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Urine in JP-Bulb

Hello all,
My father is 73 and has had a prostatectomy with the Di Vinci robot on 12/14. I assume that's the correct medical name for it; his prostate was removed due to aggressive prostate cancer.

It has been a rough few days. After his surgery his bowels stopped working and he became severely bloated. Doctors told us (my mom and I) that this was normal. On the 15th a tube was placed down his nose to his stomach to relieve any fluid/gas while shots were placed once a day in his leg that were supposed to 'jump start' his bowels. On the 17th he had a strong bowel movement which I believe included blood, but the nurses assured us that was normal and that it was still a good sign that his bowels were starting to work again.

Today is the 18th and he had another bowel movement, and I was told he was up and walking for a little bit earlier in the day.

However, we were told today that when they were looking at his JP bulb, they (hospital) found urine in the bulb. The doctor came by for a visit and we asked how that was possible. He told us that it could be a problem with the urethrea and that hopefully scar tissue would patch it up. My question was that if there were scar tissue, how would anything go through the catheter? He seemed to disregard it with some medical terms that we didn't understand and then left the room.

I need help. Everyday I come home and look up what I can to find out any more information about what I hear at the hospital. I do what I can to help my mom understand and know more about it. If anyone has any other information on things to look at, what we should pay attention to, anything to throw back to the doctor for better answers, please, let me know.

Thanks.

Re: Urine in JP-Bulb

Aloha Chris,
I'm sorry you find yourself in this position. There is not much information to respond to here. Did you have talks with the surgen/uro doc prior to surgery? How did that go? Was he responsive? How many operations has this doc performed?
When thing go wrong, doc's often become more vague and are harder to pin down. I'd suggest making an appt to discuss your fathers case or be there when the doc makes his rounds. Be firm, stand between him/her and the door. Don't let the doc leave until he explains what you do not understand. Just keep saying you don't understand until you do understand what he is talking about.
This web site can be used to find other men who have had the same procedure. E-mail them. Ask if what your father is going through is normal. It sounds as if there are unforeseen - un-discussed problems.
It takes a lot of blood, almost like unstopping hemorrage in the urinary track to be serious. Often I pass 5 to 10 cc of dried blood. It looks bad, but it is not. This much blood makes me sick to my stomach, but I am still going.
Hope your father improves,
Keep in touch, chin up, do not let the doc out of the room, he/she owes you an explanation you can understand,
Joe

Re: Urine in JP-Bulb

Urine in the bulb is often an indication of disruption in the urethra anastamosis or reattachment. Remember that the prostatic urethra is removed when the prostate is removed so that the penile and bladder urethra must be connected in order for urine to escape. (The reason why there is a lost in penile length.) The foley catheter is left in place for usually a week so that those two segments can attach. If you can imagine a tube being sewn to another tube then you can see that if a suture did not fully pull the tissue together there may be an opening that allows urine to escape into the abdominal cavity. As long as the urine escapes the body, very little problem.

Why is it leaking now and not immediately after surgery: the swelling around the urethra is diminishing. Your doctors will hope that the healing will take care of the leak rather than having to do something surgical. A point is that straining to have a bowel movement can be not good for urethra healing. Push your doctors to explain things in plain terms until you fully understand. Write down the words or terms that they use. Write down the questions you want to ask so that you don't forget.

Good Luck, Miguel

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