Most Starbuck’s do not monitor their bathroom.
Many fast food places like McDonald’s or Burger King are almost as friendly. Even if the restroom is locked, often they will tell you the code without a purchase. Memorize any place you go by frequently. Worst case you can buy a small soft drink.
I have some of the problems in this thread, exacerbated by my membership in the TWBC (Teeny Weeny Bladder Club). Having dealt with this for many years, I’ve developed a few strategies. As @Neidhart mentions, the need happens strongly and suddenly – leaving very little time to handle it.
In my truck, I keep one of these [range extender]. It can hold two “events” and seals tightly. I’ve learned to wear loose clothing so I can deploy easily under a towel (also kept in the truck). In addition, I keep a pack of those disposable urine bags in there as well. Somewhat more difficult to use, so only when I’m in a more isolated place. Since I also have IBS problems, I keep a 5 gallon bucket with lid in the truck’s toolbox. Unpleasant to think about, but the alternative is worse.
As you might imagine, I’m essentially terrified of airline travel. Having an “event” occur while in a TSA line, or airborne and unable to reach the plane’s loo would be humiliating. As such I have a strong preference for journeying via RV, for obvious reasons.
I’m pleased to give you Privy.NYC
New York City area bathroom map WITH Door Codes.
It’s like Pirate Radio. You just have to know where to look.
l understand your concerns. Complications are always possible with any surgical procedure. However, these days they are quite rare.
Ask your primary care physician for the best urologist they know, specifically somebody very experienced with this procedure. Prince of Green Laser indeed.
As for your specific questions, all I can tell you is about my own experience.
I was mildly sedated, but just barely awake. Ask your urological surgeon how much sedation you should use.
As for tears, I remember that the doctor cauterized the site immediately after each laser pulse as he went along. The smell is unmistakable.
After the procedure, I had to wear a catheter for several days - possibly a week - which was only mildly unpleasant. There was significant “discoloration,” which means my entire crotch was black and blue.
I hope none of this dissuade you from undergoing the procedure, which I highly recommend because - and I cannot stress this enough - for me, anything was (and still is) better than wearing adult diapers. On the other hand, I have a friend one year older than me who wears adult diapers and it doesn’t bother him at all.
I’m 64, low PSA, but suffered from BPA with all of the symptoms others have mentioned: frequent, urgent urination, getting up multiple times a night, etc. About 18 months ago, I had a procedure called Rezum, which uses steam to kill parts of the prostate, which are then flushed out during urination. It was an outpatient procedure done under a local anesthetic. I had to wear a catheter for a couple of days, but otherwise it was a pretty straightforward procedure. The results have been pretty good. I get up at most once a night, and can go several hours without having to urinate. One side effect, which I was told happens in about 5% of cases, is retrograde ejaculation. As others have mentioned, neither I or my wife have an issue with this.
I’m a 57 year old male taking Finasteride. I’m finding that reading this thread is making me need to go pee.
It never occurred to me but it shouldn’t be surprising that there continue to be improvements in the treatment of BHP. When I looked up Rezum I also discovered Urolift, another procedure that is less invasive than TURP (surgical or laser). It involves implanting a clip or shunt.
Anybody concerned about BHP has better options than ever before. See a urologist to learn more than even Dopers know.
(disclaimer, not male)
My father was in the “of it” group and yeah, it wasn’t good. He was in quite a lot of pain at the end.
My brother was diagnosed at about age 66. His doctor was originally of the “with it” crowd until my brother reminded him of the family history.
Caught early, and surgery seems to have been curative.
BPH – Benign Prostate Hyperplasia (for certain values of “benign,” i.e. not related to cancer)
Thank you for this level of details. Seriously.
No, none of this dissuades me from having the procedure.
Your description answers one of my biggest questions: How does one insert a laser inside of the inner tube ( urethra ), aim it towards the prostate outside of said tube, without just demolishing the …integrity of the urethra as a tube passing urine. Now I know.
