Anybody out here ever been prescribed anything like Toviaz (e.g.
Vesicare, Myrbetriq, etc.) for OverActive Bladder?

My uro just put me on Toviaz presumably because he doesn't know wtf my diagnosis really is, since all the drugs for BPH that I've been taking
(Cialis 5mg daily and Avodart) have not reduced my symptoms enough.
It remains to be seen actually, if they have relieved my symptoms at all
after being on them both now for close to 2 years.

I'm not sure how long it's supposed to take for Toviaz to start
relieving symptoms, but it's been about 4 days now and I think it might
be helping, but only minimally if at all.
Side effects have been dry mouth (not unbearable) and a bit of a cough
that went away pretty quickly.
The first 2 days it seemed to be making it worse though.
It makes it harder to pee unless my bladder is full.
I often still have the urge to pee every hour or so, I just can't do it
unless my bladder is really full now.
Sometimes, if I spend a lot of time massaging/pressing into my pelvic
area around the bladder I can empty it though, but it's a drag and it's uncomfortable to do.

My uro's sending me for some OAB-based tests next week.

Although it gets better sporadically for limited periods of time, I'm
still basically waking up every 1.5 hours to pee.
Daytime is about the same interval between pees.
But I had a 4-hour uninterrupted period the last couple of nights.
After waking up it's back to 1.5 hours though till morning.

My prostate is enlarged but not by all that much.

I first sought out medical treatment for frequent urination approx 10
years ago, maybe longer.
My GP put me on Flomax at first.
It didn't help and the sexual side effects were a drag.
Then he put me on Avodart but failed to tell me that it could take 6
months or more to see any symptomatic relief.
I gave up after about a week because of the sexual side effects.
I seemed to be having some relief from certain supplements but it may
have just been placebo effect.
At some point, approx 3 years ago now he sent me to this urologist.
The uro did some tests and then put me on Rapaflo which didn't work.
The he put me on Xatrol which did seem to work for about 3 months and
then stopped working.
Then we tried the Cialis 5mg daily which also seemed to help for about 3
months and then stopped working.
I've also been on Avodart for about 2 years now.
It seemed to help a bit after the first 8 months or so (was only
supposed to take 6 months to work) but doesn't seem to be helping much
anymore.

He sent me for a cystoscopy about 9 months ago, when I was begging him
for a TURP, and the surgeon reading the results said he couldn't find
anything wrong with me.
This is the same guy I'll be seeing next week but supposedly with a
focus on tests for OAB rather than BPH.

I'm convinced these guys are all boneheads now.

What a drag.
And if I don't actually have BPH, I sure don't want to be taking Avodart
for the rest of my freakin' life.
[The Cialis is kinda fun though. lol]

--- news://freenews.netfront.net/ - complaints: news@netfront.net ---

--- SoupGate-Win32 v1.05
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Anon Anon <nospam@nowhere.net> wrote:

Anybody out here ever been prescribed anything like Toviaz (e.g.
Vesicare, Myrbetriq, etc.) for OverActive Bladder?

Yes. Vesicare and Enablex on several occasions over the past 15 years.
Both are muscarinic antagonists and cause "Bird Cage Mouth" to an
unacceptable extent.

My uro just put me on Toviaz presumably because he doesn't know wtf my >diagnosis really is, since all the drugs for BPH that I've been taking >(Cialis 5mg daily and Avodart) have not reduced my symptoms enough.
It remains to be seen actually, if they have relieved my symptoms at all >after being on them both now for close to 2 years.

About time to think it's maybe nothing to do with BPH.

I'm not sure how long it's supposed to take for Toviaz to start
relieving symptoms, but it's been about 4 days now and I think it might
be helping, but only minimally if at all.
Side effects have been dry mouth (not unbearable) and a bit of a cough
that went away pretty quickly.
The first 2 days it seemed to be making it worse though.
It makes it harder to pee unless my bladder is full.
I often still have the urge to pee every hour or so, I just can't do it >unless my bladder is really full now.
Sometimes, if I spend a lot of time massaging/pressing into my pelvic
area around the bladder I can empty it though, but it's a drag and it's >uncomfortable to do.

