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Had Green Light Prostate Surgery. Stent Placed Due To Ureter Injury. Will It Be Healed After The Stent?

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Posted on Fri, 12 Oct 2012
Question: A friend of mine had XXXXXXX light prostate surgery and ended up with stent due to ureter injury to be in place for 3-4 weeks. He said the urologist could not see the left ureter due to trabeculation of bladder. Will it be healed after the stent? any long term complications? Also what's best meds for older 70 yr old to take for stent pain? He had stent placed 9/5/12 and didnt seem to have any pain till yesterday when he said he was voiding often with fine stream and pain. He is into natural remedies and takes DMannose. Also he was under GA for 2 hrs and woke up with right sided lower duodenal pain which he said was the same gnawing pain he had in 1964 when he had to have Billruth procedure for severe bleeding ulcers. So he was taking Hydrocodone for that and the pain got worse so he went to ER on 9/10 and was dx with fecal impaction cecum . He said thats resolved now. Also he questions whether TURP wouldve been better. He had TUNA 5 yrs ago--didnt help. He read Greenlight would make you urinate like racehorse ...why is this not happening? thank you
doctor
Answered by Dr. G.Srinivasan (11 hours later)
Hi

Thanks for your query to XXXXXXX
I understand your worry.
Stent for 3 to 4 weeks is good enough. If the repeat ultrasound scan shows evidence of obstruction, IVU needs to be done to check for drainage from the kidneys.
Stent pain can be eased with antispasmodics and anticholinergics, which your physician can prescribe.
Urine stream not only depends on obstruction but also on the strength of bladder contractions, which may be weak due to long standing obstruction.
This is too early to comment though I have written for the sake of discussion. Let the stent be out and after one month, uroflow needs to be checked to decide on further course of action.
TURP is the gold standard and laser is the latest. Its hard to compare as each has its own pros and cons.
Hope I answered your queries; kindly get back for doubts if any.

Regards
DR GS

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. G.Srinivasan (38 minutes later)
Dear Dr. XXXXXXX
Thank you for your kind response. So in your experience most ureters do heal after such an experience? Can you name some specific antispasmodics/ anticholinergics that you would recommend? He was prescribed AZO but how long is it safe to take?
Also is Ditropan safe for older people? Or would Flomax be better? or something else? Can he do anything now to strengthen bladder contractions? Is it OK for him to take warm bath
or must he shower? I still have to show him this . He may have questions. Sorry I have so many questions. I think he wishes he had TURP or stayed on Flomax. Thank you.
doctor
Answered by Dr. G.Srinivasan (4 hours later)
Hi,

Thanks for your reply and appreciation.
Your doctor’s honesty needs appreciation to have discussed the intraoperative events. Yes, ureters do heal this way and this is the usual initial approach.
Warm bath or shower makes no difference.
DITROPAN/TOLTERODINE/SOLIFENACIN/ DARIFENACIN - any of these can be taken to relieve bladder spasms. Kindly discuss with your physician before starting one - as each has its own merit and demerits.
AZO course can be taken for 3 to 4 weeks.
Flomax may not help much - unless there is left over prostate - which is unlikely.
He needs uroflowmetry test after stent removal and decide on the bladder issue.
Hope this helps. Kindly get back for doubts if any.
Regards
DR GS
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

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

Urologist

Practicing since :1991

Answered : 1412 Questions

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Had Green Light Prostate Surgery. Stent Placed Due To Ureter Injury. Will It Be Healed After The Stent?

Hi

Thanks for your query to XXXXXXX
I understand your worry.
Stent for 3 to 4 weeks is good enough. If the repeat ultrasound scan shows evidence of obstruction, IVU needs to be done to check for drainage from the kidneys.
Stent pain can be eased with antispasmodics and anticholinergics, which your physician can prescribe.
Urine stream not only depends on obstruction but also on the strength of bladder contractions, which may be weak due to long standing obstruction.
This is too early to comment though I have written for the sake of discussion. Let the stent be out and after one month, uroflow needs to be checked to decide on further course of action.
TURP is the gold standard and laser is the latest. Its hard to compare as each has its own pros and cons.
Hope I answered your queries; kindly get back for doubts if any.

Regards
DR GS