Difficulty Urinating after removal of Foley catheter

[TECTOPCAT]

My father had a Foley catheter in for about 2 months due to surgery and rehab. The surgery was brain surgery and was for  hydrocephalus. No infection worked fine etc. He had some incontinence prior to surgery primarily due to enlarged prostate-he was diagnosed with prostate cancer years ago but his PS has always been relatively low and he is now 80. He is uncircumcized.

Yesterday he had the catheter removed but after 6 hours was only able to urinate about half a cup so a new  catheter was inserted and he was able to empty his bladder.

We didn't get a lot of feedback just the suggestion that it be tried again in about 2 weeks.

My question(s):

Do these discouraging results mean he will always need a catheter?

More importantly is there something that can be done to promote continence before then? Kegal exercises for men? Other exercises? More walking? Are there special rehap nurses or PT that help with this.

He is probably not up to self catherization.

A rehab doctor once mentioned weaning off of the Foley but I’m not sure how that is done.

Any suggestions?

Thank you

[Kevin Pho, MD]

Having a catheter in for 2 months can lead to something called neurogenic bladder, leading to difficulty in urination.  Tough to predict if a catheter will always be needed.  

"Weaning off" the foley means a gradual tapering off of the foley to help allow the bladder regain independent function (i.e. instead of simply stopping the foley, only remove it for certain hours of the day).  A regimen can be devised with your rehabilitiation doctor.  

You may want to investigate for any signs of obstruction that can lead to urinary retention.  An enlarged or inflammed prostate would be the most likely causes.  If there is no obvious cause, a cystoscopy can be considered for a more comprehensive evaluation.

If there continues to be difficulty urinating, a suprapubic catheter can be considered - this is a more permanent catheter.

These options can be discussed with your personal urologist.

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.
Medical Weblog:
kevinmd_b

**Note: I'll be away until August 14th - The forums will re-open then.**

[kevinmd]

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[kenoking]

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[Okie Grandma]

I just read the above & wanted to ask your opinion about my husband's condition. He is 70 & was diagnosed with extended bladder & after foley placement drained off 2000 cc @ intervals. Up until then he was urinating alright. {Obviiously he didn't know he wasn't totally emptying!} After being on Flomax 1 week & Proscar 2 weeks {prostate is said to be 4X larger than normal}, & removal of foley, he wasn't able to urinate. Straight cath was difficult to place & so foley was reinserted. Now suppose to wait another 3 weeks before attempting foley removal again. Isn't there some bladder retraining  by clamping off cather for intervals so it will get used to holding urine again. Thanks, BJ

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