Not my problems. How big is the maximum capacity of your bladder? It
should be around 1 liter if you're an adult male. There seems to be
some doubt as to mine. On my request during a procedure to extract two minuscule kidney stones from my bladder (I was under anesthesia) the uro-surgeon pumped up my bladder to a whopping (!) 240ml so he
concluded that this was the total capacity.

When I left the hospital (outpatient) I was given instructions to
drink lots of water (I did) and watch for clots (noted several) and
take Pyridium (a urinary tract anesthetic). On the second day I
neglected to pee just before bed and the following morning I woke with
a teenage-type early morning bladder pressure. I peed and produced
450ml. So much for his expertise. I've since reperformed my "drink
lots just before bed" procedure and the morning results were 390ml,
425ml, and 380ml. To be fair to the urologist night-time peeing (or
not) is controlled by a hormone not by the daytime system (the Pontine
system) however I asked for and he commented on the bladder capacity
only.

So in the day-to-day awake activities there's something else wrong
which is limiting bladder capacity.

Switch focus slightly...

The Cleveland Clinic has an interesting paper saying amongst other
things visceral fat (that's the fat around various abdominal
organs--in males generally responsible for a beer belly) can cause
frequent urination. No description of just how it does this.

Further switching...

Reading a very popular book called "What to expect when you're
expecting" (a book for pregnant women) and happened across a couple of
relevant paragraphs which say that you (pregnant female) may
experience two side effects: frequency of urination and shortness of
breath. Both are due to the expansion of the uterus taking up space in
the abdominal cavity and preventing the full expansion of the bladder
and lungs. When I suggested this to the urologist he said "You're not
pregnant" and laughed. I wasn't amused. Anyway, he says that I don't
have enough visceral fat to cause a problem.

My uro's sending me for some OAB-based tests next week.

Is that the "potty test?" Basically you pee into a special potty which
measures the force and quantity of the stream. Afterwards they do an
ultrasound to check for residual urine in the bladder. Mine came out
OK with very little residual volume. The urologist should be able to
do this in his office.

Although it gets better sporadically for limited periods of time, I'm
still basically waking up every 1.5 hours to pee.
Daytime is about the same interval between pees.
But I had a 4-hour uninterrupted period the last couple of nights.
After waking up it's back to 1.5 hours though till morning.

Try Pyridium OTC next to the tampons and sanitary napkins in the
supermarket. Each pill is 1mg less than the prescription version and
about a tenth of the price. You could always take two pills.

My prostate is enlarged but not by all that much.

Mine is 44 grams which the urologist says is OK.

I first sought out medical treatment for frequent urination approx 10
years ago, maybe longer.
My GP put me on Flomax at first.
It didn't help and the sexual side effects were a drag.

For me the sexual side effects are a killer. You could try Uroxatral
which has no sexual side effects but neither worked for me.

Then he put me on Avodart but failed to tell me that it could take 6
months or more to see any symptomatic relief.
I gave up after about a week because of the sexual side effects.
I seemed to be having some relief from certain supplements but it may
have just been placebo effect.
At some point, approx 3 years ago now he sent me to this urologist.
The uro did some tests and then put me on Rapaflo which didn't work.
The he put me on Xatrol which did seem to work for about 3 months and
then stopped working.
Then we tried the Cialis 5mg daily which also seemed to help for about 3 >months and then stopped working.
I've also been on Avodart for about 2 years now.
It seemed to help a bit after the first 8 months or so (was only
supposed to take 6 months to work) but doesn't seem to be helping much >anymore.

He sent me for a cystoscopy about 9 months ago, when I was begging him
for a TURP, and the surgeon reading the results said he couldn't find >anything wrong with me.
This is the same guy I'll be seeing next week but supposedly with a
focus on tests for OAB rather than BPH.

