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Green light prostate laser surgery done. Stent placed in ureter. Should I be concerned?

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A friend of mine had XXXXXX light prostate laser surgery and resulting ureter stent placement due to injury ..this was about 17 days ago. He is now reporting restricted urine flow and painful XXXXXXX after having normal flow the past 2 days. Is this to be expected or a matter of concern? What should he be doing? Thank you.
Posted Fri, 12 Oct 2012 in Men's Health
 
 
Answered by Dr. V. Sasanka 47 minutes later
Hi,
What you have reported is an unusual but not an unknown complication of prostate surgery.
There is a possibility that your friend might be having what we term as a bladder neck contracture or urethral stricture. This means that the normal passage for urine flow gets narrowed despite surgery.
Ways of assessing this would be by getting an ultrasound estimation of post void residue and a uroflowmetry done.
If the pattern is suggestive of obstruction, a retrograde urethrogram needs to be done which is a specialized radiogram where a XXXXXX is injected into the urinary passage and any narrowing is noted.
The final call will be made by the urologist when he does a cystoscopy at which time he might be prepared to deal with a stricture or a bladder neck contracture depending on the findings.
Hope this answer has helped you in understanding the disease.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Green light prostate laser surgery done. Stent placed in ureter. Should I be concerned? 31 minutes later
Dear Dr. Sasanka,
Thank you for your detailed response. At what point should he seek help? Should he be voiding a certain amount? Can it wait till Monday or should he be seen sooner? At ER. Would drinking extra water help? If it turns out to be urethral stricture or bladder neck contracture, is treatment complicated and what can he expect long term? Thank you.
 
 
Answered by Dr. V. Sasanka 2 hours later
Hi again.
If there is an obvious decrease in flow, there is no reason to hold back treatment. If there is no risk of retention of urine, you can hold on till Monday, while if the stream is very poor in drops, he might need to go to Er earlier. the problem would be that should he need to get a catheter placed, an ER physician might not be able to place it if there is a mechanical obstruction.
Drinking extra water might not help, and actually might make things work. He should not postpone urination for too long, i.e.avoid withholding urination for long.
Regarding treatment for Bladder neck contracture or urethral stricture, we might be in a better position to advice if we knew what we are dealing with. Many patients with urethral stricture post prostate surgery do well after what we call XXXXXXX Urethrotomy followed by regular urethral dilatation. Bladder neck contracture might be a bit more complicated.
Either way, I suggest you keep on hold all these discussions for the time being, and get back once the Urologist gives his opinion. For all we know, there might no major problem at all!
Above answer was peer-reviewed by
 
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