Unable to urinate on my own

In Feb 08 I had a pelvic exenteration, with partial vaginal reconstruction, rectum reconstruction and descending loop colostomy (due to cancer). Since then I have been unable to urinate on my own. I was on Foley catheter for a month, then started self catheterizing but am now back on Foley as I  had problems during self cath.

My question is what options do I have? My surgeon has told me to wait a few months to see if my bladder would begin to fubction on its own. It's now 3 months and I've tried several times to urinate but it just doesn't happen. The only way I know I have to urinate is when I feel the pain of a full bladder.

Will I need to have my bladder removed and a bag installed? If so, how is this surgery done and how long for recovery?  

I will be ssing a urologist in a few weeks but want to know what to espect.

thanks for any help you can give me.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,

You are a very brave woman, having undergone a radical surgery. Yet you are approaching your current problem in a scientific way, trying to seek information, different opinions, and trying to help yourself. This is highly commendable, and I salute your spirit. I pray you get well soon.

Radical surgery very often results in damage to the lumbo-sacral plexys of nerves, and also the pelvic nerves. This disturbes the normal nerve supply to the bladder, which results in difficulty in passing urine.

You do not need to have the bladder removed because of difficulty in urinating. A long term catheter is usually advised. Many women have used it for years, without much problem.

Godbless.

[Vanessa Lacuesta]

Hi.

I understand this may not be easy for you. The foley catheter should remain at this point since the primary indication for an indwelling catheter is your inability to void normally. Your physician may test the voiding functions from time to time by removing the foley cath and observe you. If this does not seem satisfactory, the foley cath should be back in place.

I know this is uncomfortable. You may ask you doctor if physical therapy may help facilitate recovery.

Bladder removal is not indicated here. Just be patient and let us wait for the urologic consult for an assessment on the  extent of the condition .This will help in planning the next step of managing your case.