Age 69
PSA 9.8
Gleason score 7 (3+4)
All 6 biopsies on LH side positive for cancer with slight capsular bulging
Perineural invasion present
Hi
My brother undertook RP on the 2nd June this year. Following the surgery the surgeon advised all had gone well from his perspective.
As is normal he was fitted with a catheter which was removed after 10 days. Following removal he drank around 1 1/2 l of water but was only able to pass around 100 ml. His bladder was scanned several times to show it had fluid in it. More concerning was that despite him having a full bladder he had no/little sensation of needing to pass urine. After some 15 hours and with a lot more water in him they decide that he would have to be catheterized again resulting in him having an unplanned stay in hospital overnight.
He was told to return 10 days later, yesterday, when they would try again.
On this occasion before removing the catheter they backfilled his bladder with around 400 ml of water. They then removed the catheter. Soon after this he passed around 200 ml. A following scan showed around 200 ml still retained in the bladder.
He was then asked to drink around 1 litre of water. This was around 11.30 am and by around 4.30 pm he had not passed any urine with a scan showing that his bladder had plenty of fluid in it. Again, very concerning was that he had no apparent bladder constriction or sensations that he wanted/needed to pass urine.
They said that they would give it another hour and after that they would have to catheterize him again which they have done and told him that this must now remain for a further 3 weeks, much to his dismay as it is very uncomfortable for him.
Following the first attempt it was indicated that they would pass a cystoscopy up his urethra on the second attempt, yesterday, if he was unable to pass urine to see if there were any strictures or swelling. However, when I asked them to do that they said it was too dangerous though they are happy to pass a catheter?
They don't seem to have any plan of action that they will undertake in 3 weeks time if he still has the same problem and my brother is deeply concerned that he is going to be left on a catheter for the rest of his life?
Prior to the surgery the surgeon advised that he would perform the RP from behind or to the rear as this gave better outcomes with reducing incontinence? Is anybody familiar with this procedure or terminology?
Is UR a common problem with RP? I thought the opposite was the case, incontinence? At no stage prior to the surgery has anybody ever mentioned UR as being a problem or side effect only incontinence?
Is there anybody here who has experienced this problem who can advise what the problem might be or where one could get some advice as the hospital currently don't seem to have any answers or plan in place to understand/solve the problem?
Prior to the surgery my brother had problems passing urine.
Any advice or insight in this would be appreciated.