 seeds) in February, 2009. Was on 2 Flomax's daily for the first week and a half, and then down to 1, and by 6 months, weaned myself off it completely. By 8 months, I could sleep for 4 or 5 hours straight, and occasionally 7, and only have to pee a few times during the day, similar to, if not better than, to pre-seeding.

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Flomax does have side effects in some people. When I first started using it, I noticed blurred vision when I was exercizing.
I checked with my doctor and was told to take it with a meal in the evening. And to do it at the same time of
the day routinely. Seems that in some people it lowers blood pressure. Not every one gets side effects, but
it is good to be aware of them potentially so that corrective action can be taken.

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Roger on the blurry vision. Since I started the twice a day dose, I've been able to keep the output at about 75ml each time. That is so much better than before we added the second dose. But I've also had a random slight dizziness when I lie down or sit up fast. And just this morning a slight blurring of vision about an hour after I took the morning dose. Not really blurry, but more like what you see just after you've stared at a bright light - kind of a "tracking"; it disappeared after about an hour.

Frankly, I think half my troubles are related to anxiety. Tension in the abdomen, slight nausea and lack of appetite, feeling "warm" but not having any fever, not wanting to just sit and read, but not feeling well enough to do anything. Not knowing what's normal for post seeds, and what isn't.

Thanks again.
Tom in CT

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Nutmeg, the amount that comes out each time is about normal. I seldom feel that there is any urine left, but now and then, I do have to strain/push a bit to get the stream going.

As to dizziness, it does have that effect. I have been taking Lyrica just before bedtime for some time to help with severe nerve pain in my legs and butt. That definitely makes me quite dizzy in the mornings until around noon. When I started taking Flomax right after dinner, that added to the problem. My pharmacist said no problem taking them both, but "it will make you twice as dizzy." Well great! Every other day I climb a nearby mountain on a steep and rocky trail, so that makes it quite sporting, trying not to fall. I have not yet.

The problem is not too bad unless I turn my head or look up suddenly, or even turn my whole body around. So, I try not to do that, but occasionally forget. Like a cheap drunk.

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Nutmeg, same problem with me 10 years ago. I remember it well. I started eating pumpkin seeds (a handful every day) and it helped with the flow. After about a year I switched to pumpkin seed capsules so I could use them when traveling. The flow got better and better. I do recommend them.
Also have success with the vacuum pump. Pump works for erections and also helps with the flow. Now having much greater success with the flow and even sleeping thru the night occasionally. Good luck.

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I had a Gleeson of 7 and discussed RP with the Urologist and Radiation therapy with the Rad. Onco. Getting the obvious difference of opinion, I consulted with my g.p. He said definitely do the radiation at my age (?) 63. We did external beam radiation and last Mon 2/20/11 had seeds inserted. They removed the catheter before I woke up. Had intense burning urination for 2-3 days. Now my life revolves around where the bathroom is. Just took a 30 min. drive and stopped twice on the way. It isn't like that all the time, bit I do have frequent surprises with urination and bowels. Both types of rad. were recommended because they can use less of each, thus fewer side-effects. I'm told it all gets better.

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I also have the generic Flomax

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