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Urology (Expert Forum)
Urinary Blockage Following seed implants for prostate cancer
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.
Urinary Blockage Following seed implants for prostate cancer
by Leatha__0, Feb 18, 1999 12:00AM
A close friend, age 78, had seeds planted in the prostate for treatment of prostate cancer. About a year later he had a TURP to remove scar tissue. Since then, he has to use a catheter anywhere from twice a day to once a week to allow urination. It seems to be worse after ejaculation. Why is this, and can anything be done to keep it from blocking? Thank you.
Doctor's Answer
by hfhs M.D.-AK, Feb 18, 1999 12:00AM
_
Dear Leatha,
Scarring after placement of interstitial radiation seeds to the prostate is a known complication of this surgery. Resection of the scar by performing a TURP, is certainly an option to relieve urinary obstruction. It is difficult for me to comment on your friends situation because I can only assume that the TURP was successful and that the urine channel is wide open. This leaves only one other explanation for your friends inability to urinate, the function of his bladder. Patients that are unable to generate enough pressure to overcome the outlet resistance of the bladder are still in retention no matter how open there urine channel may be. The bladder function can be assessed by a pressure flow study, part of a urodynamic work-up.
I cannot think of any relation to the event of ejaculation other than a temporal relationship. If your friend attempts to urinate immediately following ejaculation, his pelvis and musculature may not be fully relaxed. Voiding prior to sexual activity and then a reasonable time after sexual activity may alleviate this problem. I don’t think it is possible for the semen to clog the prostatic fossa.
Talk to your Urologist and see if he or she has any suggestion or feels that a pressure flow study is relevant. Continue with the catheterization both to prevent infection and retention, but to also give the bladder the best chance to function at full strength.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Urinary Retention
Dear Leatha,
Scarring after placement of interstitial radiation seeds to the prostate is a known complication of this surgery. Resection of the scar by performing a TURP, is certainly an option to relieve urinary obstruction. It is difficult for me to comment on your friends situation because I can only assume that the TURP was successful and that the urine channel is wide open. This leaves only one other explanation for your friends inability to urinate, the function of his bladder. Patients that are unable to generate enough pressure to overcome the outlet resistance of the bladder are still in retention no matter how open there urine channel may be. The bladder function can be assessed by a pressure flow study, part of a urodynamic work-up.
I cannot think of any relation to the event of ejaculation other than a temporal relationship. If your friend attempts to urinate immediately following ejaculation, his pelvis and musculature may not be fully relaxed. Voiding prior to sexual activity and then a reasonable time after sexual activity may alleviate this problem. I don’t think it is possible for the semen to clog the prostatic fossa.
Talk to your Urologist and see if he or she has any suggestion or feels that a pressure flow study is relevant. Continue with the catheterization both to prevent infection and retention, but to also give the bladder the best chance to function at full strength.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Urinary Retention
