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Urology (Expert Forum)
Re: Urine Retention
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Re: Urine Retention
by HFHS MD JL, Jan 01, 1995 12:00AM
Posted By HFHS M.D.-JL on July 07, 1998 at 12:22:50:
In Reply to: Urine Retention posted by Brian on June 18, 1998 at 07:27:30:
About 6 months ago I had to go to the emergency room and be cathed because of excessive urine retention in my bladder and a inability to void. In that instance I retained 1000CC or greater. I was able to void (how well I am not sure) after the cath was removed.
I saw a uroloigist and during the initial exaime he found that I was retaining about 10 oz. after voiding. As a follow-up he they performed a cystoscope (i.e. looked into the bladder with a camera) at the hospital. During the examination they also checked my bladder pressure which appeared to be okay.
He concluded the opening out of the bladder was smaller than the norm and he prescribed 2MG Hytrin. I was told in the future surgery may need to be performed to make the opening larger. I was told that retro-ejaculation would likely occur if this was done.
I have been getting along (I thought) okay for the last 6 months and then it flared up again and they had to install another cath on one occasion because I could not void. At that time I was retaining about 750CC. The Dr. told me to increase the dosage to 4MG and he have me a cath kit. If I had to continue to use the cath kit I was to double the dosage again. I am to see him in a week and then they may do another scope examination and possibly do surgery. He felt that the bladder had gotten to full (I am told beyond 500CC the bladder starts losing pressure) and combining less bladder pressure and a marginal opening out of the bladder agrivated things.
With the increased dosage of the medicine I think I may be doing better but I still have to urinate frequently. In addition I think I am having some problems with side affects (dizziness at night, sluggish GI tract).
Does this type of surgery actually consist of enlarging the passageway by cutting out tissue? This would to me seem to pose a risk of urinary incontinence. My Dr. says that this is not a risk. Is this typically done on a outpatient basis with a local anesthesia or is it done with a general?
It seems very likely that surgery is a option we may have to take but I want to now how common is this surgery and what is the success rate and what are other potential complications other than retro-ejaculation
Dear Brian,
Benign Prostatic Hyperplasia (BPH) is a condition in which the prostate gland grows to a point where it obstructs the urethra, and adequate emptying of the bladder cannot occur. There are medical and surgical treatments for BPH. First, it must be determined that bladder outlet obstruction is the cause of urinary retention rather that a weak muscule wall of the bladder. Then medical management is usually begun with alpha blocking agents or 5-alpha-reductase inhibitors which relaxes the prostate smooth muscle and reduces prostate volume, respectively. Also minor lifestyle changes can be made such as no diuretics after dinner and limiting fluid intake.
Indications for surgery include acute urinary retention, bilateral hydronephrosis, chronic urinary tract infections exacerbated by residual urine,bleeding, bothersome symptoms, and bladder diverticula/stones.
The presence of bladder stones/diverticula and the size of the prostate may determine if a Trans Uretheral Resection of the Prostate (TURP) versus and Open Prostatectomy is warranted.
TURP has been associated with both early and late complications
Early: hyponatremia, failure to void, persistent bleeding/clot retention.
Late: recurrent BPH, bladder neck contracture, uretheral stricture, mild stress incontinence and impotence.
TURP had been shown to be an effective treatment for urinary retention with low morbidity and mortality (0.2%.)
More individualized care is available at the Henry Ford Hospital and its urban campuses by calling (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians notes and lab test results that you may be able to obtain. These will help us greatly.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
Sincerely yours;
HFHS M.D.-JL
* Keyword: BPH/ urine retention
In Reply to: Urine Retention posted by Brian on June 18, 1998 at 07:27:30:
About 6 months ago I had to go to the emergency room and be cathed because of excessive urine retention in my bladder and a inability to void. In that instance I retained 1000CC or greater. I was able to void (how well I am not sure) after the cath was removed.
I saw a uroloigist and during the initial exaime he found that I was retaining about 10 oz. after voiding. As a follow-up he they performed a cystoscope (i.e. looked into the bladder with a camera) at the hospital. During the examination they also checked my bladder pressure which appeared to be okay.
He concluded the opening out of the bladder was smaller than the norm and he prescribed 2MG Hytrin. I was told in the future surgery may need to be performed to make the opening larger. I was told that retro-ejaculation would likely occur if this was done.
I have been getting along (I thought) okay for the last 6 months and then it flared up again and they had to install another cath on one occasion because I could not void. At that time I was retaining about 750CC. The Dr. told me to increase the dosage to 4MG and he have me a cath kit. If I had to continue to use the cath kit I was to double the dosage again. I am to see him in a week and then they may do another scope examination and possibly do surgery. He felt that the bladder had gotten to full (I am told beyond 500CC the bladder starts losing pressure) and combining less bladder pressure and a marginal opening out of the bladder agrivated things.
With the increased dosage of the medicine I think I may be doing better but I still have to urinate frequently. In addition I think I am having some problems with side affects (dizziness at night, sluggish GI tract).
Does this type of surgery actually consist of enlarging the passageway by cutting out tissue? This would to me seem to pose a risk of urinary incontinence. My Dr. says that this is not a risk. Is this typically done on a outpatient basis with a local anesthesia or is it done with a general?
It seems very likely that surgery is a option we may have to take but I want to now how common is this surgery and what is the success rate and what are other potential complications other than retro-ejaculation
Dear Brian,
Benign Prostatic Hyperplasia (BPH) is a condition in which the prostate gland grows to a point where it obstructs the urethra, and adequate emptying of the bladder cannot occur. There are medical and surgical treatments for BPH. First, it must be determined that bladder outlet obstruction is the cause of urinary retention rather that a weak muscule wall of the bladder. Then medical management is usually begun with alpha blocking agents or 5-alpha-reductase inhibitors which relaxes the prostate smooth muscle and reduces prostate volume, respectively. Also minor lifestyle changes can be made such as no diuretics after dinner and limiting fluid intake.
Indications for surgery include acute urinary retention, bilateral hydronephrosis, chronic urinary tract infections exacerbated by residual urine,bleeding, bothersome symptoms, and bladder diverticula/stones.
The presence of bladder stones/diverticula and the size of the prostate may determine if a Trans Uretheral Resection of the Prostate (TURP) versus and Open Prostatectomy is warranted.
TURP has been associated with both early and late complications
Early: hyponatremia, failure to void, persistent bleeding/clot retention.
Late: recurrent BPH, bladder neck contracture, uretheral stricture, mild stress incontinence and impotence.
TURP had been shown to be an effective treatment for urinary retention with low morbidity and mortality (0.2%.)
More individualized care is available at the Henry Ford Hospital and its urban campuses by calling (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians notes and lab test results that you may be able to obtain. These will help us greatly.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
Sincerely yours;
HFHS M.D.-JL
* Keyword: BPH/ urine retention