I am guessing that the urethra is incredibly sore afterwards, having been cut open and cauterized closed repeatedly up and down some of its length. Not all, of course.
My Urologist, as it turns out, works with the Aquablation device. NOT that I won’t ask my Primary for another recommendation. But I’m a few years in with this guy and there’s a certain level of trust. I do want to find out how many of these he has performed, etc etc.
I just got a call from my urologist’s office. He’s retiring. They’re assigning me to someone else in the practice. After 25 years I now have to get used to a new “touch.”
(Belated) condolences about your father, and best wishes to your brother. Peace to all concerned.
This is just my overactive imagination, but I do not think the surgeon aims the laser at a specific point on the patient’s prostate. Rather I figure that the laser radiates in a 360° circle encompassing the entire inner circumference of the urethra.
I am too lazy to research this tantalizing image. Does anybody know for sure?
P’shaw- laziness is admirable around here. 
Agreed- the animation I’ve found this Aquablation site with a video that explains the procedure. A … “sweeping” motion of the high-pressure water jet. Instead of burning there’s water-incising. Same net result, I’d wager.
This will be lengthy and fairly granular in detail and language.
So, it’s early morning October 26th. I had the Aquablation on the afternoon of the 24th. In preparing further, I did find a video of the OR as a patient was undergoing the procedure. It was shot in a discrete manner. There was no need to focus in on the area where the robotic device is inserted anally and penile-y. However that video DID prepare me for something that my surgeon completely ignored.
Now, I’m not whining about this guy at all- I learned to trust him and trust the approach he recommended. I’m aware that surgeon’s love to cut, that’s why they’re surgeons. Some hew to tried and true traditional approaches. My hip surgeon was that person. Older, conservative. Did the traditional method there. Had zero interest in diving into the new anterior method. But my Urologist, he’s been doing Robotically assisted surgeries for a few decades now. Quite into it, had spend time in various countries learning a lot of the bits there. I wouldn’t surprise me one bit to discover that he’d been at the forefront of the campaign to get the machine into the local hospital. All this said, he’s a surgeon. HIS tunnel vision revolves around the machine, the patient and the results. How I would feel physically afterwards was solely about my urinary function.
What he didn’t tell me, and what the video did, is that the patient is basically lashed down to the OR table- which is a custom-built affair- with arms tightly bound to boards off to each side, my torso and head lashed down and my legs elevated with hips rotated way out to the side. All rigidly lashed down and in the case of the legs, clamped in place. Imagine waking up to find yourself about to be spatchcocked at someone’s Thanksgiving dinner. Very much that dynamic.
EVERYTHING is sore. Everything. All neck muscles, what passes for Abs on my corpus, both hips, arms, etc. Ironically the only place I am not sure is my ass, despite the fact that I had a robotic mapping probe inserted into that orifice. Small blessings.
So, a comment to the effect of, " You’re going to have tremendous pain for a few days from the Foley catheter, some burning when urinating for a while and oh, by the way, you’re entire body will feel as though you’ve been in a car accident" might have helped. Oh well.
I’m lucky in that I tolerate anesthesia really well. I did not see the surgeon afterwards, which was a bit weird. I learned the next morning that he and that large team- 8 to 10 people in the OR- worked well into the night on the same procedure over and over. Off I went to a recovery room, watched the ceiling move around for a while. Moved to a room.
My dread of having a Foley catheter inserted was well-founded. I do tend to buy trouble and look ahead to the darkest outcomes. I couldn’t have imagined how painful this was. Despite the fact that the rubber hosing ( and, there was a complex set of input/output hosing in this assembly, not just a drain ) was taped to my thigh for strain relief, every time I thought about shifting my right leg, I had sharp pain at the end of my penis. Brutal. And, that’s the way it goes apparently.
Skipping a lot of the more gruesome details, slept barely at all through the night. Mostly because a hospital is a lousy place to try to get sleep. Also, the pain down there from the Foley. The procedure itself was to cause pain mostly when urinating and that will subside in the coming weeks.
