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Dr. Tharun
Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3540
Experience:  MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
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I underwent 2 weeks ago a TURP and a bladder neck resection.

Customer Question

I underwent 2 weeks ago a TURP and a bladder neck resection. This happened during a cystoscopy, when the urologist found a bladder neck stenosis. Before the operation it was very difficult to urinate. The doctor suspected a prostatitis and prescribed Ofloxacin, with no results. Now 2 weeks after the operation I have a continuous urge to urinate, day and night. I can urinate but only small quantities and after some minutes I have to do it again. The doctor prescribed Detrusitol, but no improvement. Can something else be done?
Thank you
Teddy
Submitted: 1 year ago.
Category: Urology
Expert:  Dr. Tharun replied 1 year ago.
HI

This is detrusor hyper reflexia - the bladder still thinks the prostate is present and hence contracts powerfully as it did before the surgery.But the prostate being not there you have to go to urinate frequently.

In simple words , the bladder will take some time to adjust to the new outflow tract.Sometimes it can take 8 weeks to 6 months.

It has to be managed with medications which will relax the bladder during this period.
Detrusitol will help with the symptoms.Along with it you have give it some time without being impatient.

There are other drugs which can be used like vesicare and trospium which can be effective.Oxybutynin is an old drug which can be used in such cases.

Try not to drink too much water.Avoid coffee, tea and aerated drinks.

If this is also not useful,desmopressin can be used to decrease the urine production which will decrease the frequency effectively.But it has a side effect of decreasing the sodium levels of our body.This can be corrected with more salt in the food .

I hope this provides you better options to tackle your problem.

All the best and regards

Dr.Tharun
Customer: replied 1 year ago.

Thanks a lot.


How long needs Detrusitol or equivalent to have some effects?


 

Expert:  Dr. Tharun replied 1 year ago.
Hi Teddy,

They are affective from almost the same day.You should be seeing improvement within 1-2 days.

Regards

Dr.Tharun
Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3540
Experience: MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
Dr. Tharun and other Urology Specialists are ready to help you
Customer: replied 1 year ago.

Thanks a lot Dr. Tharun


 


I underwent a a TURP and a bladder neck resection. Any chance that the bladder neck stenosis/contraction will happen again? Anything to do against it?

Expert:  Dr. Tharun replied 1 year ago.
HI Teddy,

Yes, it can happen again.

There is no way to prevent it.You have to treat it when it happens.It is a structural problem which cannot be prevented with medications.

Some doctors suggest self calibrating with a soft tube periodically like once a week to keep the bladder neck from scarring again.But there is no evidence to support it.Some patients find it cumbersome and even land up in complications like bleeding and pain.

So it has to be advised carefully and judicially.

Regards

Dr.Tharun
Customer: replied 1 year ago.

Any chance, from your experience, not happening again?


 

Expert:  Dr. Tharun replied 1 year ago.
HI

Not all patients will have this problem again.Only 5-10% of patients will get it again.Remaining patients may not have any problem lifelong.

I hope you got the right message this time.

Dr.Tharun
Customer: replied 1 year ago.

Hi Dr. Tharun


Feeling better, at least statiscally!


Bladder neck resection versus incision makes a recurrence less probable?

Expert:  Dr. Tharun replied 1 year ago.
HI

Yes, bladder neck resection makes the outlet wide open thus making it less likely to become narrow again.Incision is just a single cut to the bladder neck hoping that it will heal without narrowing.

Dr.Tharun

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