Bladder Retention

[asha34]

I'm a 52 year old male.  I retain urine in my bladder.  It causes infections.  I'm now on an antiobiotic but cannot remain on it indefinitely.  I've twice had a urethral reconstruction to remove a stricture.  My prostate is only slightly enlarged -- and surgery on it is not recommended.  My urologist tells me that the only way to remove the 300-400 ccs of urine in my bladder after urination is to catheterize myself twice a day.   I am aghast at the prospect and I'm looking for options -- any options but the one presented to me.  Any ideas?

[rmprdl1964]

If there is a blockage due to a stricture than this should be cleared, however you state that this has been done twice. You also state that the urologist does not recommend surgery on the prostate (most likely TURP).

I myself have had a TURP and resection of the bladderneck in 1995 at the age of 31.
In 1996 I was found to have a neurogenic bladder, meaning that I could not control the urinary sphyncters. Due to having large amounts of urine retained in the bladder I used to end up with severe UTI, kidney infections at about every 3 to 4 months. It was determined that I would benefit from self catherization. I have been doing so at least once a day since 1996.

If you can't fully empty the bladder than self catherization would be the only option. As Dr. Singh stated there is a risk of getting UTI from inserting the catheters, however the risk of remaining urine causing a problem would be greater. It is my feeling that your urologist thinks that the benefits of self catherization outweight the risks of infections caused by foreing matter from the catheter.

With self catherization I have had some UTI as well as kindey infections, but it is less frequent. I wash and reuse my catheter during the day and use a catheter a day. It would be best to empty the bladder in the morning and than try to void normaly for the duration of the day. Than once again prior to going to bed. This way it is less likely to introduce bacteria into the bladder.

Self catherization takes time to get used to, but it is not as bad as it sounds. I have done so since late 85 and daily since 1986. Never be in a hurry to self cath. Take your time and try to relax as much as possible. Currently I have a suprapubic Foley in due to a fistula. My urologist thinks that I might have caused to fistula due to using a Foley while I was sick and that I might have inflated the balloon prior to it being inside the bladder. It is therefore important to be relexed and never hurried.

If you have any other questions in regards to self catherization feel free to ask me, I will do my best to give you answers.

One thing to ask you urologist is the option to dilate the urethra where the strictures are present using sounds. This might need to be done several times and might be an alternative to using self catherization. This most likely needs to be done by the urologist and cannot be done by yourself. A sound is a blund objec that is passed into the urethra to tretch narrowing areas of the urethra.

All the best.

Ron

[Dr J Singh]

Hi,
If you are retaining urine in your bladder, it’s probably due to some obstruction inthe urinary tract which could possibly be due to the urethral stricture or due to the enlarged prostate. I don’t think catheterizing oneself is a good idea as it’s not only uncomfortable but also significantly increases the chnaces of introducing the infections in the urinary tract resulting in more problems. I feel you should consult another urologist and seek an opinion as you might need some procedure to take care of the obstruction. I sincerely hope that helps. Take care.