Incredible pain - bladder spasms after catheter removal
Hi folks. I'm new to the forum. Was hoping to run something by the group to see if anyone has heard of this.
First my background
o 48 yr old male
o ~ 3 yrs ago PCP concerned about PSA velocity (even though PSA level only 1.5) and referred me to Urologist
o To this day DRE negative, PSA 2.6, velocity running ~ .5/yr
o April/2006 biopsy negative
o Continued close monitoring of PSA and DRE
o 12/15/2007 biopsy showed 2 of 12 cores with disease
o 1 core = 10% Gleason 3+3, 1 core = 5% Gleason 3 + 4
o 1/3/08 CT & Bone Scans negative
o 1/23/08 Radical Prostatectomy & lymphectomy via DaVinci Robot
o Surgeon had done over 550 cases
o Surgeon said all looked healthy - nerves were preserved
o Post surgical pathology = Gleason 3+3, clean margins, lymph noes clear, seminal vesicle clear, disease found in both sides of prostate.
The Problem (& reason for posting):
Yesterday at 10am I had my catheter out (7 days post surgery). Prior to catheter removal NP filled bladder with solution. She then removed catheter and not a drop was lost. I even had to ask her to leave the room so I could relax and urinate which I did without any problem. Rest of the day was great. Drank 8 oz water per hour (per NP) until 4p and reported back that I was voiding OK and all was good, small amount of blood in urine each time. I was still dry except for one small unexpected dribble later in the evening. The only issue so far was I really couldn't feel when I had to void. So I just went in and voided on a regular basis.
At 12 midnight I got up to void. Just as I attempted to relax and void I got hit with really bad bladder spasms.The pain is the worst I have ever felt in my life and I am no wimp. I teetered on the edge of blacking out and throwing up from the pain for 30 to 60 min. Pain was so bad my whole body was shaking and I was sweating profusely. Two Percocets and 3 Ibuprofen didn't help (first pain meds since surgery). Nothing would stop it other than letting the spams run their course of about 1 hour. I had no idea a human could endure this kind of pain for this long. No exageration.
So this happened twice during the night. The level of pain scared the hell out of me so I called the docs office. I was on the phone off and on with MD on call (I don't think he did the surgeries himself) and we finally agreed the ED wasn't the place to go so we decided I would come in to the office early.
Long story short after some testing and an attempt to void it happened right in the exam room. I looked so bad the med tech in the room got so freaked out at how I looked he said he was taking me across the parking lot to the ED. I said no way go get the doc (busy practice). Shortly thereafter my surgeon appeared and said he has seen this a few times. He thought it was likely that the bladder neck or something nearby was not healed enough yet. He seemed confident and proceeded to put the catheter back in until Monday. Honestly, I'd have done anything to get rid of the pain.
Sorry for the long-winded post but has anyone hear heard of this or experienced it? I am really freaked out that this will re-occur when the catheter is removed on Monday. I cannot bear to even think about experiencing that kind of pain again.
I can relate to what you've just been through concerning the bladder spasms. I had my catheter out for about three days after having davinci surgery, doctor removed it after 9 days which I thought might have been a little quick. One evening as I was sitting on the throne I had the most unimaginable pain in my abdomen which I didn't think was ever going to end. I screamed for my wife and uttered Gxx Dxxx several times. She is a registered nurse and I could tell that she was very concerned about the level of pain which seemed like it went on forever. This was naturally on a weekend about 9pm when all pharmacies in our small town were closed. She called the emergency contact number for my surgeon and she was actually talking to him in about 5 minutes. He said it sounded like bladder spasms which he said were very rare. He asked about a pharmacy and she made arrangements to call our pharmacist and see if he would call the surgeon to make arrangements to come down and open up and fill a perscription. Our pharmacist got the script I guess by fax and filled it for us. It was some type of bladder relaxer which did calm the contractions a great deal. I had the start of one the next night but got right on it and it went away. Never had one since and don't want anymore.....most pain I ever experienced in my 62 years of life. JWB
I know the pain as I am having a similar experience. I am 59 and had my Radical Prostatectomy & lymphectomy via DaVinci Robot at Mayo in Jacksonville on January 21. On January 30, I had the catheter removed. I was so happy to be rid of it.
We traveled home that day and I was able to void fine that night. Next day at 11:00 after voiding and attempting to stop is when the spasms started. They were bad, but I survived. Again at 3:30 I voided and then the pain started, much worst. Again around 6:30 and the pain was unbearable. Again around 8:00 in the emergency room where the pain was so bad I was on the floor on my hands and knees pounding the floor with my fist.
They reinserted a catheter and gave me some drugs for the spasms. By the way my urine was never clear of blood until after leaving the emergency room. Nobody prepared me for running into this problem. Good luck Rick, you have plenty of company in this. [/quote]
CoastalJoe, It really is brutal isn't it? You don't say what year this happened to you but based on the January dates I am assuming this is happening as we speak. We should keep in touch through this. It might prove helpful. My doc is saying I just need to give it more time to heal until Monday and have it out and that should take care of it. What are you being told? Also, would you mind telling me what drug they prescribed for the spasms? p.s. I once the catheter went back in yesterday I havn't had any more spasms...
JWB: any possible chance you could recall or figure out what drug the "bladder relaxer" was that you refer to? Also, did you wait until a spasm to take them? It seems that if you were taking it after it started it must have been extremely quick acting to "get right on it" so it would go away. My pain as described was enough to cause me to black out. Even 10 mins would be too much to bear...
Replicant: Your description too sounds like you had some sort of fast acting drug when you say "If I had a twinge, I'd pop a pill". Any chance you can recall anything close to the name of the drug?
