My Incontinence Was Initially Diagnosed as Enlarged Prostate

Mal, age 78, had bladder problems for many years. He had to go through a few years of unnecessary treatment because his overactive bladder was originally diagnosed as an enlarged prostate. He finally got relief with medications and self-catheterization. Mal thinks that when men have difficulty with their bladders, it can be a challenge for doctors to diagnose, so it is important to seek the best medical advice.

Getty ImagesOver the years, I've had what were really undiagnosed issues affecting my incontinence and bladder problems. I sensed there was something a little different about me—that most people had the ability to hold urine in or get rid of it with longer periods of time in between than I did.

But you get used to these things after a while and don't think much about them. I thought it was a quirk or peculiarity of mine. It seemed like a benign thing that just differentiated me from someone else. I didn't care because it didn't seem important and was more annoying than serious.

Then, about 15 years ago, I went to a urologist because the problem was getting much more intrusive. The doctor—who I think now was pretty pro-surgery—said that if I was having a problem excreting urine, it must be the result of an enlarged prostate.

I had a transurethral resection of the prostate (TURP), which is an operation that trims away excess prostate tissue constricting the urethra. Unfortunately, I continued to experience urination problems.

At that point, the doctor put me on Urecholine, which is used to help with urination and emptying of the bladder. It is a difficult medication. You have to take it on an empty stomach and get the dosage exactly right. I was experiencing all kinds of side effects like diarrhea, abdominal cramps, and indigestion. I discontinued taking it.

Although I may have needed the TURP surgery, it was clear that I had a parallel problem that was unsolved. The doctor diagnosed me at that point with an atonic bladder, which is sometimes also referred to as a decompensated, acontractile, or “pooped” bladder by urologists. He said my bladder had basically lost much of its muscle tone and couldn't contract effectively to perform the normal elimination process.

So, about seven years ago, I began performing self-catheterization, mainly in the evening as a way to get sleep. My biggest problem was at night; I was constantly getting up with the urge to go and almost needed to be tethered to a toilet.

Self-catheterization is the best treatment I've had in a long time. When I got the hang of it, I was able to have a good night's sleep without constant interruption for the first time in years. It has dramatically helped me in terms of my sleep, and I believe that it has also improved my overall bladder health. To this day, this treatment has been the most useful benefit for my quality of life.

Along with the self-catheterization, I take Detrol, a medication that is supposed to help diminish the sense of urgency; Hytrin, which while originally used to treat high blood pressure, also reduces constriction of the urethra to help facilitate urination; and Proscar, which works to help shrink the prostate.

My medications take care of my daytime needs, so the issue doesn't intrude into my daily life. I am much, much more fortunate than many people in that respect.

It has really been a journey for me in terms of figuring out what was wrong and how to deal with it appropriately. And now I handle my condition as well as I can. We really do learn from all our experiences in life—even the ones that actually proved to be less than helpful.

I am active on forums for overactive bladder. I tell people with this condition that they need to get the best medical advice they can and that the world doesn't end when you have these problems.

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