Post-Prostatectomy Urinary Retention: Causes and Solutions - Urology

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Post-prostatectomy urinary retention can be a challenging issue, particularly for older patients who have undergone surgery for benign prostatic hyperplasia (BPH). In your father's case, several factors could contribute to his ongoing urinary retention following the prostatectomy, and understanding these can help guide further management.

1. Causes of Post-Prostatectomy Urinary Retention:
- Bladder Dysfunction: After surgery, the bladder may take time to regain its normal function. The surgical procedure can affect the bladder's ability to contract effectively, leading to retention. This is often due to nerve damage or changes in bladder muscle tone.

- Prostate Size and Shape: Even though only a small amount of prostate tissue was removed, the surgery can alter the anatomy of the bladder neck and urethra, potentially leading to obstruction or difficulty in urination.

- Medication Effects: The medication "胃可麗" (likely referring to a medication like tamsulosin, which is used to treat urinary symptoms) can help relax the bladder neck and improve urine flow. However, if the bladder is not functioning well, the medication alone may not be sufficient.

- Postoperative Complications: Other complications such as infection, scarring, or the formation of blood clots can also contribute to urinary retention.

2. Role of "胃可麗" in Recovery:
- Continuing to take "胃可麗" may help manage symptoms by relaxing the muscles around the bladder neck, which can facilitate urination. However, if there is significant bladder dysfunction, the medication may have limited effectiveness. It is essential to discuss with your father's physician whether the current dosage is appropriate or if adjustments are needed based on his ongoing symptoms.

3. Alternative Management Strategies:
- Bladder Training: Engaging in bladder training exercises can help improve bladder function over time. This involves scheduled voiding and gradually increasing the intervals between urination.

- Intermittent Catheterization: If your father is unable to void independently, intermittent catheterization may be a temporary solution to relieve urinary retention while allowing the bladder to recover.

- Urodynamic Studies: Further urodynamic testing can provide insights into bladder function and help identify specific issues that may be contributing to retention. This can guide treatment decisions.

- Surgical Options: In some cases, if conservative measures fail, additional surgical interventions may be considered to address any anatomical issues or obstructions.

4. Monitoring and Follow-Up:
- Regular follow-up appointments with the urologist are crucial to monitor your father's recovery and adjust treatment as necessary. It is essential to communicate any changes in symptoms or concerns about the current management plan.

In conclusion, post-prostatectomy urinary retention can result from a combination of factors, including bladder dysfunction, anatomical changes, and medication effects. While "胃可麗" may provide some benefit, it is important to explore additional strategies and maintain close communication with your father's healthcare team to optimize his recovery and quality of life.