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Thread: Intermittant Severe Abdominal Pain Post Prostate Surgery

  1. #1
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    Intermittant Severe Abdominal Pain Post Prostate Surgery

    Hi everyone~
    I'm writing on behalf of my husband who had his prostate removed on Oct. 30th. (robot surgery) He had the catheter removed last Friday. The last several days he has had pretty significant abdominal pain, the kind that makes you double over in pain. He is taking Advil alternating with Tylenol for pain. He called the doctor's office and they thought it might be possibly urinary retention or internal bleeding and suggested going to the emergency room to get checked out.

    We might do that, but at the moment my husband fell asleep and is resting. He has been passing good amounts of urine and he doesn't feel faint as he might if he was bleeding, although that might take a lot of loss of blood to feel that way.

    He is 62, very physically fit going into surgery. I'll get around to posting a signature soon, but he was 3+4, his highest PSA was 5.6, there was no involvement of other tissues although there were a couple of positive margins (which I'm sure he'll want input on in another post). The surgeon was pleased with the surgery result.

    Any insights into what might cause intermittant abdominal pain that is pretty severe? He feels like his muscles are just cramping!

    Thanks,
    Last edited by countrygal1; 11-11-2019 at 09:56 PM.

  2. #2
    Hi countrygal1 -- Welcome to the Forum, but of course sorry your husband is in pain! The doc's office gave you a couple of suggestions for the source -- I would add that bladder spasms, when they happen, are more likely to occur when the cathether is still in, but once in a while we have a Forum Brother who experiences these spasms after the cath is removed. Bladder spasms can cause pain that reaches the upper end of the scale. It's not fun-- I know from experience -- but know that it is temporary. While bladder pain/spasm isn't exactly abdominal pain, if you husband hasn't experienced it before, he may not be able to distinguish them.

    Obviously your husband needs to be seen if the pain continues, and probably even if it subsides.

    Keep us posted,

    Djin
    Last edited by DjinTonic; 11-12-2019 at 02:39 AM.
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx, PCA3-
    7-05-13 TURP for BPH (90→30 g) path neg., then 6-mo. checks
    6-06-17 Nodule on R + PSA rise on finasteride: 3.6→4.3
    6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
    Bone scan, CTs, X-rays: neg.
    8-7-17 Open RP, neg. frozen sections, Duke Regional
    SM EPE BNI LVI SVI LNI(5L, 11R): negative, PNI+, nerves spared
    pT2c pN0 pMX acinar adenocarcinoma G9 (4+5) 5% of prostate (4.5x5x4 cm, 64 g)
    11-10-17 Decipher 0.37 Low Risk: 5-yr met risk 2.4%, 10-yr PCa-specific mortality 3.3%
    Dry; ED OK with sildenafil
    9-16-17 (5 wk) PSA <0.1
    LabCorp uPSA, Roche ECLIA:
    11-28-17 (3 m ) 0.010
    02-26-18 (6 m ) 0.009
    05-30-18 (9 m ) 0.007
    08-27-18 (1 yr.) 0.018 (?)
    09-26-18 (13 m) 0.013 (30-day retest)
    11-26-18 (15 m) 0.012
    02-25-19 (18 m) 0.015
    05-22-19 (21 m) 0.015
    08-28-19 (2 yr. ) 0.016
    Avg. = 0.013

  3. #3
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    Quote Originally Posted by DjinTonic View Post
    Hi countrygal1 -- Welcome to the Forum, but of course sorry your husband is in pain! The doc's office gave you a couple of suggestions for the source -- I would add that bladder spasms, when the happen, are more likely to occur when the cathether is still in, but once in a while we have a Forum Brother who experiences these spasms after the cath is removed. Bladder spasms can cause pain that reaches the upper end of the scale. It's not fun-- I know from experience -- but know that it is temporary. While bladder pain/spasm isn't exactly abdominal pain, if you husband hasn't experienced it before, he may not be able to distinguish them.

    Obviously your husband needs to be seen if the pain continues, and probably even if it subsides.

    Keep us posted,

    Djin
    Thank you Djin for that thought about bladder spasms. I will mention it to my husband when we awakes from his nap and he can think about that / check into those symptoms. It does seem like that could be a reason! We appreciate having a place to turn to for insights / perspectives as we navigate these uncharted (for us) waters.

