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Old 08-17-2005, 02:33 PM   #1
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One day after catheter out - couldn't urinate

My first 24 hours after catheter removal went OK, but then......

After the cath came out about 9:30 AM Tuesday 8/16 I put on my Depends brief and came home. I could feel some leakage but by afternoon I had a pretty good handle on controlling it most of the time. My only real problems involved coughing, sneezing, blosing my nose, etc. I was experiencing some pain during urination and attributed this to the urethra irritation from the removal process.

I went to bed about 11:30PM. I woke up at 2:30 AM and 5:00 AM with a strong need to urinate. I did so with a little leakage along the way. When I awoke at 7:30 AM I was able to urinate again.

I drank a 12 oz. glass of skim milk with my breakfast and a 20 oz. cup of ice water during the morning. About 10 AM after a long phone call I realized I hadn't been leaking that I knew of and went to urinate. I couldn't go - it felt like the urine made it part way and then stopped somewhere inside me up and behind the base of my penis. I tried several times and tried some tricks (put hands in warm water, took a hot shower, etc) but still couldn't. My Uro's nurse said I should come in. By the time I got there I was very uncomfortable and it was downright painful just before he started working on me on the table. He put in a coude tip catheter and hit a gusher - I expelled 600 ml of urine. He told me he didn't know why it happened; it could have been a bladder spasm, scar tissue, sphincter problem or something else. He gave me a catheter to use on myself if necessary and said if it keeps happening he'll need to scope my bladder and urethra to see what's going on. His nurse went through the procedure with me step by step and gave me some lubricant.

Anyone have any self-catheterization tips or experiences to share?
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I'm not a doctor, just a guy who used to have a cancerous prostate....but I got over it...

Last edited by james_wv; 08-19-2005 at 06:43 AM.

 
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Old 08-17-2005, 05:22 PM   #2
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Re: One day after catheter out - couldn't urinate

Hi, James. Boy, does this ever sound familiar! My husband had his radical prostatectomy a year ago, age 53, and had the catheter in for 3 weeks as per his doctor's standard procedure. We were in the emergency room 5 times over the next 3 weeks for "urinary retention". (his first shutdown was on the first day after removal, like yourself). At this time the urologist wanted him to self-catheterize, but it had been so painful for the 3 weeks that he couldn't even imagine doing it, and I sure as heck wasn't going to volunteer! Anyway, in retrospect, it appears he had a reaction to the latex catheter which caused irritation and scar tissue. Several months after things had calmed down, and several cystoscopies later, a procedure was done to clear away the scar tissue, and this time a silastic non latex catheter was used for 10 days, and there was no pain whatsoever, he could go to work and everything without any problem. (We did go back to the duckie mattress pad) But to keep the urethra open, he had to self catheterize frequently, and still does. At first it was a couple of times a day, then once a day, then once every couple days etc and now it is about once every ten days. It is not hard to do, the difficult part seemed to be learning how far to insert it. It was a bit uncomfortable at first, but certainly not as bad as the initial catheter where he couldn't even stand up for the 3 weeks it was in. He uses KY jelly, and keeping it clean is the key. He had one kidney infection, almost certainly caused by the catheter, and will have to continue the procedure at least for a year, but is managing. The doctor had never had a case like this in his many years as a well-respected prostate surgeon, and now uses only the non latex kind of catheters based on this one case. I have gone on a bit, but did want you to know that as dreadful as it sounds, the procedure is manageable. Please keep us informed, and hopefully it is just a bladder spasm. All the best.

 
Old 08-17-2005, 05:55 PM   #3
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Re: One day after catheter out - couldn't urinate

Thanks for your experience and I hope his circumstances continue to improve.

I've never had a latex reaction but I've never had it in contact for that long. I had 3 or 4 bladder spasms while in the hospital for my 3 days and B&O suppositories did the trick each time.

I had a lot of blood in my urine all during the 3 weeks and while there was quite a lot just before the catheter came out, it seemed to have almost completely disappeared yesterday following removal. However the 600ml he drained this afternoon had a lot of what he called 'old blood' in it - dark, not bright red.

We'll see - I'm peein' pretty freely so far this evening....

Thanks again.
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I'm not a doctor, just a guy who used to have a cancerous prostate....but I got over it...

Last edited by james_wv; 08-17-2005 at 06:08 PM.

 
Old 08-19-2005, 06:54 AM   #4
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Re: One day after catheter out - couldn't urinate

Now it's Friday. I had to self-cath at Thursday at 2:30 AM, 8:30 AM and 5:30 PM. I peed on my own at about 12 Noon and 11:00 PM.

Already self-cathed at 4:30 AM and peed on my own at 8 AM today (Friday).

