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Persistent urinary retention

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User
Posted 28 Mar 2022 at 16:58

Hi all,

Following my prostatectomy 22 Feb things have been a bit up and down with post op complications. One of them that I have been struggling to understand is urinary retention. It first started about a week after my catheter was removed following surgery. A bladder scan revealed there was 280 mL retained. There was a failed attempt to catheterise me but by the time they returned for another go it had sorted itself out. Move on a few days (1.5 weeks post catheter removal) I got complete retention and had to be rushed to A&E to be catheterised once more. This catheter remained in for three days and everything seemed fine after removal but then retention started again intermittently. It was manageable at first but by day 18 post catheter removal it was causing real a problem during the day. Developing a UTI last Friday has probably not helped. 

I think walking around seems to make it worse. Sleep seems to settle it and flow starts to get back to normal. I've been to A&E this morning and had a new catheter fitted which is going to remain in for a fortnight.  Can anyone share any experiences because I'm struggling to understand what's going on.

User
Posted 28 Mar 2022 at 21:17

Thanks Chris, you have given me one or two things to think about. The Catheter insertion was quite painful but I knew my urethra was sore as a result of the UTI. I spoke to the specialist nurse afterwards and she was quite annoyed that A&E didn't call for a urologist to fit the catheter on a prostatectomy patient.

I am seeing a urologist later in the week for a stuck drain removal. I'm going to take the opportunity pose some questions about the retention around what you have described. 

Thanks once again

Chris 

User
Posted 28 Mar 2022 at 21:20

Good luck Chris

User
Posted 28 Mar 2022 at 21:48

Sorry to hear this Chris, really hope you can get it sorted out with them and find out what’s going on x

User
Posted 29 Mar 2022 at 07:47

Chris, I'm not sure whether the clip is used in open surgery. The better access may mean it's not needed 

User
Posted 29 Mar 2022 at 08:09
Hi Chris, wishing you all the best and that all your problems are sorted very quickly
User
Posted 16 Apr 2022 at 14:37

Chris, I found knowing that I could self catheterise, took away the anxiety of wondering whether I would not being able to pass urnie normally. 

Hope you get sorted, remember to be gentle,if a catheter gets stuck on the way out, relax wait a few minutes and try again.

 

Thanks Chris

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User
Posted 28 Mar 2022 at 20:52

Chris, how hard or easy was the catheter insertion. The last time i went into sudden and full retention they had to stretch the bladder neck to get the catheter in and that was the day after a very minor and gentle dilatation.

My slowly developing retention was preceded by a slowing flow as the scar tissue swelled up to block the urethra The first retention was a surgical clip in the bladder. 

Any blood in the urine , could be bits of scab blocking the bladder. 

The retention when walking sounds like something could be settling in the bottom of the bladder.

Thanks Chris

 

User
Posted 28 Mar 2022 at 21:17

Thanks Chris, you have given me one or two things to think about. The Catheter insertion was quite painful but I knew my urethra was sore as a result of the UTI. I spoke to the specialist nurse afterwards and she was quite annoyed that A&E didn't call for a urologist to fit the catheter on a prostatectomy patient.

I am seeing a urologist later in the week for a stuck drain removal. I'm going to take the opportunity pose some questions about the retention around what you have described. 

Thanks once again

Chris 

User
Posted 28 Mar 2022 at 21:20

Good luck Chris

User
Posted 28 Mar 2022 at 21:42

I made a post in this thread about intermittent catatherisation .

https://community.prostatecanceruk.org/posts/t22995-Escaping-the-Catheter

As you can see I think it improves quality of life but a big caveat is that post surgery you will be repeatedly pushing the catheter past the wound which may not be good. So I hope all gets sorted out and your questions answered, but if this looks like it  will be  ongoing I hope self catheterisation will help you manage it.

 

 

Dave

User
Posted 28 Mar 2022 at 21:48

Sorry to hear this Chris, really hope you can get it sorted out with them and find out what’s going on x

User
Posted 28 Mar 2022 at 22:10

Chris

Just had a thought, I don't know if they use the hem o lok clip when performing open surgery. All the reported cases seem to reference laparoscopic or robotic surgery.

Thanks Chris

User
Posted 29 Mar 2022 at 07:43

Thanks for the link Dave. I actually read the whole thread. I take my hat off to you being able to self catheterise. That does seem a bit daunting to me but it clearly worked for you and sorted out your retention. My experience so far is that flow is good for a few days after a catheter comes out which does seem to back up the theory for self catheterisation. My urethra is still sore from the UTI at the moment although the catheter did go in okay yesterday, albeit painfully. This is one further possibility (after the soreness has cleared up) to explore with the specialist nurse/urologist later in the week.

What is concerning is that retention does not appear to be a normal side effect following surgery: it's more relevant to those who go down the HT/Rt route.

Chris

User
Posted 29 Mar 2022 at 07:47

Chris, I'm not sure whether the clip is used in open surgery. The better access may mean it's not needed 

User
Posted 29 Mar 2022 at 08:09
Hi Chris, wishing you all the best and that all your problems are sorted very quickly
User
Posted 16 Apr 2022 at 13:42

Well, the plan to keep me catheterised for a fortnight to see if my urinary retention would settle down failed miserably. After about two hours into TWOC I went into complete retention again. Bladder was emptied with a temporary catheter and I tried again. That worked for a bit then back into retention for a short while but this time it righted itself. Totally weird. There was talk about sticking another catheter in and at this point I mentioned Dave64's very useful advice about self catheterisation and they went along with it. It did sound a bit daunting when Dave mentioned it but after a short session with the Specialist Nurse I found it quite easy (as the saying goes: "a piece of piss"). So far, this seems a better option than having another indwelling catheter for a week or so and it might be what is needed for my bladder to settle down. Yesterday (first day) required a couple a couple of interventions which went without a hitch and so far today I've managed without any and I've not yet gone into complete retention. I'm just wondering how long my bladder will take to settle down. Chris

User
Posted 16 Apr 2022 at 14:37

Chris, I found knowing that I could self catheterise, took away the anxiety of wondering whether I would not being able to pass urnie normally. 

Hope you get sorted, remember to be gentle,if a catheter gets stuck on the way out, relax wait a few minutes and try again.

 

Thanks Chris

User
Posted 16 Apr 2022 at 16:02

You are so right about taking away the anxiety Chris. I left it too late the first time it happened. The pain got so bad I went into shock in A&E. Now I know I can deal with it and I can leave it until it definitely needs intervention rather than anticipating when it's likely to. With the current situation in NHS hospitals you definitely need all the DIY you can get. Chris

 
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