For a while before the surgery, I was most dreading the chance that I’d have to go home with the Foley in place for a few days. The day after the surgery, it was clear that the many gallons of sterile water being inserted up into the Foley, used to irrigate the area and gathered in a bag, were being closely analyzed for color and content. Depending on how light the color got as the day progressed was the tell as to whether or not I was done bleeding enough to go home sans Catheter.
I never saw the surgeon yesterday. He is on call this weekend, and even if not I suspect I’d have had the cell phone call I had in the morning. He informed me that the procedure went swimmingly, etc etc. No promises on leaving without the Foley. Mid-afternoon, his P.A. came around. Shot photos of my bag and my roommate’s bag and sent them off to the surgeon to assess the coloring. Apparently this is accepted practice and I took no slight from the fact that an important decision was being made by remote. He clearly does this every week, has a firm grasp of the coloring of the lighting, etc and can make a good decision. He decided to have me keep the Foley in place.
I was pretty upset but nothing to be done. In the next few hours, the coloration of my output went almost clear. Yay !! I rang for the nurse, had her message the P.A., and that person was game to shoot another few images and call my surgeon. He agreed that I’d turned a good corner and the Foley would come out prior to discharge.
He did get on the phone with me again and quite sternly said, " I’ll send you home without the Foley- but you have to promise to drink a gallon of fluids at least per day. " I’d have agreed to have a three-way with the chairman of the joint chiefs of staff and a Shetland pony if it meant I’d leave without the hosing inside of me. Now, we all retain the chemistry of the general anesthesia for days ( and, some research indicates, months ). I didn’t process what he was telling me to do. This morning, filling a milk jug with fresh water, I realized that I wasn’t replacing the many gallons of irrigation that were in place in the hospital. I wouldn’t have had all of that material in place in my home. And yet, glad to obey the instruction. I’ll drink up. Will send him a note later today asking for how many days should I hyperhydrate.
Now, my guy did paint a rosy picture. That the next day I’d be urinating like a garden hose, like someone in his 30s. Not at all the case. If anything, the amount and force every time I go is diminished from what it was pre-op. Much swelling is happening up there and I’m not freaked, nor do I think it was a failure. I think he gave me the best possible image to hold onto. That said, he DID carefully list the percentages of problematic outcomes. He did this slowly and watched me listening as he did so. Clearly a canned speech but one he has to give. Less than ten percent have this, less than one percent deal with that, etc. I’m gonna assume that in the next week or less, the swelling and bleeding will stop and things will improve.
He had made it very clear to me that the post-op period of time of incontinence, uncontrollable urgency to go and so on would last 4 to 6 weeks. With this in mind, I started trying to figure out what combination of items would allow me to function at work without urine gushing into my pants and down my leg to the floor. ( No matter what your career, never a good look. Unless you make your living being paid to urinate on paying customers. Not one to judge, do what you may. But otherwise, my statement stands. )
Overnight adult diapers are mighty NON-absorbent, near as I can find. Men’s incontinence pads seemed a good call. I decided to try combining the two. I’ve developed newfound appreciation for the women in my life who have opined that having to use a menstrual pad is akin to having a pillow jammed into their underpants. Some Googling informs me that between 2 and 5 tablespoons of blood and material is shed during the average menstrual cycle, and as is pointed out everywhere, your mileage surely can vary.
All of this said, blood is thicker than water ( especially when mixed with the shed lining of the uterus ) and so volumes released and to be contained couldn’t really be measured up. I’m trying to contain urine, which is essentially water ( the bleeding has almost completely stopped and it’s 36 hours post-op ). Thinner, more prone to running around and leaking out of a pad.
