Dr. Ankush Jairath
Urology
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Patient's Query
Hello doctor,
I have been on a foley catheter since two. COVID prohibited the procedure at that time. I am having a cystoscopy on the 18th of this month. If all is well, will my bladder be too weak since it has been on the foley for so long? Foley has been a pain and I am on Xarelto and Plavix which causes intermittent bleeding during the day. But I do not have any infection. I am also a diabetic and I cannot self cath. What do you think they will recommend? I am currently on Flomax and Finesteride.
Hello,
Welcome to icliniq.com.
Coming back to your query, you need to answer some of my questions first. When the catheter was put how much urine came in the first 15 minutes (did your bag get filled fully, half or what)? Were you on a floral Finastride combination before you were put on a catheter? For what reason you were catheterized? Was it retention of urine? Any abdominal ultrasound done till date which mentions prostate size? Do you have any urinary complaints like frequency, urgency, poor stream, nocturia, dribbling, burning, or micturition before catheter was placed and how long you were having them if any? Is your diabetic status under control? Any HbA1c report?
Patient's Query
Thank you doctor,
They removed 275 cc of urine in the initial catheterization. I was on Flomax and Finasteride before the catheter. I was catheterized because of urinary retention. My prostate size was enlarged, PSA of 2. I have slow flow and intermittent stopping, but at other times, all is normal. This has been happening for 5 years. My HbA1c is 6.4.
Hello,
Welcome back to icliniq.com.
There should be a value to prostate size (in gms or cc). Was that urinary retention painful? What is the night time-frequency (11 PM to 6 AM) before catheterization? Based on previous information cystoscopy is done to see prostatic urethra and bladder as to decide if any surgical procedures in the form of prostatic surgery are needed (TURP/HOLEP). Catheterization helps your bladder to regain strength rather than weakening it by giving it proper rest it needed so no question of weakening even after three months of catheterization. Your anticoagulants need to be stopped for five days before any major surgery.
Patient's Query
Thank you doctor,
I do not have prostate size value. Urinary retention was not painful and my night time frequency was 2 times. I was told since I was having a flexible cyst, I did not have to come off my blood thinners. Is that not correct?
Hello,
Welcome back to icliniq.com.
As this is going to be only diagnostic flexible cystoscopy there is no need to stop blood thinners right now. But in case, your doctor feels there is a need for any intervention based on the findings of cystoscopy, in that case, you need to stop your blood thinners. For example, if during cystoscopy, if there is significant prostate enlargement then you will be told to get operated for the same. In that case, you need to stop your blood thinners. Above I am coating only an example, you may not need any kind of intervention so everything depends upon cystoscopy findings. Flexible cystoscopy is a daycare procedure that does not require blood thinners to be stopped.
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