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Retention after General Anaesthetic

User
Posted 05 Apr 2018 at 17:56
Just wondering if anyone knows or had experienced retention following a GA. I’m not necessarily referring to procedures to the prostate etc.

I’m booked in for an op on my nose next week. At the pre-op I asked if I would have to be catheterised. I asked as I have a bladder neck stenosis (restriction). My urologist said a few years ago if I go into retention not to let any Tom, Dick or Harry near me. They couldn’t get the small camera into my bladder so would struggle with a catheter. The nurse at pre—op informed me that some people may need a catheter after the op due to the anaesthetic relaxing the sphincter/bladder. I explained that that concerned me as they probably wouldn’t get one in. She told me not to worry about it.

I’m in two minds now whether to cancel the op as I don’t know if they have a plan should I go into retention. After reading some stories on here I’m concerned they may cause some damage to my bladder if they decide they are going to catheterise me.

So has anyone any experience in this ie what’s the chances of my bladder not functioning following GA.

Cheers all

Bri

User
Posted 11 Apr 2018 at 09:47
Bri,

Just as you suspected, despite the urologist ' being around ' he /she wouldn't necessarily be able to see you when required. I think you've been absolutely right in the decision you made. A proper plan will now be put into place which should greatly reassure you.

Paul

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User
Posted 05 Apr 2018 at 20:52
Bri

As you know I have had loads of GAs but always on the water works so can't directly answer the retention question. I can't see why the op and GA should affect the waterworks.

The obvious way into the bladder apart from the urethral route is a suprapubic through the abdominal wall. My first one was in the recovery room and although not my favourite pastime it was tolerable, bear in mind I was just coming round from the GA, it probably helped that I was a bit groggy and the morphine helped. The suprapubic hole seals itself within minutes once removed.

The other option is self catheterization, you can get some very thin catheters, could you try some pre op ?

I have also had a full dilatation and catheterization without any pain relief at all, again not pleasant but tolerable.

I do understand your concerns, but is the nose op going to improve your quality of life.

Take care thanks Chris

User
Posted 05 Apr 2018 at 20:52

I think it is the other way round Bri - that some people wee while under or coming round. I am sure if you tell the surgeon & anaesthetist on arrival that you mustn't be catheterised, they will just pop a waterproof sheet under you instead.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 05 Apr 2018 at 21:26

Thanks Chris that’s possibly what I will discuss with them as a back up plan. The nose is QofL stuff as it effects my voice, taste, smell and I can hardly breath through my nose

Lyn they explained that the anaesthetic can cause retention due to it being a muscle relaxant. It’s the part of the sphincter I believe that we can’t voluntarily control. This relies on the signals from the brain working it. If it is too relaxed it won’t let you pee.

I just want them to tell me what the back up plan is in case. But all they say is don’t worry if it happens we will sort it

Bri

User
Posted 05 Apr 2018 at 22:36

Well I have had a lot of GA and have only been catheterised once - and that was planned beforehand - and John has had more GA than me and never been catheterised apart from after the RP. Even with these two recent knee replacements, they had him up and moving around very quickly and monitored his urine output for the first few hours but there wasn’t a problem. You will be more at risk I guess bu5 even so, I assume you would be awake at the point that UR becomes a concern and would have some control over what happens next?

This might be of interest:-

https://m.wikihow.com/Urinate-After-Surgery


"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 06 Apr 2018 at 10:23
Hiya Bri,

Just a quick thought. I wonder how much of a throw away remark the "Tom,Dick or Harry " was ? Also,your situation brought back a memory of a patient I escorted to DRI years ago who underwent a procedure under GA.I forget the full details but I know his consultant (psychiatric) informed the surgery team of possible retention problems and the gentlemans ability to cope with a urethral catheter,and he was given a suprapubic insertion.It may be worth contacting the ENT clinic and explain your concerns further as quite often we encounter the 'leave it to us we know what we're doing ' attitude as if we're challenging their expertise.It is obviously a worry for you mate so you deserve to have your mind reassured. Hope it all works out well for you Bri.

Paul

User
Posted 06 Apr 2018 at 13:54
Cheers Paul that’s my worry ie they won’t listen to the patient as they are the experts. Don’t get me wrong I know they will be doing what they can but following standard procedure.

