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Suggest Treatment For Inability To Urinate And Bladder Spasms

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Posted on Fri, 14 Oct 2016
Question: Husband is unable to urinate, having bladder spasms, Hx of prostate cancer, was treated with cryoblation, PSA was barely over 1.00 within last six months; this is a sudden onset. He refuses to go to ER or his doctor; is in care of VA in XXXXXXX City which is many miles away. Any suggestions? Wife, XXXXXXX XXXX
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Answered by Dr. Bonnie Berger-Durnbaugh (16 minutes later)
Brief Answer:
Question:

Detailed Answer:
Hello XXXXXXX

I am sorry to hear this. How long has it been since he last urinated a normal amount of urine?

Was there a reason he took the extra oxybutynins (other than due to spasms)?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh (18 minutes later)
It has been about 24 hrs since regular amt. of urination - said he took the oxy instead of the other trying to relieve the spasms - has pain and is in the bathroom all the time due feeling urgent need to go.
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Answered by Dr. Bonnie Berger-Durnbaugh (1 hour later)
Brief Answer:
Recommendations

Detailed Answer:
I'm sorry I wasn't able to get back to you sooner.

I know your husband doesn't want to go in to be seen, but he is likely having increasing urinary retention which can really harm his kidneys. He needs to have a urinary catheter passed to allow the bladder to drain. If he is unwilling to go to the ER, is there an urgent care clinic nearby where they can at least drain his bladder tonight and buy him some time until he sees his urologist?

People can self-catheterize, but given that he had prostate cancer, there is the likelihood that there is some scar tissue which could make this procedure trickier. In addition, people need to be trained how to do this, and if urine hasn't passed for 24 hours, would have to know at what point to clamp the catheter to prevent too much urine coming out at a time as that can cause some (temporary) autonomic symptom problems.

Now I am not one for going in to the ER. I didn't even go in initially when I had pneumonia. But sometimes it is absolutely necessary, and it doesn't look like there is an alternative here for your husband. Please tell him he needs to go in to prevent harming his kidneys.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh (16 hours later)
We did go to the ER and he was diagnosed with acute urinary retention, catheter put in place and quickly felt much better after the drainage of about 1500 ml of urine. He had the appropriate blood work done; kidney function was excellent so no damage. He was in severe pain and regretted his decision not to seek help sooner. He will have the catheter for 2 more days if all goeswell; also has a prescription for Bactrim. We will be checking out University of Tennessee for an quite urologist and will not be taking his current medication until we find a new doctor.

Thank you so much for your reply; it helped him make the decision that has been long delayed. The VA is too far away and I have not been satisfied with their attention to detail. I worked for years in hospitals of varying levels of care and purpose - one of those people who sometimes irritate doctors; a Ph.D. Clinical Psychologist - not terribly useful in this type of situation, but always a patient advocate who appreciates doctors' wisdom and experience.



Thank you kindly, XXXXXXX XXXX
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (1 hour later)
Brief Answer:
Thank you for this follow up.

Detailed Answer:
I am very glad to hear that your husband did go in to the ER. 1 1/2 liter of urine is a large urinary retention. From your description it sounds as though the ER staff did everything appropriately.

I very much appreciate your giving me a follow up. It is one of the disadvantages of this kind of telemedicine that we are told concerning things but don't always know what happened after we give recommendations.

Best regards to you and your husband,
Bonnie Berger-Durnbaugh, MD


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3134 Questions

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Suggest Treatment For Inability To Urinate And Bladder Spasms

Brief Answer: Question: Detailed Answer: Hello XXXXXXX I am sorry to hear this. How long has it been since he last urinated a normal amount of urine? Was there a reason he took the extra oxybutynins (other than due to spasms)?