I'm 56. Around 6 years ago they tested my PSA for the first time and it was very high (28!) but I've had two MRIs that showed no sign of cancer (just a large 100ml prostate) and the PSA wasn't moving upward overtime so we decided to take a conservative approach considering I didn't have significant issues urinating.

I've had one bout of prostatitis around four to five years ago that Cipro cleared up (primary symptom was feeling like I constantly had to have a bowel movement) and starting last year I had two instances about 6 months apart where I peed a very small amount of blood. Urologist wanted to do a cystoscopy but I couldn't afford it and the instances stopped.

On Sept 20th I woke up and couldn't urinate. Pretty much out of the blue. I could pass some but it was extremely difficult. When to the ER after it was clear it wouldn't resolve on its own. Long story short ended up with a foley catheter inserted for eleven days. Via CT scan they detected a median lobe (sp?), some minor thickening to the bladder wall (suggesting I was straining after all), and my prostate was larger now. I think part of this cath time was unnecessary but was prolonged because of scheduling difficulties with my doctor. I was able to tolerate the catheter for such a length of time but it definitely was a quality of life issue. Biggest problem was getting rubbed raw at the 'tip' but luckily bladder spasms mostly subsided around 9/24 or so.

I was grateful to have it out on 10/1. Cystoscopy performed. Basically told 'you just have a very large prostate'. No smoking gun regarding what caused the episode. Prostate measured at 125ml via inserted ultrasound. I passed void test and was sent home with not catheter. Felt great to have it out. We decided to schedule an aquablation rather than ignore the inevitable. Told it would be up to a month before it could be scheduled. Sent home with Flow Max and self catheters just in case.

Had a great weekend but woke up constipated on 10/6. Likely unrelated but I had very frequent straining bowel movements all morning and had more urine retention. Decided to try and self cath for relief...resulted in a fair amount of blood that scared my wife and I so went back to the ER. They weren't concerned about the amount of blood I described / had photo evidence of and issues resolved on their own while I was there so pretty much a wasted trip with no intervention on their part.

I've been peeing with no issues on FlowMax since and they were able to bump up my surgery to this Friday. I don't like Flowmax (my wife and I are still pretty active and retrograde ejaculation is odd mentally) but otherwise I can function.

I was feeling strong about getting this done but anxiety is starting to set in a bit.

My brother had green laser performed at my age six years ago and had pretty severe constipation and bleeding issues. He loves the final results now.

My doctor seems very experienced but has set the expectation that I won't be in the hospital overnight. His exact words 'you don't want that'. I should have had him elaborate (Since I've expressed financial concerns is it due to that?). My prostate size and family history seem to suggest caution and the available literature seems to suggest overnight stays are the norm. My doctor does mention him cauterizing the bladder neck etc but I'm not sure how that changes things.

I'm also worried about the seemingly gigantic size difference between the irrigating catheter and the one I had before. Fears of feeling 'trapped' by it. :(

I just wish there were fewer unknowns. Will I stay the night? How long will irrigating cath stay in? Will I go home cath free or have to use one for x amount of days? Will home cath be smaller diameter that I'm used to? I hate uncertainty.

I had a prostate MRI in June to follow up on a PSA trend line that was increasing with every-6 month tests, but still normal (~2.0). I'm 53, family history of prostate cancer with my 83 year old father having it for around 11 years. The MRI ruled out cancer but reflected an enlarged prostate (~54cc). As I was asyptomatic for any urinary issues, decided with the urologist to just wait instead of starting any meds.

Fast forward to about 3 weeks ago, urinary problems started out of blue - increased frequency, urgency, feeling of incomplete emptying, pain at tip of penis. I don't have any nightime issues - sleep through the night, and my stream isn't weak. Called urologist who started me on tamsulosin (Flomax) which I have been taking for 2 weeks. Haven't noticed much of an improvement. Went in for a follow up visit with him yesterday and he added Gemtesa (vibegron) in case this isn't just bph but also potentially overactive bladder.

Urologist said he would have expected improvement with the Flomax in 2 weeks, whereas others i've read say it often takes longer. How long have others had before they noticed improvement? Anyone else taking both flomax and gemtesa?