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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Urination Difficulty In A 59 Year Old?

I am a 59 year old male and in excellent health. I was on no medication till 9 days ago. I have been having difficulty voiding my urine over the last few years (day or night) basically straining to start,dribbling, and lately passing 30-40ccs at a time, going every hour or less, and it got to the point where I had to be catheterized 9 days ago due to severe pain across the abdomen,at my urologists office. (NO infection in the urine and no kidney damage) They removed 1100ccs of urine (no blood). They put me on Flowmax (tamsulosin) The urologist then made an appoint for me to see them in a week...but after 3 days I had some blood clots in my urine bag and the catheter stopped working.The urine had been clear up to that point.I had to go to the hospital emergency room,where they removed the #16 catheter (which had a blood clot on the end) and reinserted another #16 catheter to drain the bladder,which had 1100ccs of urine in it. Once the bladder had drained,they decided to replace the #16 catheter with a #20 3 way catheter,which could be irrigated,if need be,and they said the #20 catheter inlet holes are bigger,so it would not clog as easily. They had a difficult time inserting the #20 but did manage to insert it. The emergency doctor said the prostate was definitely enlarged, making insertion difficult. Very painful and traumatic. Today, 5 days after the ER visit,my urethra is almost pain free...and I can actually sleep...(no blood in urine) however, I have an appointment in 4 days to have the #20 catheter removed and have a voiding test performed. Would it be better for me to postpone the voiding test and allow the urethra to continue to heal or should I not be alarmed about doing more damage to the urethra? I honestly doubt the medication (flowmax) is going to allow me to void... (I took it 5 years ago for 6 months with no effect on flow, and the side effects were not worth continuing to take it) and I fear inserting another catheter will only do more damage at this stage,and more pain for another week..and maybe worse. I have been getting about 1/2 a teaspoon of blood drainage around the catheter and the end of my penis (in a 24hr period) but is has gotten less every day and today there was very little drainage. My fear is the void test will fail,and they will have to reinsert another #20 catheter,causing more intense trauma to an already strained urethra and possibly permanent damage to it. Should I postpone the void test? Are there any tests they can do with the catheter in place to see why I cannot void? Can they do a rectal ultrasound of the prostate and bladder with the catheter in place and get sufficient information? Thank you for your help. Mark
Fri, 29 Jun 2018
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General Surgeon 's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

* As per my surgical experience, the voiding test should not be performed till a period of 2-3 days of catheter removal as due to catheter in situ the bladder muscles were at rest and that can affect the test results.

Hope I have answered your query. Let me know if I can assist you further.
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What Causes Urination Difficulty In A 59 Year Old?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. * As per my surgical experience, the voiding test should not be performed till a period of 2-3 days of catheter removal as due to catheter in situ the bladder muscles were at rest and that can affect the test results. Hope I have answered your query. Let me know if I can assist you further.