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Unable to Urinate after Catheter Removal

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Posted 7/26/2012 10:43 PM (GMT 0)
Hi, I posted a similar message on a older thread and was advised to create a new one. Apologies to those who have read it already on the older thread.

I had a Da Vinci radical prostatectomy performed a little over a week ago and had my catheter removed yesterday. However I was unable urinate and was advised to self-cath to induce a stream. I attempted this with limited success - I couldnt get it to the bladder but the cath seemed to create enough pressure so that some of the urine flowed out. I went to my URO's office this morning and they also couldn't get the cath into the bladder, so they arranged for me to go to the ER today to have a a smaller one reinserted. This was accomplished, thankfully.

They suspect that swelling is the culprit. As someone mentioned above, the pain of this experience is such that you'll gladly allow someone to insert a tube into your penis or even do it yourself. I thought I was going to explode. I was shaking and lost control of some other bodily functions. I'm not a drama queen, and no stranger to pain; I bore the pain of the surgery recovery with a handful of Tylenol only.

I'm re-cathed now for another week, but am terrified that it's some bizarre scar, and not swelling that is the cause. I'm praying a lot right now.


Steve, aged 48.
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Posted 7/26/2012 10:53 PM (GMT 0)
hey steve,

i gave you a full answer on the earlier post, guess it disapeared when the new thread was started. was going to copy and paste it here, but can't find it.

your problem is one that i am very experienced with, having been on 21 catheters with a total of 1 1/2 years of cath time. if you have any questions related to this issue, be more than happy to help you.

david in sc
Posted 7/26/2012 10:54 PM (GMT 0)
Finally found it, so now my original answer will be here in your thread:

Steve in NY, you might want to start a new thread, you attached to a two year old thread and it might get lost in the shuffle.

Welcome here. I know all about catheters, as my original one was in for 63 days. THen for nearly two years, I had constant stricture problems, mostly related to over-scarring. I was on 21 caths altogether, and finally was on a suprapubic catheter for 51 weeks, until I underwent a bladder by-pass surgery, leaving me with a stoma (hole) in my side, which I now urinate into a plastic holding bag, and still have to hook up every night to the large catheter bag. Its no fun.

There is no pain quite like that of being blocked up and not being able to pee. Your doc may need to go up with you with a scope, and look around, to make sure that you are not scarring up or having more serious stricture issues like I did. Often, the blockages are right at the bladder neck. In many cases, they can cut away the scarring, or dialate your urethra and open it up.

Good luck, and let me know how that goes. You are preaching to the choir with me on this subject.

David in SC
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Posted 7/26/2012 11:30 PM (GMT 0)
Hi STEAVE,I really know what you are talking about.

you may have scartissue and you doc needs to take care before you be in and out of the ER. yeah

Posted 7/27/2012 12:11 AM (GMT 0)
Not to get contencious but I would question why your doctor or clinic let you leave the Catheter Removal appointment before you produced a stream on your own after removal............When mine was removed (2 weeks, ran out of percocet at 11 days) they made it very clear that if I couldnt pee on my own I would be back in the catherter mode asap.......
Posted 7/27/2012 12:28 AM (GMT 0)
Steve,

Welcome to HealingWell. Sorry you had such a bad experience.

I don't have any personal experience with this, but it's not all that unusual to have to go back for a re-cath. I wouldn't get too freaked out about it, but I agree with zampilot -- it sounds like your doc didn't handle the situation too well.

Hang in there. You've had your piece of bad luck, so everything should go smoothly from here. :)
Posted 7/27/2012 1:50 AM (GMT 0)
Steve,
Welcome to Healing Well.
I had "the pleasure" of not being able to pee and needing to be catheterized. However it was after my sling surgery, not the daVinci R.P.
I managed to urinate a little after they removed the catheter so I was sent home. But about 10 hours later, things decided to close up. By the next morning the pain was rather intense. The ride to the hospital was not my finest hour. When the cath went in I shot urine into the pan so hard it squirted up the other side and onto the floor. How do you spell relief? F-o-l-e-y.
It will get better. Good luck.
Jeff
Posted 7/27/2012 2:33 AM (GMT 0)
Thanks to all of you for your insights, whcih are very helpful.