I went through my cabinet last night to see if I had the old bottle of anti-spasm stuff, but no luck.
It MIGHT have been ditropan, but I wouldn't swear to it. I Googled drugs for bladder spasms and that's the only one that sounded familiar, but it might have sounded familiar because I've heard the word on "House"!
I had trouble logging in so had to set up a new profile.
Yes, I am going through this as we speak. Unfortunately, I am 5 hours away from my doctor and clinic. And health services in my area are lacking. I did talk with one of my doctor's nurses and was told to have the catheter removed immediately. They did not understand why the ER doctor had the catheter installed since I was voiding, but I don't fault the ER doc. I don't know what precentage of people run into this problem, but I was totally unprepared for this.
For the spasms I was prescribed flavoxate, one or two tablets, 3 to 4 times a day.
There have been no spasms for me since the catheter was added. I will have the catheter removed in a couple of hours and hope for better results this time. We will hang in there together.
Thankyou for posting the name of the drug. If I were you I'd keep taking the flavoxate for a while when the catheter is removed again.
When I was having the spasms at home I called my MD (during the night). He did not want me to go to the ED either becuase he did not feel they would give me the correct care as they would not understand the details of what was done to me surgically. He convinced me to wait until morning and he would open early and meet me there which is what I did.
It does not suprise me that you are not having any more spasms since putting the catheter back in. It may not be the drugs though. My doc after seeing me have this right in his exam room put the catheter back in me as well (just 24hrs after removing it). He said that alone would stop the spasms. He was right. Nothing again since. He just called me to check in and said again he has seen this on rare occassions and putting the catheter back in and letting things heal up a bit longer usually does the trick. He has me going in Monday to have it removed again.
I told him there was absolutely no way I wanted to chance that kind of pain again. He said he understood although he really didn't think it would happen again on Monday. I said I wanted something to take just in case. He said that he would give me something to take for the first week the catheter was out but he said again that he didn't think it would be necessary. For me it is worth the insurance.
Matt, I am very sorry for the pain you have been in. I am glad that putting the catheter back in has stopped the pain. Maybe by Monday it will be healed enough so that removing it will not cause you to again have bladder spasms. I cannot imagine how much the spasms hurt .
I removed the catheter yesterday and everything is working fine so far. I have the drugs handy in case I need them, but I am thinking that I will not this time.
Looking back, after my second horrible spasm my wife called my doctor's number and talked with a nurse who recommended that I go to the ER. I refused to go and waited until the third time and went. I should have called my doctor back personally to be sure that they understood the situation and asked about drugs for spasms.
Having the catheter in a couple of more days may have been better for me.
My doctor told me not to lift anything over 10 pounds, but I can't imagine how much stress I put on my whole body while I was having the spasms. I am doing so much better this morning.
Preston, glad to hear you have it back out. Keep me posted on how it goes.
My MD thought I just needed a few more days to heal as well. I am concerned though. For the first 7 days the catheter was in everything was nice and clear. However, since putting it back in I continue to have bleeding. I hope things are healing more in preparation for Monday even though it is still beelding.
Thanks a million Gary. Is it safe to assume you started taking the Sanctura after getting the spasms on the way home? Did it work well as in no more spasms?
Sorry for the million questions. Just two more if I could. Did you take it as needed if you experienced a spasm or on an ongoing basis to prevent a spasm? And lastly, how many days/weeks did you take it?
And thanks very much for the encouraging words.
I think I was taking it regularly until a day before the catheter came out. Then, once out, I took it only when needed, which was only a few times. By two weeks after the catheter was out, I never took it again. But everyone is different, and if you are uncomfortable, talk to your doc. That's what he's there for.
PSA 8/2007 3.5
PSA 9/2007 4.6
Biospy 10/2007 - 1/8 5% Cancer Gleason 6
RP 11/28/2007 Mt. Sinai Hospital, NY, NY
Gleason 6, Negative Margins
PSA 1/2008 < 0.05
Thanks Gary, I will be speaking with him in detail on Monday but I always find things work out much better when I am dealing with anyone or anything in healthcare from a position of knowledge. It is the only way effectively manage one's care. Thanks. -Matt
I had bladder spasms the were unbelievable when the catheter was in, but minimal ones for a few days after. I was reading some info that recommended magnesium, so I have been taking it. It might help. It is "Natural Calm" by Peter Gillham. Try to take it 3x per day if you can. Might cause a little loose stool. Good Luck.
Four days after having the catheter re-inserted becuase of severe bladder pain/spasms I have now successfully had it removed again. However, this time the day before having it removed I started taking the antispasmodc drug Ditropan. I will say that my surgeon/urologist said I just needed the few extra days and did not need the drug. However, after experiencing this severe pain the first time around I decided it was worth it as an insurance against it happening again.
In any event, the catheter came out this time on Monday and now it is Friday and I have not had a single spasm attack. So I don't know whether it was the 4 extra days of healing or the antispasmodic drugs or both but it has been great to get off the cathether.
I hope the information in this thread will be helpful to others should the ever encounter this problem.
I am not sure whether it was the Ditropan or whether it was a few more days of healing which the surgeon was so sure would be the solution. Either way the pain was so bad if I had to do it over again I'd take the anti-spasmodic as an insurance policy given the side effects are likely to be minimal.
Sorry I haven't had a chance to get back to you sooner, but the medication that was prescribed to me was ditropan along with pain pills (oxycontin). This didn't knock the spasms immediately but eased them greatly. The next evening that I referred to when I first felt a twinge I took the oxycontin, as I had been taking three or four ditropan pills a day. The spasms only occured a couple of times with me. I haven't had any more and not looking to have anymore. jwb.[/b]