Urinary Retention after Robotic assisted Prostatectomy

Posted by trimmer @trimmer, Nov 6, 2022

Is anyone experiencing recurring urinary retention and pain in the urethra post Robotic assisted nerve sparing Radical Prostatectomy? After my husbands initial surgery he was told he had a bladder neck contracture and a laser incision surgery was performed. Now the contracture seems to be returning. Pain, urine flow is not straight and trouble emptying the bladder. Just wondering if anyone else has experienced this and what advice someone may have moving forward.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Hi @trimmer,
I'm tagging @rec48 and @paul55 as I believe they also experience urinary retention related to prostate cancer treatments. @predictable may also have some thoughts to add.

While we wait for others to chime in, you might also appreciate the comments in these related discussions:
- Urine Retention: Tight Pelvic Floor Muscles & Stretches https://connect.mayoclinic.org/discussion/urine-retention-tight-pelvic-floor-muscles-stretches/
- Bladder neck constriction https://connect.mayoclinic.org/discussion/bladder-neck-constriction/

REPLY

Hello, I had a Radical Robotic prostatectomy on 8/18/2022; ever since I had the catheter removed, I've had a very weak and thin stream when urinating along with pain towards the exit of the penis as well as a stream that has a mind of it's own and can go in different or forked direction to where I always have to sit to urinate.. I've also taken 3 rounds of antibiotics for a MRSA urinary tract infection. When I told the doctor about my symptoms, she thought it was something that would improve with physical therapy which I'm attending for urinary incontinence and perineal pain. I had also told her I'm pretty sure I have a urethra stricture but she didn't want to do a cystoscopy at the time as she thought it was too soon after surgery as it had only been about 3 weeks and said strictures are rare. Well, last week, I had trouble urinating where just drips were coming out; I had to sort of manipulate towards the exit of my penis which helped the thin flow to start up again. (this was quite scary). I was able to get an appointment with my urologist this past Monday the 7th. The urologist attempted to do a cystoscopy but was unable to insert the scope, she then tried a metal object which I was told to try to dilate the urethra which also would not go in, she then tried a thin wire which can also be used which also would not go in. She said it's likely a stricture caused by the catheter at the time of surgery. I'm now scheduled for a Cystoscopy, retrograde urethrogram and urethral dilation on Friday, they'll have to put my under with anesthesia because the urologist was unable to insert anything into my urethra in the office visit. I'll have to also go home with a dreadful catheter for a few days; I'm told the dilation may just be temporary as the stricture can return. I'll also have to self catheter at home to keep the dilation stretched. Ugh, I'll try to keep you all aware of how it goes. Wish me luck.

REPLY
@cirrussantafe

Hello, I had a Radical Robotic prostatectomy on 8/18/2022; ever since I had the catheter removed, I've had a very weak and thin stream when urinating along with pain towards the exit of the penis as well as a stream that has a mind of it's own and can go in different or forked direction to where I always have to sit to urinate.. I've also taken 3 rounds of antibiotics for a MRSA urinary tract infection. When I told the doctor about my symptoms, she thought it was something that would improve with physical therapy which I'm attending for urinary incontinence and perineal pain. I had also told her I'm pretty sure I have a urethra stricture but she didn't want to do a cystoscopy at the time as she thought it was too soon after surgery as it had only been about 3 weeks and said strictures are rare. Well, last week, I had trouble urinating where just drips were coming out; I had to sort of manipulate towards the exit of my penis which helped the thin flow to start up again. (this was quite scary). I was able to get an appointment with my urologist this past Monday the 7th. The urologist attempted to do a cystoscopy but was unable to insert the scope, she then tried a metal object which I was told to try to dilate the urethra which also would not go in, she then tried a thin wire which can also be used which also would not go in. She said it's likely a stricture caused by the catheter at the time of surgery. I'm now scheduled for a Cystoscopy, retrograde urethrogram and urethral dilation on Friday, they'll have to put my under with anesthesia because the urologist was unable to insert anything into my urethra in the office visit. I'll have to also go home with a dreadful catheter for a few days; I'm told the dilation may just be temporary as the stricture can return. I'll also have to self catheter at home to keep the dilation stretched. Ugh, I'll try to keep you all aware of how it goes. Wish me luck.

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@cirrussantafe, I'm sending as much luck as possible. It sounds like your hunch that something wasn't right, was correct. This sounds like a very uncomfortable situation.

Here are a couple of discussions you might find helpful as you prepare to the few days with the catheter.
- How often does a Foley catheter need to be changed? https://connect.mayoclinic.org/discussion/foley-catheter-change-frequency/
- Any suggestions of how to keep catheters from getting plugged up? https://connect.mayoclinic.org/discussion/catheter-blockage/

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