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Dr. Andrew Rynne

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Had endoscopy for removing urethra valve. Diagnosed with extended bladder. Using catheter, severe fatigue. Related?

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Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 9746 Questions

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Posted on Mon, 20 May 2013 in Urinary and Bladder Problems
Question: Hi, My father had endoscopy done two weeks ago to remove a urethral valve and was also diagnosed with an over extended bladder. He is now home with a catheter to ensure that his bladder rests and hopefully recovers so that he can empty his bladder again. But he is complaining of severe fatigue since the surgery and the urologist has been dismissing it as mental anxiety. What could be the cause of his extreme fatigue? This morning he almost blacked out and fell down.
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Answered by Dr. P. T. Patil 56 minutes later
Hello
Thanks for your query.Based on the facts that you have posted it appears that your father has undergone endoscopic surgery .I assume that he has undergone Trans Urethral Surgery for enlarged Prostate(TURP), which is common at this age.(You have mentioned valves in your query but valves are common in childhood) .I shall be happy you clarify this statement.

Normally the tone of the bladder musculature is reduced if patient has long standing outflow obstruction due to enlarged prostate.He has indwelling catheter kept to drain his bladder and to give rest to bladder so that bladder tone will regain in few weeks time and he will be able to pass urine freely.

His fatigue and weakness could be due to his diabetes and hypertension which fluctuates after any major surgery..Please get his blood sugar level test done to confirm whether it is well controlled or not and consult qualified General Physician for assessment and further treatment.. He should be fine with vitamin supplements in 2-3 weeks.

Hope I have answered your query.
Please feel free to ask if you have any more questions I shall be happy to help you.
Thanks with Regards.
Dr.Pati

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. P. T. Patil 11 minutes later
Thanks Dr. XXXXXXX

Yes, he went through TURP to make an incision on the prostate and the urologist also removed a valve that he mentioned could have been in the urethra since childhood. He also found a diverticulum and made an incision on the mouth of the diverticulum to make it larger so that there is no residual urine in the diverticulum.

He prescribed Urotone (twice a day) and has an indwelling catheter for about 4 more weeks to give rest to the bladder. His urine retention was around 1000 cc before surgery and also immediately after surgery. The urologist is now suggesting self catherization as the only option if the bladder does not recover. Are there any other options we can consider?

Also could his fatigue/weakness be due to UTI that he may be developing because of the bladder? He has started complaining about some pain in his lower back.

Thanks,
XXXXXX


doctor
Answered by Dr. P. T. Patil 40 minutes later
Thanks for follow up.
He had chronic retention of urine due to long standing outflow obstruction due to enlarged Prostate.
He has to be on catheterisation for a long time .Sometime it takes more than 6-8 months for bladder to regain its tone.
It is cumbersome to keep catheter through urethra for such a long time .Hence I would suggest to discuss with your Urologist for feasibility to put catheter through supra pubic route.(S.P.C).If I would have been his treating doctor I would have put him on S.P.C

This will avoid UTI and he will have free movements and normal routine activities.
Thanks And Regards.
Dr.Patil.


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