THe good news is there's no leakage - my one remaining valiant little sphincter is working well. There's just something keeping me from peeing when I need to. My Uro's nurse says it's sometimes part of the healing process from trauma the urethra, bladder and the new connection between them had from the surgery, reconnection and Foley moving around in there.
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Old 08-19-2005, 09:49 AM   #5
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Re: One day after catheter out - couldn't urinate

I know how maddening the peein' routine can be James, but you have to remember ... you're only three plus weeks out from surgery. Your contenance won't return overnight for exactly the reasons your uro nurse gave you. The healing process is sometimes very slow, so (pardon the pun) hang in there big guy I have my three month followup with my robotic surgeon in two hours and I am still using 4 pads a day. That sounds like alot but compared to last month (8-10 per day) it is a vast improvement. One thing I am re-learning through this whole process is PATIENCE! Good luck & know in the end, this will all be worth the final result.
Regards,
Thom in VA

 
Old 08-19-2005, 11:17 AM   #6
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Re: One day after catheter out - couldn't urinate

Thom - I just didn't expect this. I thought I'd be worried about only peein' when I want to; instead I'm unable to pee at all - no leaks, no pee at all until I self-cath.

Information has gotten me through all this - knowing what would happen made it easier to prepare for. THe nurse says this heppens sometimes and to just bear with it, but..........this self-cath, while not difficult, is something I never thought I'd be doing.
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I'm not a doctor, just a guy who used to have a cancerous prostate....but I got over it...

 
Old 08-19-2005, 06:07 PM   #7
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Re: One day after catheter out - couldn't urinate

Hi again James, so sorry you are still having problems. I think that the fact that you are peeing occasionally is pretty encouraging. It seems to confirm what the nurse said about getting over the trauma. Also glad you aren't finding the self-catheterization too difficult. I have so much empathy for you--I know how tough this is.
Thom-I'm interested in hearing what your uro says today about your use of 4 pads per day after 3 months. Ours was surprised to hear how many my husband was using at the 3 month check-up, and has worked hard to correct that. It is so important to keep the urologist informed about what is happening, after all they can't help fix what they aren't aware of. Let us know.

 
Old 08-20-2005, 06:46 AM   #8
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Re: One day after catheter out - couldn't urinate

James in WVA: good luck with the self-catheterization. I've heard this isn't as abnormal as we think. Glad you have a good degree of continence, even if some of it might be from the scar tissue! Hope your condition continues to improve and best of luck.

GR8Hare: Sounds as if you're about on the same track as I am. I'm now 3 months 11 days, post-op, and I'm using about 3 pads a day myself (down from 6-7, with total leakage!). The one great thing is that at night (providing I manage my liquid intake reasonably) I don't need a pad anymore!! So nice to sleep "free and swingin'". You're so correct when you say that it is a slow gradual process, and one has to think back to how it was right after catheter removal to see how far we've progressed.

Wishing all of you a great recovery!

Ken in NY & CA

 
Old 08-20-2005, 05:27 PM   #9
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Re: One day after catheter out - couldn't urinate

Hey there again Gang!!
I know exactly what you mean James ... the not knowing part. I think what happens is the docs get caught between a rock and a hard place. Each one of us who had surgery here on this board has had a uniquely different experience even though we all chose the surgical route of treatment (whether it was the open radical, the periernial radical or the laproscopic/robotic approach). We each responded to the trauma of surgery differently, our healing process, though similar, none the less, are as different as night and day. Same with the contenance issue. I have heard of guys who say they are nearly "dry" after only a couple of weeks. From what I have read and from the experiences I know others have had, those 'blessed' guys are in the minority. Most of us will have contenence issues for months (3-6 is the norm), some will be dry quicker, some longer, and sadly, there is a small percentage of us who will not be as we once were before the surgery. Our surgeons (I believe) do their best to prepare us for the possibilities postop, but unfortunately individual complications do arise. I know for myself, it's a good thing I haven't had to worry about not being able to go ... I would have a difficult time doing the self-cath thing. Like Liane said, it's encouraging that you can go on command occassionaly and if I were a betting man I'd say you'll get better with time. How much time is another matter

Liane, my uro says I am about normal for a post-op robotic patient. The da Vinci folks had a conference in New York recently where the surgeons compared notes, exchanged techinical information, etc., and it seems that the average time runs between 3 to 6 months to recover contenence control to where the patient is satisfied with it. I completed a rather extensive questionaire prior to surgery, and at the three month mark, about my urinary function, bowel function, and sexualn/erectile function. I am certain they are feeding the info into a data bank to track patients progress and the time involved for patient recovery.

Kenneth, you are right on about how we were right after surgery. We were the opposite of James, in fact. At the time we wondered if we were ever going to be able to stop the flow ... it flowed so freely!! gggrrrrr!!!! But ever so slowly, control has returned but we still have a ways to go. Not to worry my firends, there is light at the end of the tunnel, though I agree, at times it's difficult to see it. Keep the faith guys and remission and cures to all!!

Thom in VA

 
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