I have been doing unsuccessful research and hope you can help me. A male suffers 2nd degree electrical burns on his penis and testicles and requires use of a catheter. First, how long will he require the use of the catheter? And two, at what point is he able to urinate on his own and the catheter removed?
Denise, this is a difficult question to answer without a more complete history and the ability to examine the patient. Normally, the burns themselves should NOT interfere with urinating (other than discomfort from touching the penis while "aiming") unless the urethral meatus and/or inner portion of the distal urethra was burned as well. In the latter case, a catheter is usually placed to allow healing of the meatus and urethra to occur. This would take several weeks (2-3) and then the catheter is removed for a trial of voiding. Assuming there are no pre-existing urologic problems (such as an enlarged prostate gland), the patient should be able to urinate normally at this time. To follow is some information I have written on how the bladder empties in a male and some of the conditions that might interfere with proper emptying, regardless of the burns.
There are many conditions that may cause a male to have difficulty emptying the bladder. Ones ability to urinate depends on 2 opposing factors: the force with which the bladder muscle contracts which has to work against the resistance in the urinary canal (urethra). Anything which decreases the former or increases the latter make it more difficult to urinate and empty the bladder efficiently. Normally, after urination the bladder should retain less than 30 cc (one ounce) of urine. This is called the "residual urine". Excessive residual urine can predispose to urinary infections and kidney damage from back pressure.
Disorders that may increase the resistance in the male urethra include an enlarged prostate (the most common causes being benign enlargement or prostatitis), urethral strictures (narrowing), urethral valves, contractures of the bladder neck, etc.
In addition, chronic distention of the bladder muscle prevents it from contracting with maximum force which exacerbates the residual urine accumulation. Contractile force can also be adversely affected by a number of medications including those used for anxiety, depression, pain (especially narcotics), antihistamines, GI disorders, & many other conditions. Furthermore, putting off the desire to void by holding your urine too long over-stretches the bladder muscle which then may not be able to contract forcefully enough to empty. Many men with pre-existing urologic problems often go into urinary retention after surgery due to many of the factors mentioned in this paragraph including the effects of anesthetic agents. Retention can also be precipitated by excessive alcohol as this is a central nervous system depressant. Alcohol may also prevent one from being aware that the bladder is full before it is too late. Certain neurologic diseases, such as herniated discs, MS, Parkinsonism, etc. often adversely affect bladder emptying. Lyme disease sometimes affects the central nervous system and occasionally causes urinary retention.
As there are so many conditions that can cause male voiding difficulty, one need to see a urologist in consultation . A complete history, physical examination and some laboratory tests need to be done. At the very least, measurement of your residual urine will be done. Depending on the above, further testing such as a cystoscopy. urodynamic studies, and imaging of the upper urinary tract may be indicated. After a diagnosis is established, a proper plan of management can be recommended. Good luck.