Have you had an abdominal CT scan? This is how I found my kidney
stones and also found that I have Diverticular disease-- probably diverticulosis but it requires a CT scan "with contrast" to diagnose diverticulits (more serious). By the time you're 80 almost everyone
has diverticular disease which causes small pouches to protrude from
the colon. How small and do they expand and regress? Er, well, no one
really knows or they're not telling. Could it be possible that they're interfering with the expansion of the bladder? Er, well, they don't
know that either.

I'm convinced these guys are all boneheads now.

What a drag.
And if I don't actually have BPH, I sure don't want to be taking Avodart
for the rest of my freakin' life.
[The Cialis is kinda fun though. lol]

IIRC Avodart works on 5alpha-reductase which converts testosterone to dihydrotestosterone (DHT) which is responsible for growth for the
prostate and also hair loss. Have you had your hormones tested
(serum/blood)? My DHT is 4 times the upper end of the reference range
and has been for at least 10 years. No one seems to have a clue what
this means.

Good luck.

--- SoupGate-Win32 v1.05
* Origin: fsxNet Usenet Gateway (21:1/5)

Anon Anon <nospam@nowhere.net> wrote:

Thanks for your input.
Although I didn't understand much of what you said I'll try some
internal replies below anyway.

On 2016-08-03 12:34 AM, JohnDoe@BadISP.org wrote:

Anon Anon <nospam@nowhere.net> wrote:

Anybody out here ever been prescribed anything like Toviaz (e.g.
Vesicare, Myrbetriq, etc.) for OverActive Bladder?

<snip lots>

Have you had an abdominal CT scan?

At my first visit with my regular uro he did several tests.
that might have been one of them.

Very unlikely. A CT scan is sometimes called a Cat Scan and involves a
huge machine that you're inserted into on a gurney-type bed and
internally an X-Ray machine is rotated around you taking pictures
frequently. For mine it took 830 X-rays in about 5 minutes. The
pictures are assembled by computer and various slices of your insides
can be viewed by the radiologist who then does a report listing
abnormalities and advising a course of action The sign on the machine
said "PET" which I believe is Positron Emission Tomography.

At that time, 3 years ago, he told me that I also had a small kidney stone. >If it has passed in the interim then it wasn't painful because I haven't >noticed.

The passing from the bladder to the outside is not the first pain and
is sometimes not even painful at all. Usually the first is when the
stone passes from the kidney down the ureter into the bladder. If it
is in the bladder it might stay there for years with no problem...well
except that my urologist says it (even small ones) can cause a "ball
valve" effect where the stone moves to the bladder outlet and blocks
it. It's like a wine bottle where you push the cork in instead of
pulling it out. The cork blocks the neck and stops the flow of wine.
Then if you put the bottle the right way up the cork falls away.

This usually causes an interrupted urine stream. You think you've
finished but the bladder continues to fill and a short time later
you'll have to go again. Removal of my stones didn't reduce my
frequency but we're all different and your mention of rubbing your
belly would seem to indicate a possible problem of this type.

Further you may have not passed it at all. One of my stones was
embedded in the wall of the bladder and had to be destroyed by shock
wave.

This is how I found my kidney
stones and also found that I have Diverticular disease-- probably
diverticulosis but it requires a CT scan "with contrast" to diagnose
diverticulits (more serious). By the time you're 80 almost everyone
has diverticular disease which causes small pouches to protrude from
the colon. How small and do they expand and regress? Er, well, no one
really knows or they're not telling. Could it be possible that they're
interfering with the expansion of the bladder? Er, well, they don't
know that either.

I'm convinced these guys are all boneheads now.

The propaganda is that the doctors know everything about the human
body but the facts are that they don't know lots of how it works, not
just to cure a defect. Take any recent textbook of medicine or even
Wikipedia or Medscape and you'll find huge numbers of items where
there are theories about why something occurs but they admit that they
really don't know. This is without adding in items where the studies
are the proverbial "one researcher and 9 of his best drinking
buddies".

Even the canonized saints of the profession are shown later on to have
feet of clay such as Halstead with his pushing of the radical
mastectomy (removal of the entire breast) for breast cancer but when
asked for proof of increased survival he was unable to supply it.
Today, depending on the type and spread of the cancer, a simple
lumpectomy is the usual first treatment.

