Pain after BCG

Thanks Joe!  I’ve always felt that urine and even BCG start down past bladder sphincter causing pain and urgency and this diagram with your description makes me think that may just be what happens.  

of course it’s all subjective on my part.  But I feel like something starts coming down, then a lot of times I only urinate a very small amount.  It also seems I can most of time work out more urine by pulling/squeezing base of penis.

sorry to be so graphic.  

my GP told me years ago that the prostate can retain urine and this helps visualize how that’s possible.

I am not familiar with this matter either.  I hope the pain will subside soon.  I am also guessing from shaky's description about timing of bladder spasm that it happens when either bladder neck sphincter (extension of smooth muscle of bladder)  or external sphincter (different muscle) below prostate squeezes to close to stop urination.  Shaky says no spasm while urinating.  While urinating, smooth muscle of bladder wall constricts, but bladder neck sphincter and external urethral sphincter  relaxes so urine can be voided outside.  When bladder is empty or some signal sends to brain through nerves, External urethral sphincter and bladder neck sphincter squeezes urethra so urine will stay in bladder.   Incidentally, bladder neck sphincter is controlled autonomous and involuntary, meaning just like hear or lung, squeezing and relaxing are done without a specific nerve signal.  External urethral sphincter is controlled specific nerve signal from brain.  My guess is that it is bladder neck sphincter's action to squeeze at the end of urination to stop urination is causing the bladder spasm.   The reason is that external urethral sphincter was not likely affected by TURBT or BCG unless it was injuring during catheterization for BCG.     On the other hand, Bladder neck sphincter (muscle) could have been  injured by TURBT or BCG as BCG stays longest in the bladder neck area.      Note that both sphincters surround urethra. 







According to Google, 

Myrbetriq is used to treat overactive bladder (OAB) with symptoms of urgency, frequency and leakage

Uribel is a cocktail of 5 different mediations (hyoscyamine, methenamine, methylene blue, phenyl salicylate, and sodium phosphate) of which hyoscyamine  is used to treat a variety of stomach /intestinal problems such as  cramps  and  e . It is also used to treat other conditions such as  and bowel control problems, cramping pain .  Methenamine and methylene blue are antiseptic drugs, which help clear a urinary tract infection. bacteria that cause UTI. Phenyl salicylate is a pain reliever. Sodium phosphate makes the urine more acidic, which helps methenamine work better.

I don't know why either, but I do agree with your observation of more discomfort toward the end of voiding vs during.  I have completed my first session of 6 treatments and was fortunate to have minimal discomfort.  Compared to me, you are an old pro.  I hope everything stays positive for you.  Keep the faith!  Hank

I’ve now had 20 weeks of BCG and know the side effects pretty well.

was wondering though why the pain is most intense at the end of urinating?

I have pain on urgency, no pain initiating flow but when it gets to the end it kills.  I’m thinking it’s bladder spasms but not sure.

I'm on Mybetriq and Uribel.  Seems to help and gets worse if I forget a dose.