I can't fault the doctors office...I put out a good stream immediately upon removal. It was about 8 hours later that I noticed how easy it had been to keep dry. I thought "gee, this incontinence thing isn't so bad". Then the agony commenced and I attempted the self cath with limited results. What an oblivious fool I was!

I'd closed up so tightly that the ER Doctor almost had to resort to using a guide wire. The cath I'm using now is one of the narrowest. As i learned a few minutes ago, I can't even drink a big glass of water without overloading it's draining capacity!

Thanks again, gentlemen.
Posted 7/27/2012 2:46 AM (GMT 0)
steve,

i agree with you, i wouldnt be blaming your doctor. after my first cath was removed at 63 days, i peed fine for the first 4 hours, and like you remarked, had no problem holding it in, but like you, it was because i was already blocking up, lol.

you know you are in trouble if they can't get the smallest guide wire in place, i was in my 2nd ER situation with that happening, and at the last moment, they were able to get it in, and placed what was a child's size cath in place, until my regular uro had a chance to fix that particular stricture. had they not been able to get it started, it would have involved an emergency op to quickly put in a suprapubic catheter.

for a small group of men, they say in the 3-4% range, they can have chronic stricture problems, so hopefully you won't be in that elite group, its not fun, trust me. a few other men here at HW had singular stricture problems, once their uro dialated their urethras, it pretty well cured the problem. but for thos of us that have severe scarring issues, it usually ends up being more of a chronic condition.

good luck again, i know that none of this is any fun.

david

p.s. you mentioned self-cathing. they had such a dificult time sewing my urethra back to my bladder neck, thus the 63 days of waiting, that i was not allowed to self cath by my surgeon, as he was afraid that all i would do is damage myself further. not sure i could have done it, ended up being really traumatized by all the stricture and multiple catheter troubles i had.
Posted 8/1/2012 9:12 PM (GMT 0)
Hi all,

My catheter was removed about 6 hours ago and Things appear to be flowing quite freely this time as opposed to last time. Thanks for all your support. Now I have to start haunting the incontinence forums. ;-)
Posted 8/1/2012 9:23 PM (GMT 0)
Glad, and hopefully, that is behind you. Now on to being dry! Good luck.

david
Posted 8/1/2012 10:24 PM (GMT 0)
Great, hope things continue to stay open and , at a later time, will close naturally, so you can have the best of both worlds.
Posted 9/26/2012 1:26 PM (GMT 0)
Im new here and reading this helpful thread. I am very impressed by all the good will shown.
I've had prostate problems for many years in reduced urine flow. Im 71 yrs old. I had my first complete stoppage a couple of weeks ago and went to the Emergency room for a catheter after being unable to urinate for a couple of days (I was scared of the catheter). Anyway, I thought that my flow would return after wearing the catheter for several days. I avoided seeing a doctor (poor thinking) as 'normal'-reduced flow always returned in the past. So, after ten days I had the catheter removed yesterday... I went home and I couldnt pee.. I had a horrible several hours until I got a new catheter. I nurse told me that I should have done bladder exercises the day I was to remove it... pinching the tube for fifteen mins and releasing it every three hours.. I don't know if it would have helped but I do know that I never want to go thru what I did yesterday again.
I am in Mexico and have only dealt with emergency rooms both times until now... I go to a Urologist ASAP now... If anyone has any comments to make about anything but my stupidity, I would appreciated reading them... also, scarring has been mentioned frequently above... what is this scarring and what causes it? is it possible that I have such without having had surger yet? many thanks
Posted 9/26/2012 8:17 PM (GMT 0)
sopelote,