What a drag.
And if I don't actually have BPH, I sure don't want to be taking Avodart >>> for the rest of my freakin' life.
[The Cialis is kinda fun though. lol]

IIRC Avodart works on 5alpha-reductase which converts testosterone to
dihydrotestosterone (DHT) which is responsible for growth for the
prostate and also hair loss. Have you had your hormones tested
(serum/blood)?

Nobody's sent me for a hormone test as far as I know.

I wouldn't think that anyone would "send you" for a hormone test.
They'd just take blood and send that out for testing.

I'm surprised they put you on Avodart without a full sex hormone
panel. If nothing else it's good to establish a baseline.

Good luck.

--- SoupGate-Win32 v1.05
* Origin: fsxNet Usenet Gateway (21:1/5)

Thanks for your input.
Although I didn't understand much of what you said I'll try some
internal replies below anyway.

On 2016-08-03 12:34 AM, JohnDoe@BadISP.org wrote:

Anon Anon <nospam@nowhere.net> wrote:

Anybody out here ever been prescribed anything like Toviaz (e.g.
Vesicare, Myrbetriq, etc.) for OverActive Bladder?

Yes. Vesicare and Enablex on several occasions over the past 15 years.
Both are muscarinic antagonists and cause "Bird Cage Mouth" to an unacceptable extent.

My uro just put me on Toviaz presumably because he doesn't know wtf my
diagnosis really is, since all the drugs for BPH that I've been taking
(Cialis 5mg daily and Avodart) have not reduced my symptoms enough.
It remains to be seen actually, if they have relieved my symptoms at all
after being on them both now for close to 2 years.

About time to think it's maybe nothing to do with BPH.

Why it's taken the Canadian medical establishment 10 years to come to
that conclusion is beyond me.

I'm not sure how long it's supposed to take for Toviaz to start
relieving symptoms, but it's been about 4 days now and I think it might
be helping, but only minimally if at all.
Side effects have been dry mouth (not unbearable) and a bit of a cough
that went away pretty quickly.
The first 2 days it seemed to be making it worse though.
It makes it harder to pee unless my bladder is full.
I often still have the urge to pee every hour or so, I just can't do it
unless my bladder is really full now.
Sometimes, if I spend a lot of time massaging/pressing into my pelvic
area around the bladder I can empty it though, but it's a drag and it's
uncomfortable to do.

Not my problems. How big is the maximum capacity of your bladder?

I'm not sure.
But when I had my cystoscopy the technicians and the supervising surgeon
didn't seem to think there was anything unusual or even unhealthy about
my urinary system.
Basically they stick a tube (I think it has a camera in it too) into
your urethra, fill your bladder up with fluid while asking you how uncomfortable it is to hold it in and then tell you to let it out when
it's so full you feel like you have to.
They were impressed with me.

It
should be around 1 liter if you're an adult male. There seems to be
some doubt as to mine. On my request during a procedure to extract two minuscule kidney stones from my bladder (I was under anesthesia) the uro-surgeon pumped up my bladder to a whopping (!) 240ml so he
concluded that this was the total capacity.

When I left the hospital (outpatient) I was given instructions to
drink lots of water (I did) and watch for clots (noted several) and
take Pyridium (a urinary tract anesthetic). On the second day I
neglected to pee just before bed and the following morning I woke with
a teenage-type early morning bladder pressure. I peed and produced
450ml. So much for his expertise. I've since reperformed my "drink
lots just before bed" procedure and the morning results were 390ml,
425ml, and 380ml. To be fair to the urologist night-time peeing (or
not) is controlled by a hormone not by the daytime system (the Pontine system) however I asked for and he commented on the bladder capacity
only.

So in the day-to-day awake activities there's something else wrong
which is limiting bladder capacity.

Switch focus slightly...

The Cleveland Clinic has an interesting paper saying amongst other
things visceral fat (that's the fat around various abdominal
organs--in males generally responsible for a beer belly) can cause
frequent urination. No description of just how it does this.

