inability to void - previous over expanded bladder

[st43]

My 45 y.o. husband apparently had an injury as a child resulting in a urethral stricture.  The first time there was a problem - he didn't recognize the sx's (neither did the MD) and his bladder was allowed to expand way beyond normal capacity. When they did realize it and tried to insert a catheter - it would not pass.  

They placed a suprapubic catheter and drained approx two liters gradually.  They did surgery to open the urethra and he had an indwelling cather for approx one month.

He recovered completely except for some loss of bladder sensation - but was able to urinate normally.

5-7 years later, (1999) his stream became smaller and smaller, so he saw a new Urologist who reccomended surgery again. He had the surgery and kept the indwelling catheter approx 5 days - removed it himself and urinated normally.

5-7 years later (10-2006) His stream had been getting smaller and smaller for a year or so - he finally saw the same Urologist who reccomended another surgery to open the urethra.  He had this done 10-12-2006 and appeared to be recovering more quickly this time - less pain, less bruising and swelling etc.

He kept the indwelling catheter for 5 days and removed it himself. He was unable to urinate that day - but thought maybe it was just too soon. He cathed himself to relive the pressure (he could feel some urgency to go) and drained a large amount of urine.

My husband saw the Urologist the next day and he reccomended keeping the indwelling catheter another week and try again.  Unfortunately he has been unable to urinate on his own since the surgery and now has an infection from the indwelling catheter.

I understand that the bladder was severely over expanded and therefore he might have problems empyting - but the morning of this last surgery, he was ABLE to urinate - just had a small stream and probably was not completely emptying his bladder.

So far, the urologist hasn't given us any explanation for why all of a sudden he cannot urinate at all and not much hope for the future except self cath several times a day.

Options?  Suggestions?  Thanks for any help.
STaylor

[Kevin Pho, MD]

Difficult to say without evaluation.  Treating any infection first is recommended.  Checking for any blockages (i.e. from an enlarged prostate) also should be done.  If the stricture continues to be present, another urological procedure may need to be performed.  Depending on where the stricture is located, a stent is a possibility.

Obtaining another urological opinion - preferably at a major academic medical center - can be considered if the problem recurs.

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.
kevinmd_

[st43]

0

[billt76]

A related discussion, bladder problems was started.