Urinary Retention After Laparoscopic Gallbladder Surgery

Q: Urinary Retention After Laparoscopic Gallbladder Surgery

Hello： Some patients with benign prostatic hyperplasia may experience urinary difficulties after undergoing general anesthesia. <br>Below are common symptoms of patients with benign prostatic hyperplasia for your reference. <br>It is recommended that if you experience any of the

Anuria issue?

I just had laparoscopic cholecystectomy two days ago.
I can urinate on my own, but I have no urge to urinate.
What should I do to improve this? Is it caused by general anesthesia? Thank you.

Tawtai, 50~59 year old female. Ask Date: 2011/12/30

Dr. Zhou Xinpei reply Urology

Hello: Some patients with benign prostatic hyperplasia may experience urinary difficulties after undergoing general anesthesia.
Below are common symptoms of patients with benign prostatic hyperplasia for your reference.
It is recommended that if you experience any of the following symptoms, you should visit a urology clinic for further examination.
Symptoms and conditions of benign prostatic hyperplasia:
1.
Early stage: Frequent urination, slow urination, and a weak urine stream.
2.
Intermediate stage: Urgency incontinence, feeling of incomplete bladder emptying, sensation of residual urine, bladder inflammation due to residual urine, and increased nocturia.
3.
Late stage: Obstructive renal dysfunction due to bladder dysfunction, which can lead to increased uremic toxins or chronic pyelonephritis, resulting in bilateral renal function decline and ultimately leading to uremia.
Diagnosis of benign prostatic hyperplasia:
1.
Digital rectal examination: A urologist inserts a finger into the rectum to palpate the prostate for enlargement or potential cancer.
2.
Urinalysis: Checking for the presence of white blood cells, bacteria, or even hematuria in the urine.
3.
Blood screening: An elevated PSA level (greater than 4 ng/mL) in the blood may indicate a potential risk for prostate cancer.
4.
Transrectal ultrasound of the prostate: Using ultrasound to visualize prostate tissue.
5.
Uroflowmetry: Normal maximum urinary flow rate in men is greater than 15 mL/s, which can assess the patient's urination time and speed.
6.
Urodynamic studies: These can provide detailed evaluations of bladder function and determine if urinary symptoms are due to prostatic obstruction.

Reply Date: 2011/12/30

More Info

After laparoscopic gallbladder surgery, experiencing urinary retention or a lack of urinary urgency can be concerning, but it is not uncommon. The absence of a strong urge to urinate following surgery can be attributed to several factors, including the effects of anesthesia, the surgical procedure itself, and postoperative pain management.

1. Effects of Anesthesia: General anesthesia, which is commonly used during laparoscopic surgeries, can temporarily affect the bladder's ability to contract and signal the need to urinate. Anesthetics can alter the normal functioning of the nervous system, leading to a reduced sensation of bladder fullness. This can result in urinary retention, where the bladder fills but the patient does not feel the urge to void.

2. Postoperative Pain Management: Pain medications, particularly opioids, which are often prescribed after surgery for pain relief, can also contribute to urinary retention. Opioids can inhibit the bladder's ability to contract and may lead to constipation, further complicating the situation. If you are taking any narcotic pain medications, it may be worth discussing with your healthcare provider about alternatives or adjuncts that have less impact on urinary function.

3. Surgical Factors: The surgical procedure itself can cause temporary swelling or irritation in the pelvic area, which may affect the nerves that control bladder function. Additionally, if there was any manipulation of the surrounding tissues during surgery, this could also lead to temporary changes in bladder function.

4. Hydration and Positioning: Ensuring adequate hydration can help stimulate bladder function. Sometimes, simply changing positions or walking around can help encourage the urge to urinate. If you are able, try to get up and move around a bit, as this can stimulate the bladder.

5. Time Frame for Recovery: Generally, the effects of anesthesia and pain medications should diminish within a few days post-surgery. If you are still experiencing urinary retention after a few days, it is important to follow up with your healthcare provider. They may perform a bladder scan to assess how much urine is retained and determine if further intervention is necessary.

6. When to Seek Help: If you experience any signs of urinary tract infection (UTI) such as fever, chills, burning sensation during urination, or if you are unable to urinate at all, it is crucial to seek medical attention promptly. Persistent urinary retention beyond a few days should also be evaluated by a healthcare professional to rule out any underlying issues.

In summary, while it is not uncommon to experience a lack of urinary urgency following laparoscopic gallbladder surgery, it is important to monitor your symptoms and communicate with your healthcare provider if the situation does not improve. They can provide guidance tailored to your specific circumstances and may suggest interventions to help restore normal bladder function.

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