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Am I messing up my hormonal status with supplementation ??

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 Posted 11/3/2013 2:24:20
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At 5 months from (bipolar) TURP my PSA was at 0.8 (3x less than prior to surgery). Beside the terribly low DHEA-S, hormones were OK (posted elsewhere full results). Decided not acting on DHEA!

I also continued my physiotherapy. Therapist first introduces a special probe in the rectum and checks a real time curve on the screen showing my ability to relax or contract the sphincter as an indirect test of the same ability to relax/contract the urethral sphincter prior to urination, relaxation being a prerequisite to a better voiding. I have a little challenge to get the curve on the screen flat at the start (you can imagine the stressful position!) but with little time and talking I noticed I can be trained to do so.  The best result is when therapist can feel me pushing as when voiding while at the same time the curve on the screen remains flat: that indicates full urethral sphincter relaxation and better likelihood to fully void.  Message is to take time, relax, image to "open the door" before any attempt to void. When relaxed and stream starts apply gentle pressure to increase voiding. Key is also to regularly go; suggestion is every 2-3 hours in my case, do not wait for the urge. Keep drinking 1.5L liquids per day. With my "procedure" as described I feel I can void almost entirely.

Comparing to few months ago, I did a new PVR test last week at 9 months from TURP. This time I was unhappy. I drank more than normal before going to doctor. An emergency with another patient made that I had to wait longer time before my visit, resulting in increased stress. At ultrasound my bladder had ~600mL. I first went and voided ~300mL and then tried to void the rest using my procedure. I could not relax at all and despite trying nothing much was going out (maybe 50mL). Result: my PVR after the process was as high as 250-300mL (competing to <20mL last time). As described above,  relaxation is key before applying the gentle pressure while urinating. Doc decided to see me again in a couple of months with empty bladder this time (voided at home). I think this is important. Immediately when back home after the visit I was relaxed and emptied very well. I should have a personal ultrasound device to test by myself! Oh, a confounding factor might be I stop medication 30 days before the new test (distigmine bromide).

Sorry for this diary, I hope this helps others ...
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 Posted 5/30/2014 3:56:06
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Update: last Feb I hab my urologist check up at 1 year from surgery. PSA was 0.8 last June (6 months post-surgery). Overall situation looked looked pretty good !

Test was done after I fully voided, taking time, without stress (at home and at the location restroom). Relaxing really looks key in my case and points to many, many years of bad habit. Full voiding was after about 2L drinking during past 10 hours and including all liquids, probably going 6-7 times prior to test.

My feeling was of being "light". Before the ultrasound, the doctor pressed just under the umbilici and asked if I had feeling to urinate. I said no and he noticed he can press without encountering much resistance indicating a good voiding. Ultrasound confirmed this with PVR or ~30 mL. She also looked at kidneys and did a DRE. Everything looked normal. Flow looks good.

In conclusion, TURP still looks was a good decision, I am not messing up with my hormones (to stay on the topic subject, side effect acceptable (retrograde ejaculation) and physiotherapy really helped to learn how to relax and fully void.

Still trying eating well, keeping my supplementation deck, focusing on lowering inflammation, and exercising. No DHEA unfortunately as level is very low but not willing to take risks.

I hope this can help others.
Post #12993
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