I've often mused that my issues might be due to belly fat and more
recently also on the fact that I'm on a very high fiber diet that causes
lots of abdominal gas especially at night.
Feels like there's pressure on my bladder even when it's not very full.
I'm 62 years old, 5' 8" tall, and have recently got my weight down to
185 lbs.
At my worst, about 5 years ago, I was up to 250 lbs.
But most of my remaining fat is around the belly.

Further switching...

Reading a very popular book called "What to expect when you're
expecting" (a book for pregnant women) and happened across a couple of relevant paragraphs which say that you (pregnant female) may
experience two side effects: frequency of urination and shortness of
breath. Both are due to the expansion of the uterus taking up space in
the abdominal cavity and preventing the full expansion of the bladder
and lungs. When I suggested this to the urologist he said "You're not pregnant" and laughed. I wasn't amused. Anyway, he says that I don't
have enough visceral fat to cause a problem.

My uro's sending me for some OAB-based tests next week.

Is that the "potty test?" Basically you pee into a special potty which measures the force and quantity of the stream. Afterwards they do an ultrasound to check for residual urine in the bladder. Mine came out
OK with very little residual volume. The urologist should be able to
do this in his office.

My regular uro does that test almost every time I see him.
He always tells me how I've emptied my entire bladder completely and
then I tell him that I still feel like I have to pee.
Then he doesn't say anything.
I think he thinks I'm a hypochondriac.

Although it gets better sporadically for limited periods of time, I'm
still basically waking up every 1.5 hours to pee.
Daytime is about the same interval between pees.
But I had a 4-hour uninterrupted period the last couple of nights.
After waking up it's back to 1.5 hours though till morning.

Try Pyridium OTC next to the tampons and sanitary napkins in the
supermarket. Each pill is 1mg less than the prescription version and
about a tenth of the price. You could always take two pills.

Hmm. OK. Maybe I'll try it.

My prostate is enlarged but not by all that much.

Mine is 44 grams which the urologist says is OK.

I think he told me it was either 31 or 41 CCs which is equivalent more
or less to grams.
He says it's enlarged but not by all that much.

I first sought out medical treatment for frequent urination approx 10
years ago, maybe longer.
My GP put me on Flomax at first.
It didn't help and the sexual side effects were a drag.

For me the sexual side effects are a killer. You could try Uroxatral
which has no sexual side effects but neither worked for me.

See below.
Xatrol is the Canadian equivalent.

Then he put me on Avodart but failed to tell me that it could take 6
months or more to see any symptomatic relief.
I gave up after about a week because of the sexual side effects.
I seemed to be having some relief from certain supplements but it may
have just been placebo effect.
At some point, approx 3 years ago now he sent me to this urologist.
The uro did some tests and then put me on Rapaflo which didn't work.
The he put me on Xatrol which did seem to work for about 3 months and
then stopped working.
Then we tried the Cialis 5mg daily which also seemed to help for about 3
months and then stopped working.
I've also been on Avodart for about 2 years now.
It seemed to help a bit after the first 8 months or so (was only
supposed to take 6 months to work) but doesn't seem to be helping much
anymore.

He sent me for a cystoscopy about 9 months ago, when I was begging him
for a TURP, and the surgeon reading the results said he couldn't find
anything wrong with me.
This is the same guy I'll be seeing next week but supposedly with a
focus on tests for OAB rather than BPH.

Have you had an abdominal CT scan?

At my first visit with my regular uro he did several tests.
that might have been one of them.
At that time, 3 years ago, he told me that I also had a small kidney stone.
If it has passed in the interim then it wasn't painful because I haven't noticed.

This is how I found my kidney
stones and also found that I have Diverticular disease-- probably diverticulosis but it requires a CT scan "with contrast" to diagnose diverticulits (more serious). By the time you're 80 almost everyone
has diverticular disease which causes small pouches to protrude from
the colon. How small and do they expand and regress? Er, well, no one
really knows or they're not telling. Could it be possible that they're interfering with the expansion of the bladder? Er, well, they don't
know that either.

I'm convinced these guys are all boneheads now.

