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Difficulty urinating

Winchef's picture
Winchef
Posts: 13
Joined: Jun 2009

I had a RP on March 24, 2009 with nerve sparing on one side. 2 tumors with Gleason scores of 3+3 and 4+4. Surgery went well with very minimal pain. Recovery was a little challanging due to a blocked catheter, about a week after surgery, because of bladder stones, that sent me to er 2 days in a row. Excruciating pain when the cather backs up. I ended up travelling 2 hours to see my surgeon in London, Ontario and he did a cystoscopy and replaced the catheter. I had the catheter in for 21 days. I had bad a lot of bladders spasms and blood leaking from the tip of the penis while the catheter was in. No issues removing the catheter. No pain, just a strange sensation. No pain meds or anything like that required.
My problem now is that the flow of urine is so weak that it takes forever to go pee and now my output is about 1 ounce per urination, if I'm lucky. Now bladder spasms have returned to boot. I am now getting nothing but a DRIP DRIP DRIP flow. It has been about 3 months since the surgery. My next appointment is at the end of July for a follow up.
Incontinence is not a huge issue, it is just that when I have to go, it is immediate and urgent. Anything can set it off to boot, having my hands in water, a cool breeze, walking into an airconditioned room etc. I can usually make it to the bathroom but have to pee into a cup so that I don't wet my clothing due to the weak stream. At home I have a small funnel in the bathroom-very frustrating. The very low volumn means frequent visits to the bathroom. I have to go at least 7-10 times per night, so sleep deprivation is becoming an issue. I have tried to get in to see the urologist but to no avail. So, I have to wait until my July appt. Has anyone else been plagued with this problem?

Nothing in the way of erections yet so that is on the ajenda to be discussed. Just wondering if anyone else has had difficulty with urination after this surgery.

RRMCJIM's picture
RRMCJIM
Posts: 149
Joined: Mar 2009

This does not sound right to me, I am not a Dr, but not urinating sounds like something is still blocked. I am about a month out from surgery, and I pee like a young man again. I sometimes think I will blow off the back of the toilet.. lol ...Erections are still normal, ED has not been an issue for me, was getting erections while the cath was still in, very uncomfortable, but he saved the nerves from both sides. I might be tempted not to wait, and go to the ER and have this looked into, especially if you are concerned about it. The less stress the better.
Jim

ismetals's picture
ismetals
Posts: 70
Joined: Feb 2009

can't agree more Jim. There definily must be a blockage and it seems like some doctor should take the problem seriously.
Gary

Winchef's picture
Winchef
Posts: 13
Joined: Jun 2009

Thanks for the feedback. I am going to my GP on Wednesday a.m. and am going to ask him to put some pressure on the urologist to see me. Bladder spasms are getting stronger even though I am taking Buscopan every 6 hours now. Output seems to be getting less than 1 oz. now. I am going on vacation in early July and don't want to have to deal with anything while I am away.

shubbysr's picture
shubbysr
Posts: 87
Joined: Jun 2009

I agree with comments from Winchef and Jim. Your symptoms are not improving. I am @ 8 weeks post robotic and 6 wweks post catheter. I had my surgery at John Hopkins in Baltimore (8 hour drive for me). So, I need to use local doctors for any "immediate" problems. I feel as if I am a bother for the doctor, when I try to make an appointment. They have a "don't worry" "it's normal" attitude.
My own research led me to John Hopkins. I have no regrets, but wish local doctors could be more understanding or maybe the "human" touch?
Glad to hear you are persistant in getting care and going on vacation!

Jim (shubbysr)

Watch.repair.man's picture
Watch.repair.man
Posts: 49
Joined: May 2009

I am so sorry for all you have and are going through. I hope and pray your doctor can help.
Keven

Winchef's picture
Winchef
Posts: 13
Joined: Jun 2009

After my follow up appt. with GP, I asked him what he thought of me showing up at the ER in London, ON and telling them that I needed to see the urologist because I couldn't urinate. When I arrived I was in a bed within 5 minutes and within 10 minutes, an ER Dr. was attending me. He ordered a catheter be put in and after 2 failed attempts, a resident of my surgeon came down and was going to try to put in a catheter guided by a wire. He said if that didn't work, he would take me up to the urology clinic and do a cystoscopic and try to see why the catheter wasn't going in. I told him why wait for another failed attempt and just go up with the scope and see what was going on. He agreed that that was the most logical approach. Duh. I was brought to the cysto lab. We discussed what could be the problem and what the treatment options would be. I told him about the stones in the bladder post op and he said it could be a stone that could be falling into the bladder neck and blocking the flow of urine. If that was the case, surgery would be the course of option. That stressed me out as I really don't want to have more surgery. The other possible cause could be scar tissue and sure enough, that is what he saw. He dialated the bladder neck, very uncomfortable, and put a catheter in with some difficulty. I was told that I would have to have that in for a week and then a nurse would come to the house and take it out and make sure I could pee. If not, then worst case scenario, in it goes again and I would have to have it in during my vacation. I really hope that that is not the case. I was also told that it would probably happen again. Something to look forward to. (Yep, that was sarcasm) My follow up with the surgeon is on July 24th so we will have to see what the prognosis is. As my GP said, sometimes you just have to be your own advocate.

