Suggest Remedy For Urinary Retention Caused By Enlarged Prostate

Posted on Mon, 9 Nov 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 9 Nov 2015 Answered on

Mon, 7 Dec 2015 Last reviewed on

Question : My urologist has told me that my prostate has been enlarged for so long that is has caused my bladder to lose its toning and ability to empty itself very much at all. Now my kidneys are suffering as well. He has told me to use a 16 inch catheter on myself each morning and evening for one month. I have only had success twice in getting the tip to enter the bladder and empty it. I got out 1250 ml the first time and 1285 a few days later, so it gets very full and I feel miserable. Usually when I enter the catheter, I can feel when the tip reaches the prostate area, but I keep pushing and get it past it. When I was successful there was still about one to two inches of catheter that had not gone inside me. When I am unsuccessful, I push the entire 16 inches in with just a tiny bit of urine coming out. I can't figure out where the tip is going and what I am doing wrong. Any help you can give me would be very greatly appreciated.

Answered by Dr. Manuel C See IV (28 minutes later)

Brief Answer:
You need an indwelling catheter for 2 weeks

Detailed Answer:
Good day and thank you for being with healthcare magic!

Bladder drainage is very important for you and urine reflux to the kidneys would cause organ damage. Your enlarged prostate is making it hard for you to do intermittent self catheterization thereby your urine accumulates in your bladder to cause reflux to your kidneys.
I think it would be better for you to be on an indwelling catheter for 2 weeks with an alpha blocker therapy (e.g. Flomax ).

After 2 weeks, trial of voiding should be done to check if you can freely void without catheter. Two weeks is needed so the bladder can regain its contractility and at the same time the alpha blocker has already taken its optimal effect. If you are still unable to void freely, surgery might be needed to remove the obstruction.

I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.HealthcareMagic.com/doctors/dr-manuel-c-see-iv/66014 I would gladly help you. Best wishes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (25 minutes later)

That sounds good and I am planning on asking my local doctor to inset an indwelling catheter tomorrow since I am having so much difficulty doing it myself. However, I would like to successfully self-catheter tonight so I can hopefully feel better and get a good nights sleep tonight. Any idea why the tip of my catheter is not going into the bladder? I can't figure out where it is going since I am putting it in almost two inches farther than when I successfully use it.

Answered by Dr. Manuel C See IV (1 hour later)

Brief Answer:
Catheter coils in the prostate fossa.

Detailed Answer:
Thank you for your follow up question. The catheter would likely be coiling in the area of the prostatic fossa. This potential space could accommodate the whole length of the catheter. Another problem is that if you had a previous false passage of the catheter in a false tract then the catheter would go to the false tract and this might lead to recurrent urethral strictures in the future. My suggestion is go to the emergency room tonight to have an indwelling catheter to prevent damage to the urethra.

yours truly,Dr Manuel See

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar