Urinary Retention after Prostate Radiation

The specialist for this would be a urologist.

Hello, @ddewitt, and welcome. I'm adding your post to the prostate cancer support group, where you might find others who have had a similar experience after radiation therapy.

Here's a little more information about urinary retention after cancer treatment and what treatments are available. https://www.cancer.org/cancer/managing-cancer/side-effects/stool-or-urine-changes/urine-retention.html

It's certainly frustrating to not have any actionable answers for your husband. Has his doctor identified the source of the urine retention?

Thank you your response. No he has not. Just prescribed Tamulosin to help urine flow. Do you know what test should we ask for.

Yes, we've been to several urologist. In my opinion they seemed to not know much but to give you pills and self catherization. There is got to another way. I have to search what test to ask for.

Hi, after radiation almost anything can happen. What type of radiation did your husband receive?
SBRT (Cyberknife, etc) and HDR brachytherapy +SBRT use very high doses of radiation and swelling and inflammation can follow.
Also, if your husband had urinary issues before radiation, slow or weak stream, BPH, this will be exacerbated by radiation. Many times, these issues are addressed BEFORE radiation, since they will only become worse after treatment.
Unfortunately, until that internal swelling subsides, self - catheterization, while unpleasant, may be the only solution.
I’m mot a doctor, just relating what I’ve learned thru my own experience and that of others. Best,
Phil

Self-catheterization is not the only solution. I developed chronic urine retention which I didn't realize for several months because I felt like I was peeing fairly normally. Greatly enlarged prostate. I didn't like the idea of self-catheterization even though my urologist suggested it because of the nuisance of carrying supplies around, maintaining sterile conditions when out and about or travelling, etc.
I opted for an indwelling Foley and after much trial and error am using it with a simple valve on the end. Much more convenient than a bag, can wear shorts, etc. Despite the warning of likely bladder infections, I have been using it for over two years and have established a routine of changing the valve once a month and the catheter once every three months.
I am aware that most urologists recommend every 4-6 weeks, but a CDC infection control panel disagrees and some other countries allow longer times as well. I am careful about hygiene and have never (knock on wood) had a bladder infection. Happy to share more details if you wish.

Thank you for your post. I will research further on the indwelling Foley.

Thank you for your post. I'm learning a lot from these posts.

What is his diagnosis that is causing the retention? Is there tissue damage, is there inflammation, is the problem in the urethra or the bladder? Lots of questions need to be answered before a good solution can be found.

On the 3rd day of my proton radiation treatments (April-May 2021), I had similar urinary issues. My RO told me that with some men there’s an inflammatory response to the radiation, and if that inflammation is near the urethra can cause the issues that I was experiencing. He recommended that I take 2 Tamsulosin/day for the remainder of the treatments. Everything cleared up by the next day; I haven’t had any issues since.

Once they find out what exactly is causing your husband’s problem, they’ll be better able to come up with a solution.

I have read that 10-15% of SBRT may have not only acute urinary symptoms which subside similarly to IMRT but also delayed urinary tract symptoms. [RTOG >G2, sp? ). The delay can be months to years. The PROSTox test from MiraDX company helps detect those who are genetically sensitive to radiation to either or both SBRT & IMRT. The SBRT accuracy appears to be about 75-80%. Otherwise the base rate is about < 5% for delayed onset of urinary tract symptoms. The SBRT (ex: Cyberknife from Accuray ) current protocol for primary irradiation of the prostate gland (not spot RT for oligomets) is alternate days for < 2weeks. Some who score HIGH on the PROSTox test and who still wish to pursue SBRT have requested modifying the treatment intervals to once weekly times five weeks. The total radiation dose is the operative criterion and maybe not how quickly it is achieved? It begs the question as to whether the residual < 5% delayed rate of urinary tract symptoms might be further reduced by stretching the treatment intervals to once weekly?