TURP and bladder complications
Posted , 14 users are following.
Hello everyone,
Five days ago, I had TURP surgery for an enlarged prostate (BPH). As background, I'm a 58-year old male who had been taking medecine (Flomax) for about two years for BPH. Then one day, the medecine stopped working and I had a severe case of urinary retention. My urologist sent me to the Emergency Department for a catheter, proscribed more medecine and scheduled me for the TURP.
I had the catheter removed four separate times in hopes that I could void, each time unsuccessfully voiding. Two weeks prior to the TURP, I met with the urologist and insisted he remove the catheter. Reluctantly, he agreed and I was able to finally urinate. So now following the surgery, I don't seem to be able to urinate. It's frustrating! The doctor said that my bladder had probably expanded so much because of the urinary retention and does not place the pressure it needs to urinate.
He's ordered me back to the Emergency Department for yet another catheter and said we'll leave it in place for two weeks then switch to a self-catheterization procedure. I assume the idea is to train my bladder again.
But, I could use the advice of anyone and everyone who's gone through this. I'm very frustrated because my urologist, despite being gentle, doesn't seem to explain or do his job fully.
I'm doing everything I can think of right now to urinate before I go back to the Emergency Department. I don't want to go!
Anyone have any advice, suggestions or recommendations?
Thank you!
0 likes, 55 replies
jimjames stedavi
Posted
Hi Stevadi,
Sometimes a prostate reduction procedure or sugery like TURP doesn't work because of the reasons your doctor gave with your bladder. It's unfortunate that you weren't told this prior to the TURP but that's another story, another topic.
Going forward, his advice is good. See how you do in two weeks when the Foley comes out and if you still can't void by yourself, then learn how to self cath (CIC).
Many of us here, including myself, have been self cathing for years and although it can be a little bumpy for some in the beginning, after a few weeks it's pretty easy and soon can become a non issue. It also has the potential to rehab your bladder ato the point where in the future you will be able to stop CIC completely, although no guarantees.
We have several threads here dedicated to CIC, but I'll just make two quick points.
First is to order the right catheter which your doc probably will not give you. There a few good ones to start with but I'll give you the names of two.
My favorite is the Coloplast Speedicath Coude. Second would be the Coloplast Speedicath Flex Coude. You should try and get samples of both and see which ones you like. Just call up Coloplast and get some free samples. The size most men start with is "FR14" but I would also get a few samples in the next bigger size "FR16" in case you can't get the 14's in. It may seem counter intuitive but sometimes a bigger size goes in easier than a smaller size.
If it looks like you're going to be self cathing in two weeks I'd be proactive and get your rx's and catheters in order now. Otherwise, you will probably walk home from your doc's office with whatever caththeters he happens to have in his drawer. Not the end of the world but also not the best way to start self cathing.
Jim
jimjames
Posted
I guess I forgot my "second point". LOL. It had to do with your self cath schedule but that can wait until you see how it goes. But in general, if you can't void very much at all on your own, in the beginning you will want to self cath around 6x/day. So it's important that your doctor writes you an rx for 180 catheters a month. You don't have to use them all, but you want the rx on hand.
There's still a possiblity that in two weeks you will be able to void OK when the Foley comes out, but better to be prepared in case you can't.
Jim
jimjames
Posted
Stevadi,
While you're ordering some samples, ask for the non-coude version of both catheters to try as well. Since you've had a TURP, you may not need the coude versions. Also, if your doc is knowlegeable in self cathing (most aren't) you can ask him about this as he knows your anatomy. But IMO the best catheter is the one that works best for you, that's why trying a few is helpful.
Jim
kenneth1955 jimjames
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stedavi kenneth1955
Posted
Thanks, Ken and Jim. I'm holding out hope for a few more hours. I'm doing all the things that typically make me want to pee....doing the dishes, holding a hand under warm water and some kegel exercises. The only thing I can't do is "p*ss on a sparkplug." LOL if you get the reference!
Waffalobill stedavi
Posted
wally5 stedavi
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stedavi wally5
Posted
jimjames wally5
Posted
dalebf stedavi
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stedavi dalebf
Posted
I had the surgery last Friday, 2 June and the doc removed it yesterday, 5 June which makes about three days total. I agree, I think it should have stayed in a few more days but I also think I should have stayed in the hospital for at least 24 hours following the TURP.
After reading some posts here and on other sites, I think that constipation caused by the opiate painkillers I took for two days may be causing some of the retention. I took a laxative and I'm hoping that helps.
Waffalobill stedavi
Posted
The longer you have the Cath in, the longer it takes your bladder to learn how to do its thing. Why they pulled it. I was cathed 2 days. Took a couple weeks for my bladder to even start to work right. It never gets full, it stops contracting. If your lucky. Sometimes it gets mad and contracts when it doesn't need to. That's painful.
jimjames stedavi
Posted
Jim
dalebf stedavi
Posted
My catheter was in for 5 days. When it came out my stream was slower than I expected it to be and my urologist said it was because of surgical swelling. It has improved slowly. Patience. You'll get there. It sounds like a good discussion with your urologist is in order so you can have some answers and peace of mind while you are healing.
stedavi jimjames
Posted
Jim, my urinary retention started about 24 April. That's the day I received the first of five foley catheters. We left it in about a week or so and did a voiding trial. All unsuccessful until the fourth one and after insisting the uro remove it, I was able to void...until the surgery.
To make matters even worse, as a result of the foleys, I contracted a very strong and nasty bacteria, pseudomonas and a fungal infection. The antibiotics were enough to make me want to just give up.
Update: After taking a laxative, I am able to void. Still a little painful but I'm emptying.
Question is will the small stream eventually become stronger as I void all the blood, tissue and gunk from the surgery?
Thanks.
jimjames stedavi
Posted
Hi Stevadi,
I think it's positive that your retention started only after the TURP. You've had a lot of recent insults to your system including inflammation, opiates, bacterial infections and the anathesia. Any of these alone could account for your bladder retaining more urine than it should. So if that is the case, hopefully you will be voiding normally in a little time without any catheters.
Again, I think your doctor's plan is a good one. Stay on the Foley for another 2-3 weeks, and then do a voiding trial. If you pass, then things are good. If you fail the voiding trial, then have them teach you CIC so you won't need to wear the Foley 24/7. And hopefully, the CIC will only be very temporary until your bladder regains some of the tone it lost when it stretched out after your TURP.
What medications are you on now, both rx and over the counter? You really should take stock and evaluate all your meds before you do a trial off the catheter as many meds can cause retention.
Jim