Dr. Vaibhav Vishal
Urology
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Patient's Query
Hello doctor,
My mother is 75 years old and weighs around 88 pounds. For quite some time she was having a problem with urine accumulation and difficulty in clearing up. Ultrasound abdomen pelvis showed a distended urinary bladder with normal wall thickness. No calculus is seen in the lumen. The duct is normal in caliber, pre-void volume 17.7 fluid ounces, postvoid - unable to void. Ultrasound impression suggests of cystitis, significant postvoid residual urine, arc-like calcification in the posterior wall of the fundus with degenerated myoma. I can send pictures of the report. Two weeks of the catheter were advised and extended for another two weeks. I seek your opinion and advice.
Thank you.
Hello,
Welcome to icliniq.com.
In elderly females, the problem of being unable to clear urine is common due to weakness in the bladder muscle due to age and bladder support muscle weakness. This can either be temporary due to bladder infection or permanent due to extreme bladder muscle weakness (age-related). According to the condition described by you and the sonography report, the correct treatment has been started. Treatment consists of two to four weeks of catheterization with tablet Urotone and antibiotics for cystitis ( bladder infection). All these things have already been done in your case. The next step would be to remove the catheter after four weeks and give a trial of spontaneous voiding of urine. If she is not able to pass urine then again catheterization will be needed. And you will need to get a test called a urodynamic study, which is done by a urologist in his clinic. This test tells about the exact bladder pressure and whether self-spontaneous urination is possible or not.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply. I would also like to know, for how long one can use catheterization and how safe it is? If it is due to extreme bladder muscle weakness (age-related) then what could be the course of treatment? Can it be related to or caused due to sciatica, or lower spinal problems due to which nerves may be pressed? Request you to please clear these doubts.
Thank you.
Hello,
Welcome back to icliniq.com.
Catheterization can be used for four weeks at least. If longer catheterization is needed then the catheter needs to be changed. In case of bladder weakness initially medications like Urotone are continued for a longer period. If that is not successful then catheterization is continued. Yes it can be related to sciatica and nerve compression. An MRI and neurosurgeon opinion may be needed.
Thank you.
Patient's Query
Hello doctor,
Thanks for all your clarifications. Should we continue to use catheters for a week more? Or try to do something else? Our nurse is available who usually changes the bag and can be present if anything else needs to be tried.
Hello,
Welcome back to icliniq.com.
If the catheter is not blocked then it can be continued. The catheter needs to be changed only if it is blocked or after 1 month (in the case of a normal latex catheter) or 3 months (in the case of a silicone catheter). The latex catheter is yellow and the silicone is white. So I suggest you to continue your catheter even if it is required for more than 1 week and then visit your urologist for catheter removal and a trial of voiding. If your present catheter has been there for more than a month then ask the nurse to change it.
I hope this has helped you. Thank you.
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