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Urine flow after catheter removal post-RARP

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User
Posted 16 Oct 2024 at 11:53

Hi guys.

I was wondering what sort of "flow" is common after catheter removal.

I had it removed on Monday, ten days post-op, and passed the TWOC. However, I'm not getting much flow when going to the loo. Is this normal? It's not exactly a dribble (until the end, anyway), but it's probably 25% of what I was getting pre-op in that what used to take 30 seconds now takes two or three minutes. It does all come out, though.

There's loads of comments on leaking and gushing but I haven't seen anything on actual flow quality and just want to make sure it's not an issue. 

User
Posted 16 Oct 2024 at 12:46

Hello mate.

It's possible that your urethra may have been narrowed during surgery. I'm not medically trained but, so long as it's not causing any great discomfort, I'd see how things go. However, if you feel that you cannot pee, acute urinary retention, you need to be seen urgently.

This is from our site:

'Difficulty urinating

Some men may find it difficult to urinate after surgery (urine retention). This is caused by scarring, which can cause the urethra to become narrow. This isn’t very common after surgery.'

To put your mind at rest it maybe worth ringing the nurses who did your catheter removal.

Best of luck.

 

Edited by member 16 Oct 2024 at 12:54  | Reason: Additional text

User
Posted 16 Oct 2024 at 13:14

I had normal flow right after twoc albeit with two streams fairly early on first thing in the morning sometimes. 

be mindful probably lots of swelling still and the anastomosis stitches don’t really begin to soften until ~5 weeks then soften their fastest until 6 months then slowly completely heal up to ~12 months.

if you have flow that’s a good thing so keep drinking and bounce any changes off your clinical team.

Incidently I found at six months caffeine caused me massive flow issues as it appeared to irritate my bladder lining and slowed the flow to the point of retention. I stopped drinking caffeine and the problem went away.

Edited by member 16 Oct 2024 at 13:15  | Reason: Not specified

User
Posted 16 Oct 2024 at 14:30

ðŸĪĢ😂 pleased to hear I’m not the only one. Can come out as perpendicular streams first thing or if slower stream so one has to go somewhere other than the pan ðŸĪŠ Laser targeting doesn’t work 👀 Gave my dental surgeon a laugh when he mentioned stenosis ðŸŦĒ 

Edited by member 16 Oct 2024 at 14:33  | Reason: Not specified

User
Posted 16 Oct 2024 at 14:52

DrC ,as already mentioned there is still a healing process going on in and around your new joint.  I and a few others did have hem o lok surgical clips migration into the urethra and or bladder,my first symptoms where at around five weeks and started with very smelly urine. I also got the twisted stream.

I did go on to form a stricture that required a few dilatations. My flow got down to 0.5mls per seconds just before a dilatation. If you want to check you average flow at home it is quite simple. Get a urine bottle or a cheap measuring jug, time how long it takes to urinate into the jug. Divide volume by time taken, e.g. 300mls in 30 secs equals 10mls/second. 

 

Thanks Chris 

User
Posted 16 Oct 2024 at 15:09

I seem to recall thinking it wasn't too strong at first. Your bladder has had an easy time with its muscle function for over a week. The catheter just allows free flow.  It might be leaking a bit to take away pressure.  There might be blood clots or scabs in the area. So as yet it might be early to say. Presumably you're drinking enough. 

Without a prostate it should be a very large flow and strong.  Although the level of acceptability might be a factor if it's less.  Mine has been strong for a long time.

 

 

User
Posted 16 Oct 2024 at 17:22

I would not get too concerned at the moment so soon after surgery.  The average flow for an adult male is supposedly around 20mls/second. Just keep your eye on things, if you ever think you are going into retention get some urgent medical attention.

Thanks Chris 

User
Posted 16 Oct 2024 at 18:40

Following my RP I noted my flow was much reduced. What you describe is pretty much where I was 2 years ago. Much improved now.

User
Posted 17 Oct 2024 at 09:51

Originally Posted by: Online Community Member

Originally Posted by: Online Community Member
I've just measured it at 250ml in one minute,

I hope that you wash out that jug before you use it for making gravy. 😂

😀  Actually I used a proper urine bottle but now you mention it I think it would make quite a nice gravy boat. It would certainly be a good conversation piece at our next dinner party!

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User
Posted 16 Oct 2024 at 12:46

Hello mate.

It's possible that your urethra may have been narrowed during surgery. I'm not medically trained but, so long as it's not causing any great discomfort, I'd see how things go. However, if you feel that you cannot pee, acute urinary retention, you need to be seen urgently.

This is from our site:

'Difficulty urinating

Some men may find it difficult to urinate after surgery (urine retention). This is caused by scarring, which can cause the urethra to become narrow. This isn’t very common after surgery.'

