my father suffered CVA in Jan-2009.In June-2009,he developed urine retention.HE was put on Foleys Catheter for 21
days,after 21 days catheter was removed ,but he could urinate about 50 ml in7 hrs,He was again put on Foleys Catheter.He was prescribed URIMAX(.4mg) to be taken once daily.USG shows wt.of prostrate to be 36 gms.Doctors have advised TURP.
My question is ,wether there is only one medicine URIMAX ,ONLY for treatment of urine retention.IF not please suggest other medicine so that my father need not undergo TURP,more-so-over my father aged 76 years did not have any urinal complain before JUNE-2009.Is this urine retention because of any infection,why doctors are thinking of TURP,IS there no alternative for curing this urine retention without surgery.
Hi, Urinary retention is a common problem in the elderly male. A stroke can cause urinary retention by altering the brain's ability to cause the bladder to contract on demand. The CVA preceeded the retention by 6 months so it's unclear whether this is a factor. It's not uncommon for patients to have an unrecognized problem causing difficulty voiding after a CVA that became apparent later in time. The second possible problem could be an enlarged prostate (BPH) causing obstruction of the urethra resulting in retention. BPH usually occurs slowly over decades and I suspect your father was not emptying his bladder completely 3 months prior to the retention episode. This problem (BPH) occurs in over 80% of men. An Alpha blocker (Urimax) is the appropriate drug to try. The question is what to do when the Urimax and prolonged catheter drainage do not reestablish normal voiding? Since a prolonged catheter drainage will eventually cause problems with infections and urethral pain, It is recommended that he be started on intermittent catheterization. Your father can be easily taught to sit on the toilet and pass a catheter into the bladder every 4-6 hrs to drain the urine. The catheter is immediately removed so he is catheter free between caths. This way he can attempt to void on his own and hopefully empty his bladder a lot better. If he can't or won't cath his bladder the doctor can do a urodynamic test. It's a bladder function test, done by filling the bladdeer with water and testing the bladders ability to contract and whether there is an obstruction. Almost any Urologist can do it in the office and it can sort out bladder causes of retention vrs outlet obstruction problems vrs both. If his bladder contracts, and/or there is an obstruction, and pills are ineffective, then he may certainly need the TURP or a similar procedure to relieve the obstruction. The alternative is continued intermittent catheterization, while adding a second drug Proscar to try to shrink the prostate and get him voiding. This is not the best alternatives because studies show that prostates respond best to there drugs like proscar if they are 40 grams or larger and it takes 6-12 months to work . Start with the urodynamic evaluation to determine the correct reason for the retention, but most men his age are obstructed and will probably need surgery at some point. Good Luck.
I am a male with almost exactly the same symtoms as in 'Treatmnt for Urine Retention' above, except I am age 47, not 76 ...and feel like my current doctor is too prone to advise a TURP, when I really don't want surgery.
I am told my prostate is not that large, and I have difficulty urinating that seems to be getting worse, as I've just last week increased a dosage of Hytrin from 5mg to 10mg, with only marginal benefit (Hytrin used to work great at only 5mg). I've been originally told that it's likely an inability to relax the bladder sphincter, by one urologist, and told that I may need a TURP by my current urologist, who seems to see the problem differently. On top of that, I think there has been an occasional/periodic slight burn or stinging for several years now (it's so hard to clearly feel what the heck is really going on). I have some ED and I have a general 'dead' feeling down there, but some pointed discomfort around the groin and pubic area sometimes. I also feel uncomfortable like I may have an UTI or something. I don't want surgery - Im only 47. Confused and worried. ???
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