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Done ureteroscopy and laser lithotripsy. Difficulty urinating, UTI. Due to muscle weakness from catheter?

Hi, I have a post-surgery urology question. A month ago, I had ureteroscopy and laser lithotripsy to remove a large kidney stone (2cm), that the surgeon cut out near where the ureter meets the bladder. I've had a foley catheter for most of the time since the surgery -- removed after 4 days, the ureteral stent removed after 4 more days, and another one put in 4 more days after that (12 days after surgery) because I had so much difficult peeing (abdominal muscle spams, etc.), plus had a UTI. That catheter was in for 10 days, and then when I didn't void within 90 minutes, they insisted on putting another catheter in for 2 more weeks. I'm about to be checked again, and I have two questions: 1. Will my muscles have weakened (after 3.5 weeks with catheters), thus making it more difficult for me to urinate? And if so, what do I do about it? 2. Should I object if they want to keep me with a catheter for a longer time? My theory is that I don't void much in the afternoon anyway, judging from what shows up in the catheter bag, and that giving me 60-90 minutes to void is too short a time to tell.
Asked On : Sat, 13 Apr 2013
Answers:  1 Views:  118
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Urologist 's  Response
I do agree that you did require the procedure that you mentioned as you seemed to have a fairly large stone at your VUJ - this is the junction of bladder and ureter. Though it is a large stone, this procedure should usually not have caused you much discomfort, and to prevent even the minor discomfort, I place stents for any calculus beyond 1.5 cm which has been obstructing the passage. I guess in your case, the stent was removed perhaps a shade early. This is however a matter of opinion, and not everyone would agree with me when I retain stents for at least 2 - 3 weeks after the procedure. I feel that this gives the ureter time to recover completely from the auguries of the ureteroscopic procedure of such a large stone. The fact that you seem to require catheter for so many days after the procedure certainly sounds odd, and i think you can certainly attempt a trial void after catheter removal again, and this time as you yourself have suggested, maybe hold on for at least 3 -4 hours or till your bladder becomes well distended to know whether this trial is successful or not. Most patients would be able to pass urine comfortably in that time. I do not think stent will prevent you from voiding urine, but if you have pain while voiding urine after removal of Foley's catheter, there are medications like alpha-blockers to reduce the discomfort which will probably be quite useful to you. Let me know your progress, and if any further doubts, I will be more than happy to answer.
Answered: Tue, 25 Jun 2013
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