To put your mind at rest it maybe worth ringing the nurses who did your catheter removal.

Best of luck.

 

Edited by member 16 Oct 2024 at 12:54  | Reason: Additional text

User
Posted 16 Oct 2024 at 13:14

I had normal flow right after twoc albeit with two streams fairly early on first thing in the morning sometimes. 

be mindful probably lots of swelling still and the anastomosis stitches don’t really begin to soften until ~5 weeks then soften their fastest until 6 months then slowly completely heal up to ~12 months.

if you have flow that’s a good thing so keep drinking and bounce any changes off your clinical team.

Incidently I found at six months caffeine caused me massive flow issues as it appeared to irritate my bladder lining and slowed the flow to the point of retention. I stopped drinking caffeine and the problem went away.

Edited by member 16 Oct 2024 at 13:15  | Reason: Not specified

User
Posted 16 Oct 2024 at 13:29

Originally Posted by: Online Community Member
I had normal flow right after twoc albeit with two streams fairly early on first thing in the morning sometimes. 

😀 I forgot about 'snake tonguing'. I got more pee on the floor than in the bowl. I had to buy the wife a new mop!

User
Posted 16 Oct 2024 at 14:30

ðŸĪĢ😂 pleased to hear I’m not the only one. Can come out as perpendicular streams first thing or if slower stream so one has to go somewhere other than the pan ðŸĪŠ Laser targeting doesn’t work 👀 Gave my dental surgeon a laugh when he mentioned stenosis ðŸŦĒ 

Edited by member 16 Oct 2024 at 14:33  | Reason: Not specified

User
Posted 16 Oct 2024 at 14:52

DrC ,as already mentioned there is still a healing process going on in and around your new joint.  I and a few others did have hem o lok surgical clips migration into the urethra and or bladder,my first symptoms where at around five weeks and started with very smelly urine. I also got the twisted stream.

I did go on to form a stricture that required a few dilatations. My flow got down to 0.5mls per seconds just before a dilatation. If you want to check you average flow at home it is quite simple. Get a urine bottle or a cheap measuring jug, time how long it takes to urinate into the jug. Divide volume by time taken, e.g. 300mls in 30 secs equals 10mls/second. 

 

Thanks Chris 

User
Posted 16 Oct 2024 at 15:09

I seem to recall thinking it wasn't too strong at first. Your bladder has had an easy time with its muscle function for over a week. The catheter just allows free flow.  It might be leaking a bit to take away pressure.  There might be blood clots or scabs in the area. So as yet it might be early to say. Presumably you're drinking enough. 

Without a prostate it should be a very large flow and strong.  Although the level of acceptability might be a factor if it's less.  Mine has been strong for a long time.

 

 

User
Posted 16 Oct 2024 at 15:09

Thanks. 

I've just measured it at 250ml in one minute, so just over 4 ml/s which doesn't sound too bad compared with your pre-delatation value! And of course that was an average over a minute, not peak which would have been a little higher.

User
Posted 16 Oct 2024 at 17:22

I would not get too concerned at the moment so soon after surgery.  The average flow for an adult male is supposedly around 20mls/second. Just keep your eye on things, if you ever think you are going into retention get some urgent medical attention.

Thanks Chris 

User
Posted 16 Oct 2024 at 17:35

Originally Posted by: Online Community Member
I've just measured it at 250ml in one minute,

I hope that you wash out that jug before you use it for making gravy. 😂

User
Posted 16 Oct 2024 at 18:40

Following my RP I noted my flow was much reduced. What you describe is pretty much where I was 2 years ago. Much improved now.

User
Posted 17 Oct 2024 at 09:51

Originally Posted by: Online Community Member

Originally Posted by: Online Community Member
I've just measured it at 250ml in one minute,

I hope that you wash out that jug before you use it for making gravy. 😂

😀  Actually I used a proper urine bottle but now you mention it I think it would make quite a nice gravy boat. It would certainly be a good conversation piece at our next dinner party!

User
Posted 17 Oct 2024 at 13:14

Originally Posted by: Online Community Member

😀  Actually I used a proper urine bottle but now you mention it I think it would make quite a nice gravy boat. It would certainly be a good conversation piece at our next dinner party!

😂 Nice one 😂

User
Posted 03 Dec 2024 at 09:18
Just a quick update in case useful for others - after my original post, flow very gradually improved over the following weeks, then there was a step change improvement at around week six, after which flow returned pretty much to pre-op levels.

I still have the occasional slow flow, but generally flow is now back to normal. I'm also lucky in that incontinence hasn't really been a problem for me. Just the occasional slight leak during the day with none at night. I still use a single light pad a day but more for confidence than necessity.

 
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