I chose to put one of the pads linked above INSIDE of a men’s adult diaper. Which in turn will be held in place by my normal jockey shorts. It’s pretty bulky below decks. I thought this out, bought a pack of each item, and in the last few weeks, well, made myself test it out. First just standing in the bathtub. It all seemed to have zero leakage. I then tested again with clothing on, walking around, sitting down- onto a Chox pad on my office chair, just in case. No leakage. Hopeful that this approach will hold in leakage through more than one “event”, I think I’ll be good to go back to work next week. I sure as hell can’t take 4-6 weeks off. One week wasn’t much of a push. I didn’t get specific with my employers about what was up. I’m a freelancer and so operate in a corporate environment in much a different manner than staff employees. They nodded, said they’d set about finding a sub for me. Anyway, 4-6 weeks would have me lose a steady job and now more than ever, nobody can afford that. So I’ll go back to work and manage this. Just as tens of thousands of incontinent people do every day.
I’ve chosen not to bring my family in on this one. They’re pretty share-y and I needed to not be detailing all of this with Mom and my brother, etc. Ironic that my cover story for missing work next week was going to be that I have the Flu. Since my entire body is sore, well, that will be an easy sell.
I’d be interested to hear anyone else’s experiences with treatment of BPH, either with this new fancypants robotic approach or with the TERP laser or other methods.
I see my surgeon in a month unless something emergent occurs.
A separate post because this in many ways is a separate conversation.
I had a very positive experience with the entire staff at the hospital. Mt. Sinai/ Queens in Astoria, NY. On all levels of professional responsibility, I was met with upbeat polite professional staff. Conversations were warm, support was given, questions were answered. Late on a Friday with time hanging heavy on her hands, our Pre-Op nurse chatted with me for a while. Turns out she’s Filipina. Our daughter in law is and the conversation went rapidly- and predictably- to food, family, traditions, cooking, how to murder a pig in the back yard when you’re planning for a part of 150, and so on. Entirely delightful and took my head right out of the stress.
A few other longer conversations with employees in the brief stay. It’s not their job to chat up the patients. But, I do believe that management can either encourage or discourage the kind of conversations that I had. I’m grateful that the staff felt that they could take a few minutes to talk to me. It matters.
The slightly macabre iteration of this was when I walked into the OR. ( No need to wheel me in, I’d not been sedated at all at that point. ) I experienced this before the other two surgeries I’ve had since 2018. EVERY single person in the OR turned to me and smiled broadly behind their masks and exclaimed, " Hello There Mr. Cartooniverse !!! " What their eyes said is, "Here’s another one in a long stream of meat puppets coming in, getting knocked out, getting worked over, getting rolled out. " But I do appreciate the tone they set. Beats people just staring at me before I feel that cool infusion into my left arm that tells me I’m about to take a brief pause in consciousness.
The interactions truly matter. To the owners of the hospitals it’s business. On the ground, in the hallways, in the rooms, it’s human interaction. Perhaps it is why someone takes a job mopping the floors in the hospital instead of an office. The lovely tall fellow named Anthony who walked in to mop up yesterday wound up having a lengthy chat with me. Started with the weather and whether (heh) we prefer hot or cold, and moved on to deeper stuff. He was comfortable bringing forth enough of his private life that it wasn’t just me yammering at a man with a mop. It was a dialogue.
It matters, these moments.
Have you had those moments in a hospital setting? Or the opposite?
Excellent article rating the best incontinence products, by Wirecutter of the new York Times:
I’ve been a nurse for 44+ years helping folks maintain their dignity and ability to function confidently out in the world. I’ve also been through robotic surgery similar to yours myself (9 years ago) and I have had to figure out reliable solutions and products for myself as well.
Get on Amazon and order a supply of the recommended briefs so you’ll have them soon. This is not something you want to try to save pennies on, trust me.
I have to go now but I’ll be back. Hang in there. And as a nurse, I promise you, you fo want yo drink that gallon of water every day, no matter what a bother it seems. The alternative is not prettyI assure you.
Hi. Thank you SO much for this post !
I’ll seek out that article now.
Yeah. I got home last night. I’m 2/3 of the way through my gallon.
Currently I’m peeing ever 10-14 minutes. Seriously. I sure hope that abates over the next week…at least to a degree.
ETA: Lucky me : I already bought those Tenas.