Cant Urinate after sed implants

[jfirvin]

I had seed implants for my prostate cancer in Jan 04 after 6 months of Lupron shots to reduce the prostate size. Ever since the treatment I have been unable to urinate unless my bladder is extremely full (over 800cc's) and then it is just in small amounts, and having to go every half hour or so. After 2 weeks like this I was catherized for 3 weeks, but when I took the cath out I was still unable to urinate so I had to start self-catherizing. At first I used a very soft cath but had to change to a much harder one after about 3 weeks. At about four months the Urologist put me on a drug cocktail of Flomax (which I had been taking all along) Bethanechol, Diazepam and warm baths twice a day, all with no success. I had a cystoscopy done and there was nothing obvious, some tissue damage near the bladder but not what he considered extreme since I had had both implants and later beam radiation. All along the Dr seemed to indicate this happened some time but usually started to get better after a year. I started to have trouble catherizing myself, pain and the fairly rigid cath not wanting to go in. In July I went for another cystoscopy and the Dr was unable to perform it because he couldn't get the tube in. At that time he had me catherized again and scheduled to have the cysto done under general anesthetic. In July He did the cysto and also dilated me, but when I took the cath out I was still unable to urinate. This time he put me on Uroxatral and Diazepam but I have noticed no difference. At the last visit I asked him about surgery, but he said he thought it was more muscular then tissue damage or scaring. I have also had sonograms to rule out kidney problems and the CT scan I had done about a year ago showed the prostate was only slightly enlarged. I also had a additional Lupron shot after the surgery to make sure the prostate remained small. My Oncologisat/Radiologist said he had never really seen this problem last so long. I have been going to a major Uroliogical clinic in Jacksonville FL, Would the Mayo clinic here have a specialist that might be able to help me. I am starting to get frustrated after not being able to urinate for over 16 months

[Kevin Pho, MD]

Persistant urinary retention can occur in 5 percent who receive brachytherapy.  There seems to have been a comprehensive workup done already.  Basic things like infection and stricture have already been evaluated for.  You can consider further urodynamic testing to evaluate for any functional abnormality of the urinary tract.

If every test comes back non-revealing, there is a percentage of patients who need chronic catheterization - either intermittent catheterization or an indwelling cathether.

Before going towards that route, you can discuss your case further at a teriary care facility like the Mayo.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com