Suggest Treatment For Atonic Bladder And Chronic Retention Of Urine

Posted on Fri, 6 Jun 2014

Question: I was told by my urologist that I my bladder has folded in and has lost contraction my options are
#1 prostate surgery to try to make smaller with only 40% success rate.
#2 A suprapubic catheter(which I do not want) a hole in my belly and a bag for the rest of my life I am 62.
#3 To learn to self catheter which I am willing to learn if #1 and #3 don't work I'll have to do #2.
Is the any other options that my doctor is missing?

Answered by Dr. Dr. P. T. Patil (4 hours later)

Brief Answer:
Looks that you have Cronic Retention of Urine.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you have atonic bladder and chronic retention of urine due to long standing benign enlargement of prostate.

I would try to explain the options that you have thought of .
1) Prostate surgery at this stage will be of no help as your bladder has no power to expel the urine. Even though the passage is cleared after prostate surgery you will not be able to void the urine naturally.
2)Supra pubic cauterization is a temporary option till bladder regains power of contraction .This may take even one year for bladder to regain it's tone and power.You can go for Prostate surgery after your bladder tone and power recovers satisfactorily and enough to expel the urine without any efforts.
3) Self catheterization is also one of the viable option but it requires to catheterise 2-3 times in a day and every time you pass the catheter there is risk of introducing infection from outside leading to getting chronic UTI and stricture formation.

Normally I have been practising following routine since last 30 years of my practice for my patients who come to me with chronic retention of bladder and atonic bladder.I do SPC (Supra Pubic Catheterization) and monitor improvement in bladder power by doing Cystometry study every month and do prostate surgery (TURP)after bladder power recovers satisfactorily.This takes 9-12 months but the final outcome is encouraging and satisfactory for the patient for rest of his life as far as natural voiding is concerned.

Hope I have answered your query ,please feel free to ask if you have more questions ,
I shall be happy to help you
Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (5 hours later)

I have lost 148 pounds over the last five years and plan to have a tummy tuck next year to get rid of all the loose skin. Will the SPC prevent me having this done next year?
What can I do to regain bladder control if I do the SPC or self catheter so I can have tummy tuck next year?
How does the SPC affect sex can I still get a erection?

Answered by Dr. Dr. P. T. Patil (3 hours later)

Brief Answer:
SPC will not affect your sex life.

Detailed Answer:
Hello
Thanks for follow up.
SPC will not affect surgery of getting rid of loose skin ..

You do not have to do any special measure to regain bladder power as bladder will be drained continuously with SPC and bladder will get complete rest which will automatically help to regain recovery of bladder power..This advantage will not be there with self catheterization .

Thanks and Regards.
Dr.Patil.

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