Are you taking any meds for your condition? If not I recommend starting with an alpha-blocker such as Flomax, Doxazosin, or Terazosin, and supplement it with Avodart or Proscar for longer-term relief. There is also anecdotal evidence that the herb Saw Palmetto sometimes helps. I'm on Doxazosin and Saw Palmetto myself and haven't needed to add the Avodart or Proscar yet. I also have the ability to self-cath and have done so on several occasions when my fear got the best of me. It's not as bad as it sounds.
Posted 9/27/2012 9:49 AM (GMT 0)
thanks for replying Otfence. Yes, I finally got to the Urologist yesterday and he gave me hope...and medication... the Avodart and Proscar, one in the morning and the other at night. He also disconnected the bag from my catheter and added a syringe-stopper which i am simply to open every two hours to let the urine out. This way my bladder will regain it's ability to void. This really was good news 'cause I coudn't see how the heck I was ever going to pee on my own after the failure the day before. I return in five days to remove the catheter and try urinating on my own again..I go to the office early in the day, I suppose to have time to have it work. The following week I am to get an ultra sound. I was given the rectal exam and he said that 'yes, you surely have a big prostate'...so, I guess the ultra sound will tell if I will need surgery..? ...at least this gives me space as beforehand, I could only see myself going directly to the operating room. ..Any comments, suggestions, insights from reading my experience would be greatly appreciated as all this is new to me....I was told to take the two medications without missing and return in five days to try out urinating without the catheter...and to avoid really fatty foods and alcohol.
Posted 10/2/2012 9:47 PM (GMT 0)
my present situation, please read and comment if you would. thks
hello, thank you for responding... I'm 71 years old and have had diminished urine flow for years. But just a few weeks ago, after having imbibed more alcohol than usual for two weeks and having eaten very/ hot food for two weeks, in the night my urine stopped, I could not urinate. I waited another two days still couldn't pee and then I went to the hospital and got a catheter..I know this seems stupid but that's what I did..I couldn't think clearly.
I figured that without alcohol and chille , I would be able to pee the next day or a couple days later.
.So, that was still my thinking with the cath. and ten days later, I had the catheter taken out but no luck...had to have it re-inserted that night, couldnt pee at all ...went to an Urologist the next day...he told me yes I have a large prostate after the exam. He took off the bag and told me to retrain my muscles to urinate by simply stopping it with a syringe and letting it out each couple of hours, that the bag wasn't helping but hindering my bladder from expelling..
He seemed confident that if I returned in five days, he could remove the cath. and I would be able to pee..afterwards, I was to go get the Sonigram study... well, I tried everything that day but never got more than a few drops now and then. I had a strange tingling sensation thru my pereniam and anos that was strange... I remember that I had that same feeling while urinating the week before my first incident... could it be a lingering infection? I haven't had experience with this..Anyway, I called the specialist after several unsuccessful hours and he told me to get to a hospital right away and get another cath.
Well, I must have gone to the wrong hospital because it was a nightmare experienc. The medic tried six different caths. and none worked..he said that I had been blocked by blood clots..and showed me one ..several times he was pushing the tube way into my body and pulling it out again and again.....my penis at this point was traumatised and numb so I just watched in pain from the unvoided urine. By the time he was finished (he gave up and said I need an operation) there was blood everywhere..I went immediately afterwards to the General Hospital ... They had trouble getting the cath. to drain..all that was coming out was the water they shot in and dark blood. After three hours of this and nothing progressing, another Doctor came in and used a larger cath. (22?) , and thank God it worked!
OK....after this harrowing experience (s)....I am home resting in bed with the cath and bag.
I only know one thing now, and that is that I want to be able to urinate on my own like I was doing a month ago. I feel positive about eliminating all irritating substances and alcohol from my diet..I don't know if the blockage was formed by my prostate (will go for sonigram in a week) or infection or blood clots or un conditioned muscles due to cath.. I just want to solve this problem first..then, I will feel better and be able to make clear, informed decisions...right now, i feel like an invalid.... my cath. bag is voiding urine a tintish color of tea,.(blood) and I am taking anti-biotics.. any comments are more than welcome....thanks
Posted 6/29/2014 12:14 PM (GMT 0)
Have read the 14 pages on the topic and very helpful. After 4 days with the Catheter in place following a bladder inspection, I removed the Catheter myself yesterday morning and within a few minutes was comfortably peeing clear urine. All day yesterday, i continued to pee easily and frequently, without pain,with no great flow but normal for me. Felt great! had dinner with 2 glasses of wine, went for a big walk, off to bed with one last pee. Woke up this morning and can not pee at all but the need and pain is there to do so, Unless something happens soon we will be off to the hospital to get a new Catheter. I saw a mention of alcohol in the thread, is it a problem? Should I try more water to precipitate the peeing when I am already in pain? If they install a new Catheter which relieves the problem temporary should I try removing it immediately to see if that did the trick?
Posted 6/29/2014 1:04 PM (GMT 0)
You need to see a doctor and follow the advice given by the doctor
Posted 6/29/2014 3:49 PM (GMT 0)
JeffTheChef,

