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Urinary issues post catheter removal

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User
Posted 22 Jun 2023 at 06:35

Hi,

I had my catheter out yesterday after two weeks post RARP. Whilst I passed the two/three pee test at hospital I have gradually struggled more and more over the past 24 hours.

over night was up a lot as bladder felt full but volume was definitely not full bladder worth and flow was down to almost dribble only. Also mild burning throughout urethra on urinating. 

my best guess is UTI as well as possible stricture from urethra join in surgery. CNS said she would phone me today as a follow up to check on my urinary performance.

i have antibiotics that they  gave me as well just in case, and have started taking those.

Just wondering whether others had similar issues immediately after catheter out. I have to admit that my original assumption was that bladder and urethra were simply getting used to the whole idea of empty bladder to full bladder, urges and remembering what happens next?

what was your experience of this?

 

User
Posted 22 Jun 2023 at 11:36
I've had something similar following Hifu: - focal therapy, partial ablation of prostate, one lobe (that had very localised cancer) zapped by high frequency ultrasound.

In my case I passed the Trial Without Catheter at the hospital but at home that night I went into such severe urine retention that I had to go to my local A&E for emergency recatheterisation. I gather this was due to the swelling of the prostate, presumably including the unzapped parts of it, after the Hifu. A few weeks later it is still a serious problem for me and I might start a separate thread on it.

More generally, I think burning pain with difficult peeing or during attempts to pee is characteristic of urine retention whatever the reason for retention, and isn't necessarily due to a UTI.

But for someone who's had complete prostate removal, there obviously can't be a swollen prostate left to squeeze the urethra and shut off urine flow. According to Professor Google (but I can't find the reference, sorry) after prostate removal there can sometimes be a stricture at the newly made join of the bladder and urethra, as already mentioned.

User
Posted 22 Jun 2023 at 12:46

The first few p***** after catheter removal is like pissing razor blades, so don't read too much in to that symptom unless it lasts more than a day or two.

I had urinary retention six months before treatment, so knew what to look out for. 

When I had hdr brachy I passed the post catheter urine test, but within an hour I knew that retention was happening. They wanted to discharge me, and said if it became a problem go to A and E. I refused to be discharged until they put a catheter back in.

Retention is a serious problem, the time of your post is 6:35 the time now is 12:35. So in those intervening six hours have things got better worse or stayed the same?

If things have not got significantly better, go to A and E now. There is no point in delaying and hoping for the best. You will be waiting about four hours in most AE hospitals. Things may get better or worse during that wait. If you do not go now, chances are you will have to go this evening or tonight, so I say get the ball rolling.

Of course if thing have got significantly better (not just "I think it's a bit better") in the last six hours great, the above advice is irrelevant. 

*Edit: the fourth word in my post seems to have been replaced with p*****. Not very helpful of PCUK, on a forum which deals with the urinary tract.

Edited by member 22 Jun 2023 at 12:51  | Reason: Comment on censoship

Dave

User
Posted 22 Jun 2023 at 13:12

I developed a stricture but that didn't start causing problems until a few weeks after the catheter removal. I and a few on here did have issues with the migration of surgical hem o Lok clips. There could be a bit of swelling that needs to go down or a bit of debris lodged in the water works.

As already said if you do feel you are in retention get yourself off to A&E or your urology department if possible. You don't need to put any extra pressure on the joint. You will probably be told to keep drinking plenty of water. Water is probably better than tea or coffee etc.

Thanks Chris 

 

User
Posted 22 Jun 2023 at 14:01
For the first week or so post RARP catheter removal my pee flow was about what it was before surgery (slow) but since then it has gradually improved until I am now peeing like a horse and it empties completely.

I just assumed that it was inflammation where the surgeon has sewn the urethra into the bladder which over time dissipates.

If it goes on longer than a couple of weeks then I'd seek medical advice.

User
Posted 22 Jun 2023 at 16:48

Hi CDB, I have been following your thread as husband had exactly the same last night after catheter taken out on Tuesday following RARP and I was so worried.  He also had some severe stomach pains.

He has been given antibiotics today after contacting the team so hopefully you will both feel much better over next 24 hours or so.

All the best.

Take care,

Tulippy 🌹 x

User
Posted 22 Jun 2023 at 17:41

CDB, this happened to me post RP. Unlike you, my retention came on gradually over a week or so. I kept putting off getting it looked at because it kept improving slightly then got worse to the point I had full retention. I was in agony in A&E. The Dr who inserted the catheter was quite dismissive that my bladder wasn't all that full. Perhaps he should try having is prostate whipped out and see how much his bladder can hold.

I had the catheter in for a few days but the same thing started happen after just 24 hours. Back to A&E for another cather insertion. This happened three times in all and in the end I was shown how to self catheterise, which isn't as bad as it sounds. However there was a happy ending to all of this. After self catheterising a couple of times at home the retention just went away and has never returned. I pee quite normally and long may it continue. The surgeon was unable to give any explanation as to what caused the retention, other than sometimes it it does happen. 