What a drag.
And if I don't actually have BPH, I sure don't want to be taking Avodart
for the rest of my freakin' life.
[The Cialis is kinda fun though. lol]

IIRC Avodart works on 5alpha-reductase which converts testosterone to dihydrotestosterone (DHT) which is responsible for growth for the
prostate and also hair loss. Have you had your hormones tested
(serum/blood)?

Nobody's sent me for a hormone test as far as I know.

My DHT is 4 times the upper end of the reference range
and has been for at least 10 years. No one seems to have a clue what
this means.

Good luck.

--- news://freenews.netfront.net/ - complaints: news@netfront.net ---

--- SoupGate-Win32 v1.05
* Origin: fsxNet Usenet Gateway (21:1/5)

On 2016-08-03 11:58 PM, JohnDoe@BadISP.org wrote:


Thanks for your input.
I see this other uro, presumably for some OAB oriented tests, on Monday.
I'll probably post here again after that.

--- news://freenews.netfront.net/ - complaints: news@netfront.net ---

--- SoupGate-Win32 v1.05
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On 2016-08-04 10:05 AM, Anon Anon wrote:

On 2016-08-03 11:58 PM, JohnDoe@BadISP.org wrote:

Thanks for your input.
I see this other uro, presumably for some OAB oriented tests, on Monday.
I'll probably post here again after that.

--- news://freenews.netfront.net/ - complaints: news@netfront.net ---

Sigh.
After having to retell my embarrassing tale of woe to a really good
looking female urologist intern because my own uro had not forwarded to
them the purpose of my appointment, she informs the doctor/surgeon of my
past history and symptomatic issues.

I went there expecting this guy to do a battery of new tests so that I'd finally have an accurate diagnosis of what is causing my issues and
hopefully a new course of treatment for those issues.
But all he does is to suggest that I try another drug, this one designed
to reduce the production of urine during the night.
It's called Nocdurna.
There's a catch in that if my blood sodium levels are too low this drug
can cause some serious side effects having to do with my brain evidently.
So he sends me for a blood test and will call me if I'm a suitable
candidate for this drug.
Anybody else out there have any experience with this drug?

Then as I'm leaving I get a chance to ask him a few more questions one
of which is about my diagnosis and he says; "Forget getting a diagnosis.
All we're trying to do is treat your symptoms."

What kind of medicine is this?
Is the medical specialty of urology just a joke?

--- news://freenews.netfront.net/ - complaints: news@netfront.net ---

--- SoupGate-Win32 v1.05
* Origin: fsxNet Usenet Gateway (21:1/5)

Anon Anon <nospam@nowhere.net> wrote:

On 2016-08-04 10:05 AM, Anon Anon wrote:

Sigh.
After having to retell my embarrassing tale of woe to a really good
looking female urologist intern because my own uro had not forwarded to
them the purpose of my appointment, she informs the doctor/surgeon of my
past history and symptomatic issues.

I went there expecting this guy to do a battery of new tests so that I'd >finally have an accurate diagnosis of what is causing my issues and
hopefully a new course of treatment for those issues.
But all he does is to suggest that I try another drug, this one designed
to reduce the production of urine during the night.
It's called Nocdurna.
There's a catch in that if my blood sodium levels are too low this drug
can cause some serious side effects having to do with my brain evidently.
So he sends me for a blood test and will call me if I'm a suitable
candidate for this drug.
Anybody else out there have any experience with this drug?

Not me but it's not approved in the US and probably won't be.

The commentary can be found at:

http://www.medscape.com/viewarticle/838078

You need a good medical dictionary to understand the words and
remember too that Wikipedia is your friend.

You may need to register seeing that you like me are the great
unwashed. Hint: state your occupation as "Press" or "Media".

Then as I'm leaving I get a chance to ask him a few more questions one
of which is about my diagnosis and he says; "Forget getting a diagnosis.
All we're trying to do is treat your symptoms."

What kind of medicine is this?
Is the medical specialty of urology just a joke?

It's not just urology <g>.

--- SoupGate-Win32 v1.05
* Origin: fsxNet Usenet Gateway (21:1/5)