Welcome to the forum. Sorry you have troubles but glad you found us.

You sound like a sensible guy. That being the case I am sure you've already headed off to the hospital to get yourself fixed up. And like Patrick said, those are questions to be answered by your doctors, not by us.

We have lots of Jeffs here. Dunno why. Quite a few Susans too. But we've had really good luck with Jeffs so far -- some of our best, most helpful guys are Jeffs and we are always glad to welcome another one.

I started a new thread for you so folks can say hello. It is here:

www.healingwell.com/community/default.aspx?f=35&m=3118939

Post Edited (PeterDisAbelard.) : 6/29/2014 9:53:13 AM (GMT-6)

Posted 7/19/2015 9:27 PM (GMT 0)
I had robotic prostate surgery on June 26th at UAB Birmingham and then came home to Fort Walton Beach, Florida. They removed the catheter here on the 6th day but I didn't pass any urine on the 7th day so I had to make two trips to the emergency room on the 8th day for reinsertion of the catheter and tests. Apparently there was scabbing and debris in the bladder causing blockage. They did a "backflush" of the cathe and that cleared it. I kept the cathe in for a total of 19 days, removing it five days ago. I can now only "dribble" but I can sometime force a weak stream by clamping down with my abdominal muscles. The instant I relax the flow stops. The doc put me on "Flowmax" and I assume it's working? My pad dry at night and in the morning I can do my "dribble & force" thing but quantity is very low. Throughout the day I feel my bladder is full but I cannot force it out. I keep trying all the time and I get some "drips & dribbles" but nothing that would fill a teacup. I am a bit worried about it as I do not want the pain and discomfort of that cathe again. My local doc says to wait, it'll get better as the bladder & urethra are still swollen. I go back to Birmingham on August 10th and it'll be good to see them. I hope I'm better by then but I am very worried that I cannot urinate even a medium stream. Nothing I can do I guess but keep trying.
Posted 7/20/2015 3:55 AM (GMT 0)

onthefence said...
sopelote,

Are you taking any meds for your condition? If not I recommend starting with an alpha-blocker such as Flomax, Doxazosin, or Terazosin, and supplement it with Avodart or Proscar for longer-term relief. There is also anecdotal evidence that the herb Saw Palmetto sometimes helps. I'm on Doxazosin and Saw Palmetto myself and haven't needed to add the Avodart or Proscar yet. I also have the ability to self-cath and have done so on several occasions when my fear got the best of me. It's not as bad as it sounds.

Here's an alert regarding "Flomax"; it has a very serious effect in lowering blood pressure so if you have high blood pressure and are taking one of the blood pressure lowering medicines, you better coordinate with your doctor before taking the Flomax. My pressure went down to 98/54 from its usual 130/56 and I was told to stop all blood pressure lowering medicine until I was off Flomax. Be advised....
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