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Urology/Cystoscopy complications


QUESTION: My father aged 87 had a cystoscopy and was released with a catheter that was removed 5 days later. Within 2 months he was taking 10-15 minutes to urinate and upon visiting emergency they (both a nurse and then doctor) were unable to insert a catheter. The urologist had to use a circular sharp bladed instrument to cut through scar tissue and then a catheter was inserted, removed days later and all was well again. Two months later my father was again taking more than 10 minutes to urinate, being unable to force anything more than a dribble. This time the urologist used a laser to open the flow, and then inserted a catheter that was removed 6 days later. Within 6 weeks the flow of urine was back to a dribble and another appointment has been made with his urologist. Have you seen this type of problem before and if so is there any solution?

ANSWER: Chris:

The problem here is we don't have a diagnosis.  Does he have prostate cancer or enlargement?  What was found at the original cystoscoy?  Why was the catheter left in originally (that is not common practice unless there is some other problem)?  

It sounds now like he has substantial scar tissue.  At 87, this may not be curable and he may need either intermittent dilation to keep the passage open by gently stretching it a little on a daily basis or a suprapubic tube where there is a permanent tube placed in the bladder which bypasses the scarred area.  It isn't clear why one of these solutions has not already been suggested by his urologist.  I would suggest that you arrange for a second urology opinion to help sort this out.

---------- FOLLOW-UP ----------

QUESTION: Thank you for your advice and sorry for not providing more detail. My father had his prostate removed 25 years ago (cancer) with no reoccurrence. The cystoscopy was done to investigate and remove some small growths on the bladder, diagnosed as superficial low grade bladder tumours, transitional cell carcinoma. We don't know why a catheter was required and simply assumed that this was standard procedure. There was no problem with urine flow prior to the cystoscopy.


With a history of bladder cancer, regulary cystoscopic examinations of the bladder are required, usually at 6  month intervals.  A suprapubic tube is usually not recommended in cases where there has been any bladder cancers sot hat leaves consideration for possible intermittent self dilation as a way to minimize the need for more surgery.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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