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User
Posted 22 Jun 2023 at 11:36
I've had something similar following Hifu: - focal therapy, partial ablation of prostate, one lobe (that had very localised cancer) zapped by high frequency ultrasound.

In my case I passed the Trial Without Catheter at the hospital but at home that night I went into such severe urine retention that I had to go to my local A&E for emergency recatheterisation. I gather this was due to the swelling of the prostate, presumably including the unzapped parts of it, after the Hifu. A few weeks later it is still a serious problem for me and I might start a separate thread on it.

More generally, I think burning pain with difficult peeing or during attempts to pee is characteristic of urine retention whatever the reason for retention, and isn't necessarily due to a UTI.

But for someone who's had complete prostate removal, there obviously can't be a swollen prostate left to squeeze the urethra and shut off urine flow. According to Professor Google (but I can't find the reference, sorry) after prostate removal there can sometimes be a stricture at the newly made join of the bladder and urethra, as already mentioned.

User
Posted 22 Jun 2023 at 12:46

The first few p***** after catheter removal is like pissing razor blades, so don't read too much in to that symptom unless it lasts more than a day or two.

I had urinary retention six months before treatment, so knew what to look out for. 

When I had hdr brachy I passed the post catheter urine test, but within an hour I knew that retention was happening. They wanted to discharge me, and said if it became a problem go to A and E. I refused to be discharged until they put a catheter back in.

Retention is a serious problem, the time of your post is 6:35 the time now is 12:35. So in those intervening six hours have things got better worse or stayed the same?

If things have not got significantly better, go to A and E now. There is no point in delaying and hoping for the best. You will be waiting about four hours in most AE hospitals. Things may get better or worse during that wait. If you do not go now, chances are you will have to go this evening or tonight, so I say get the ball rolling.

Of course if thing have got significantly better (not just "I think it's a bit better") in the last six hours great, the above advice is irrelevant. 

*Edit: the fourth word in my post seems to have been replaced with p*****. Not very helpful of PCUK, on a forum which deals with the urinary tract.

Edited by member 22 Jun 2023 at 12:51  | Reason: Comment on censoship

Dave

User
Posted 22 Jun 2023 at 13:12

I developed a stricture but that didn't start causing problems until a few weeks after the catheter removal. I and a few on here did have issues with the migration of surgical hem o Lok clips. There could be a bit of swelling that needs to go down or a bit of debris lodged in the water works.

As already said if you do feel you are in retention get yourself off to A&E or your urology department if possible. You don't need to put any extra pressure on the joint. You will probably be told to keep drinking plenty of water. Water is probably better than tea or coffee etc.

Thanks Chris 

 

User
Posted 22 Jun 2023 at 14:01
For the first week or so post RARP catheter removal my pee flow was about what it was before surgery (slow) but since then it has gradually improved until I am now peeing like a horse and it empties completely.

I just assumed that it was inflammation where the surgeon has sewn the urethra into the bladder which over time dissipates.

If it goes on longer than a couple of weeks then I'd seek medical advice.

User
Posted 22 Jun 2023 at 16:36

Thanks for that response. So I emailed the CNS at 7:30 am and 20 mins later she phoned me. Very reassuring and said that because I had a successful Cystogram/Fluoroscopy the previous day before taking it out that she felt it was unlikely to be retention. Told me to drink liquids as before and see how I went. It has got much better and flow has returned to something better than yesterday. She also advised to take the antibiotics they gave me yesterday as a precaution in the event of UTI.

She said that first couple of days it would feel weird and not be itself especially at night lying down but would get better.

so much happier now thanks. Ever watchful of retention though as does appear to very nasty indeed. 

It’s also really useful having access to this forum for any symptoms or weird things that happen on this crazy journey we are all having, so all and any comments much appreciated. Thx

User
Posted 22 Jun 2023 at 16:48

Hi CDB, I have been following your thread as husband had exactly the same last night after catheter taken out on Tuesday following RARP and I was so worried.  He also had some severe stomach pains.

He has been given antibiotics today after contacting the team so hopefully you will both feel much better over next 24 hours or so.

All the best.

Take care,

Tulippy 🌹 x

User
Posted 22 Jun 2023 at 17:41

CDB, this happened to me post RP. Unlike you, my retention came on gradually over a week or so. I kept putting off getting it looked at because it kept improving slightly then got worse to the point I had full retention. I was in agony in A&E. The Dr who inserted the catheter was quite dismissive that my bladder wasn't all that full. Perhaps he should try having is prostate whipped out and see how much his bladder can hold.

I had the catheter in for a few days but the same thing started happen after just 24 hours. Back to A&E for another cather insertion. This happened three times in all and in the end I was shown how to self catheterise, which isn't as bad as it sounds. However there was a happy ending to all of this. After self catheterising a couple of times at home the retention just went away and has never returned. I pee quite normally and long may it continue. The surgeon was unable to give any explanation as to what caused the retention, other than sometimes it it does happen. 

 
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