Watch.repair.man's picture
Watch.repair.man
Posts: 49
Joined: May 2009

Sorry you had to get the catheter again.
Does the doc think the scar tissue will shrink?
Keep us posted on how it all works out.
Keven

Winchef's picture
Winchef
Posts: 13
Joined: Jun 2009

The resident who did the dialation told me that in all probability I would have to have the dialiation for the bladder constrictions done again. When I was about 25 I had to have a catheter in for about 10 days. I spent the next 10+ years seeing different urologists and having uretheral dialations. I had everything from cutting the scar tissue to having to insert a tapered vial of sterile water into the opening to stretch it. When I spoke with the pre-op team about my concerns, they said yes, it could happen.
I get the catheter out tomorrow and as long as I can pass urine, then they will leave it out. If I can't go, then I will have to have it put back in and have to take it on vacation with me. Really hoping not to have to do that. I have an appt. with my surgeon on July 24 to see where my psa test results are and i'm sure scarring will be brought up. For sure it will be brought up by me.

Dave

shipjim's picture
shipjim
Posts: 130
Joined: Apr 2006

Boy,
This is the opposite of most of us. I do have to ask, are all the delays the product of socialized medicine? Is this is a course we face in the US? Hope your better, can an artificial spinchter make a difference?

Winchef's picture
Winchef
Posts: 13
Joined: Jun 2009

After the bladder neck dialation and sporting a catheter for a week, I am happy to report that I am still going. The stream is about half of original. It was nice to have been able to pee like a racehorse for a few days. The stream is about half of what it was but I can live with that. One thing I have noticed since the dialation is some leakage. I am using a pad a day and notice that when I squat down to pick something up or sneeze I have an occasional leak. I am also experiencing a lot of urgency to go, which I have had for a while.
I go to the surgeon tomorrow for my 4 month check up and will be getting my first PSA results. I have lots to discuss with him.
I think the problem with all the delays is the result of getting the head of urology in one of the busiest urology departments. Trying to get through the administration is the tough part. Once I got there, I was seen immediately and treated. Sometimes you just have to show up on their doorsteps. The nice thing about socialized medicine was that I got to choose who I wanted to see and didn't have to pay a cent for it out of pocket.

wolf
Posts: 7
Joined: Apr 2002

I've had a similar problem for years. My doctor is giving me 4 mg of cardura daily. This medication relaxes the muscles in the area and takes care of the problem for me.

Wolf

ClaynTexas
Posts: 3
Joined: Jul 2009

I wish you well Dave.

I just got out of the hospital yesterday and having severe bladder spasms. They hurt like hell but I'm not telling you anything you don't already know. I can only say I feel for you since your issues are far greater than mine.

Best of luck/care

Keep us informed of your progress.

ClaynTexas

Winchef's picture
Winchef
Posts: 13
Joined: Jun 2009

Yes, the bladder spasms are a royal pain. They do go away though. Just got back from my 4 month post op appt. My PSA was >0.01 He was very pleased with the numbers and said that basically they got all the cancer. He was disappointed that I still had to use a pad a day and I told him that it was since my bladder neck dialation. I told him that a few days after the dialation, the stream diminished to about half. Since then, it has been maintaining but I am leaking a lot more than pre dialation. He has now started on the residual ed since surgery. I have had only one semi erection. I was prescribed viagara which hasn't worked so far. Perhaps my expectations are not realistic. I am scheduled for classes for the injections and hope they work. I was also told that whereever I was at by 18 to 24 months is what I could probably expect as far as recovery goes. That was a little unsettling but it is what it is. Thanks for listening.

Dave

batterup
Posts: 3
Joined: Aug 2009

How are the injections going for you? Are they difficult to administer? I just had my 6 month follow up appt & PSA also >.01, no leakage but also no erection yet. I'm scheduled for injection training this Tues, Wed & Thur.

lion1
Posts: 239
Joined: May 2007

It all seems so early for injections. I didn't have erections for 8 months and started taking Cialis in the 9th month and it helped. I have noticed that alot of men are directed by their doctor to start these treaments much earlier than my Doc. My Doc wanted to wait for all the healing to occur--he new that the nerve sparing surgery would eventually kick in and it did. BUT, HE HAD NO ANSWERS FOR THE INCONTINENCE 3 YRS LATER--ADVISED THE ADVANCE SLING-but of course he was the surgeon and the urologists have tried everything else.

Lion1

Winchef's picture
Winchef
Posts: 13
Joined: Jun 2009

Still after two months, I have not received a call for the injection classes. I am feeling as though I have slipped between the cracks. I tried Viagara, which was given to me at my 3 month check up with very bad side affects. I had my gp prescribe some cialis with much better results. Still nothing usable though. I am getting a little anxious that it may not happen at all. I need to get rid of my negativity I think. How did your injections work for you? I am surprised that it took 3 days of classes. I was told it was a couple of hours max. Please let me know how you made out.

Dave

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