I’ve spoken to the urologist secretary. She has suggested I ask DRI to contact Hallamshire for my clinical info about my bladder stenosis. I’ve spoken to the pre assessment nurse and she is going to speak to the ENT consultant on Monday and asked me to speak to the urologist. I have no idea why the two consultants can’t comminicate regarding this ie ENT “dear urologisti my patient has a bladder neck stenosis. If he goes into urine retention following surgery what is the safest way to respond to this for this particular patient ”

I can honestly see me cancelling the operation unless they reassure me they have a suitable plan

Bri

Edited by member 06 Apr 2018 at 13:56  | Reason: Not specified

User
Posted 06 Apr 2018 at 18:53

Hi Bri 

Please read my Bio re Cathetering 

I have a stricture and sometimes have to selfcatheter

Barry

Edited by member 07 Apr 2018 at 07:44  | Reason: Not specified

User
Posted 07 Apr 2018 at 11:35

Thanks Barry

But it’s the bladder neck that is restricted and they couldn’t get the camera in the bladder. It’s the words from the urologist that worry me when he said don’t let any Tom, Dick or Harry near you with a catheter

Brian

User
Posted 07 Apr 2018 at 17:43

I have had a bout of retention years ago following brain surgery and had to have a catheter.

When A had retention following his FLA he had to self cath, which he said was much better than having a nurse do it. He was given training ( 30 mins) and a supply of pre lubed Cath’s with own ‘catch bags’ Plus an ointment to numb the tip.

Would it be worth asking for training/ equipment and trying it before the surgery?

I wasn’t sure it was the general but that I wasn’t allowed any movement and lying flat in bed my ‘let down’ reflex just refused to operate. Maybe if I had tried a bedpan before surgery but the ‘do not wee the bed’ training seemed to override all attempts to use a bed pan!

Maybe it was the general now you mention it!

Good luck

User
Posted 07 Apr 2018 at 18:55

Originally Posted by: Online Community Member

Thanks Barry

But it’s the bladder neck that is restricted and they couldn’t get the camera in the bladder. It’s the words from the urologist that worry me when he said don’t let any Tom, Dick or Harry near you with a catheter

Brian

Yes Bri that would worry me , the problem is sometimes THEY don't listen

 

Barry

User
Posted 07 Apr 2018 at 20:45

Thanks Claret.... it’s not the worry of someone catheterising me it’s the issue that my bladder opening is not big enough to take a catheter regardless of who does it 😫

Cheers Barry, yep that’s why I want the assurance that they have a pro-active plan just in case rather than them being reactive.

Fact is if by the end of Monday there is no plan I’m cancelling the op

Bri

Edited by member 07 Apr 2018 at 20:46  | Reason: Not specified

User
Posted 07 Apr 2018 at 21:06

Good luck Bri..,fingers crossed for a plan

Clare x

User
Posted 07 Apr 2018 at 21:23

Get a black Sharpie and write “ do NOT catheterise “ on your tummy. I had a huge shoulder op after a motorcycle accident when I was 18. The consultant came in and marked an arrow on my shoulder. Didn’t fill me with confidence lol. Good luck whatever

If life gives you lemons , then make lemonade

User
Posted 08 Apr 2018 at 15:24

Chris, you'd have had less confidence if he'd operated on the wrong shoulder! Those arrows are a failsafe measure where bits being removed could be on either side. Simple but effective!

AC

User
Posted 10 Apr 2018 at 08:32

Well looks like I will be postponing the op. There waiting for me to speak to the urologist today to get his view. Why I have to speak to him I don’t know.
The other option is that I go with the op on Thursday and be reassured it’s near the same place we’re the urologist is so if he is needed they can call him. He won’t have my records as they are at Sheffield and will he really be readily available?
All I wanted was for them to say we’ve talked to your urologist and we now know what we would have to do if you go into retention.
Instead I’m the one trying to get the information to share with them

Very disappointed with the NHS at the moment

Bri

User
Posted 10 Apr 2018 at 09:00
Bri

Slight complication of first SPC, they need to scan you to ensure they hit the bladder. Mine was done by a radiographer using a portable scanner in the recovery room. Apparently the bladder sometimes gets moved during RARP.

Thanks Chris

User
Posted 10 Apr 2018 at 20:55
Thanks all

I’ve cancelled the op. I spoke to the urologist nurse at Hallamshire who said that whoever does the catheter would need to know how to do it with my stenosis.

Shared that info with the pre op assessment nurse. She said the ENT had said the urologist would be around. The nurse checked calendars and told me the urologist was in theatre all that day. When she said it was up to me if I wanted to take the gamble that made my mind up. Op cancelled. Now waiting for a urologist appt to put a plan together. I suspect they will want to take a look at the stenosis but that’s fine

Bri

User
Posted 11 Apr 2018 at 09:47
Bri,

Just as you suspected, despite the urologist ' being around ' he /she wouldn't necessarily be able to see you when required. I think you've been absolutely right in the decision you made. A proper plan will now be put into place which should greatly reassure you.

Paul

 
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