Urinary Retention after Prostatectomy

[Dan087]

Has anyone experienced urethral scarring or inflammation following catheterization after prostate removal surgery? I had robot assisted prostatectomy this past summer with severe urinary blockage following removal of catheter one week from surgery date. Ended up in emergency room and was re-catheterized for an additional week. Surgeon said it was likely inflammation that caused the blockage.

I am now five months post surgery and still experience mild to moderate pain when urinate. Contemplating a scope procedure to see what is going on in urethra. Very unpleasant. Just wondering if anyone on here has experienced anything similar and what you did to help alleviate the pain or fix the problem.

[cpcohen]

Something similar happened to me -- but it was about 4 or 5 months after surgery.

I had an almost-complete urethral blockage, with a drip-drip-drip urine stream.

After one urethral dilation (under sedation -- it's a painful procedure), I started doing self-catheterization to keep the urethra open.

That was 11 years ago. I started with a size 14 catheter, once daily. I'm still doing self-cath, graduated to a size 16 catheter, once every week.

I haven't had a recurrence of the blockage.

Urinary blockage is serious. Googling "urethral stricture" will get you lots of fun reading. From what I read (11 years ago), urethral dilation often has to be repeated. So I decided on self-cath -- much less pain, and done by me, not the doc.

I was trained by a urological nurse -- it took about a half hour. You need "clean technique", not "sterile technique". I haven't had any infections.

My sense is that docs often don't suggest self-cathing; I suspect many patients would avoid it. But my urologist thought it was a good idea, and supported me.

Please keep in touch -- I'd like to know how things work out for you.

. Charles

[Dan087 in reply to cpcohen]

Hi Charles, thanks for your response. I had a follow up with the surgeon and he scheduled me in for a cystoscopy. He mentioned if they see anything they might dilate the urethra. How bad is this procedure? You mentioned it’s pretty painful. The surgeon said I could either do it in his office with a local numbing agent or at the hospital under sedation. I’m pretty freaked out about the whole thing. At the same time I don’t want to continue along with this burning sensation. Is there a chance the urethral dilation could fix the problem?

[cpcohen in reply to Dan087]

Possible that the dilation will fix it. Procedure may have to be repeated. I would choose sedation.

[MelbourneDavid]

I had a near blockage (a "stricture" - a form of scarring) 4 weeks after my surgery. Treated surgically. Two years later I was having various pains around urination and had the rigid scope (under general anesthesia). Nothing found but the problem went away as I recovered from the procedure. Apparentlythat is quite common. I suspect some scarring that was stretched out by the scope.

[dadzone43]

A couple of the men in my support group had this. Not rare. Had cystoscopy to look inside. One had to self catheterize for several months. All of them had resolution of scarring and narrowing. Some have residual burning when they owe.

[Dan087 in reply to dadzone43]

Thanks, I met with my surgeon and he scheduled me for a cystoscopy. If they see anything he might recommend dilation of the urethra. Sounds painful to me and I’m worried about it. On the other hand, I want the burning sensation to end. Do you know anyone who’s had this done? Also, where is your support group located?

[dadzone43 in reply to Dan087]

Support group in Providence RI. I know several. The cystoscope often dilates the narrowing in the urethra. That may/may not be permanent. It for sure will give you burning when you pee for 20-14 days afterward. There are some medicines that the surgeon can prescribe to reduce the burning. It turns your time a red-orange color and it helps the burn.

[dadzone43 in reply to Dan087]

Phenazopyridine or Pyridium®

[TinCanSailor-Texas in reply to Dan087]

I am going into Urologist's office in morning for my 6th dialation in in 18years since successful Bachytherapy 2001. Scar tissue was not an issue until 10 yr.ago....I need dialation about every 12-15 months now. This was first time my Urologist offered, " his office or hospital out-patient."

Painful....not really, but definitely 100% uncomfortable.

Right now just a dribble or very weak stream with terrific burning sensation at tip of penis. Test just couple weeks ago show no infection.