  4. #4
    Countrygal1 is the severe paint after he urine? If so, it's mostly likely spasms and cath was taken out too soon. My husband went thru this. Reinserting cath a few more days will do the trick.

  5. #5
    Moderator Top User HighlanderCFH's Avatar
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    Welcome to the forum, CG,

    Another thing that is VERY common after surgery is significant gas pain. This could be part of the answer.

    During the robotic surgery, they pump the abdomen full of gas to expand the surgical site. And it can take a good number of days before the various pains go away. Even pain in the shoulders, etc, has been accounted by the residual gas.

    Hoping he feels better VERY soon!
    Chuck
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Eight annual post-op exams 2012 through 2019: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  6. #6
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    Quote Originally Posted by Honeybun078 View Post
    Countrygal1 is the severe paint after he urine? If so, it's mostly likely spasms and cath was taken out too soon. My husband went thru this. Reinserting cath a few more days will do the trick.
    Hi Honeybun~ He did notice (after his nap) that the pain started after urinating. It did seem to start in the bladder area and spread. He read online that a heating pad can help relax the muscles, so he tried that and it is helping.

    I'm guessing the gas is also a player to some extent as he burps fairly often.

    We are going to see the doctor (who is the surgeon) tomorrow. It will mean a long drive (2 1/2 hours one way) but is worth it for piece of mind and his perspective.

    I do appreciate all of you taking the time to suggest possibilities. It means a lot to someone who is hurting!!!

    Thank you and I'll let you know what the doctor says.

  7. #7
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    Countrygal1 several people on this forum have had the same thing including myself. It starts shortly after urinating an can last from ten min to an hour. The pain is so severe that no pain meds will touch it. My resolution was to have Cath put back in for five days.

  8. #8
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    Quote Originally Posted by Busby View Post
    Countrygal1 several people on this forum have had the same thing including myself. It starts shortly after urinating an can last from ten min to an hour. The pain is so severe that no pain meds will touch it. My resolution was to have Cath put back in for five days.
    It does seem like he is experiencing bladder spasms as the pain starts after he urinates. Why does putting a catheter back in resolve it? He had the catheter in for a little over a week and he was REALLY happy to get it out. He would not look forward to getting "Piddles" (as we named the catheter bag) back again.

  9. #9
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    It's R&R for the bladder. Seems bladder spasms can occur if the catheter is in too long or not long enough. Either condition can be irritating.

    Very painful. Like a leg cramp, but in your bladder. It's a powerful muscle. My catheter was in too long and doc said it was trying to reject it. I suspect the same may be said about the wound it suffered.
    Last edited by Another; 11-12-2019 at 06:22 PM.

  10. #10
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    I would concur what the other responders said about bladder spasms after the catheter is removed. I didn't have any while it was in but had numerous in the weeks after. I also recall that caffeine seemed to exacerbate the issue, so it's best to stay away from that for a while. He's still only a few weeks out from surgery. Lots and lots of healing is still taking place. Check with the doc and I'm sure things will get better. Best wishes.
    Age 52, No symptoms, healthy, GrF had PCa at age 78
    First PSA test ever 5/2019: 7.037 (referred to urologist)
    Normal DRE
    PSA 7/2019: 5.152, Free 8%
    PSA 8/2019: 4.652, Free 7%
    Biopsy 8/16/19
    Dx PCa 8/30/19
    16 cores taken/ 5 positive for PCa
    L Apex and L Mid: (G 3+3=6) involving 2 cores, 10% of ea / Grade Group 1
    L Lat Apex: (G 3+3=6) involving 20% of 1 core/ Grade Group 1
    L Lat Mid: (G 3+3=6) involving 60% of 1 core/ Grade Group 1
    L Medial Mid: (Gleason 3+3=6) involving 70% of 1 core/ Grade Group 1

    DaVinci RP 10/10/19 Nerve Sparing
    Post RALP Path:
    G 3 + 4 = 7 (was 3 + 3 = 6 on biopsy)
    Grade Group 2
    % of prostate involved by tumor: 6%
    EPE, BNI, SVI, Lymph invasion, Margin positivity in area of EPE: All of these were not identified
    Margin involved by invasive carcinoma: Limited (<3mm), Focality: Unifocal, Location: L Mid Posterior
    PNI: Present
    Pathological Staging: T2 N0 MX

 

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