Q. When will the wound created during urolift procedure heal?

Answered by
Dr. Saurabh S Pandya
and medically reviewed by Dr. Divya Banu M

Hello doctor,

I just had my second urolift a week back. My doctor-surgeon pinned down the median lobe of the prostate and removed a bladder stone during that surgery. Had voiding trial two days back. Urinated out about 200 cc at urologist's office. I think she put in 300 cc if I recall correctly. Went home and had to come back and be recatheterized at 4:30 PM. Had 485 cc in.

My bladder at that point was able to get a fairly good stream going for a while but then got spasms and just dribbling so the amount out was not good enough to handle the amount of liquid going into the bladder. The head of my penis had stopped bleeding from the surgery but the recatheterization has caused it to start bleeding again. PA wants another voiding trial next week. I am concerned that this is too soon and that the wound inside the head of my penis will never heal and the spasms which do not allow me to accomplish a successful voiding trial will never cease if I am not given enough time to heal. Your thoughts?

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Dr. Saurabh S Pandya

M.B.B.S.., M.S. (SURGERY)., M.CH. (UROLOGY
Urology

Hi,

Welcome to icliniq.com.

In urolift, there is no cutting and therefore no wound. The prostate tissue is pinned to its covering and this widens the urine tube. So one week's rest should be fine for whatever healing there has to occur. The spasms that occur with a catheter in place are due to bladder trying to push out the catheter and these go once the catheter is removed.

I think another trial of catheter removal is fine. If it does not work, or you are not happy with the flow or symptoms, or if you have more than 100 to 150 cc residue, better to undergo a formal TURP or HoLEP surgery for the prostate. It is an endoscopically performed, under anesthesia and little side effects. In your case, the urolift is causing problems and this defeats the whole purpose of urolift being less invasive than prostate surgery.

Thank you doctor,

It appears to be the inside of the head of the penis that is bleeding, not the prostate so there is a wound. The spasms have not stopped after the catheter was removed during the voiding trial and I thus failed the voiding trial. How is the urolift causing the problem? It appears to me the bladder spasms are the problem. How can they be alleviated? What is causing them and what can be done about them?

Dr. Saurabh S Pandya

M.B.B.S.., M.S. (SURGERY)., M.CH. (UROLOGY
Urology

Hi,

Welcome back to icliniq.com.

So this can be a tear in the urinary tube when your urologist had to insert a cystoscope for removing the bladder stone, or while doing the urolift. Usually, it should heal in a week's time. You can apply topical antiseptic cream around the point of exit of the catheter twice daily. If there is a pain, you can apply topical anesthetic gel (Lignocaine) alternately with the antiseptic cream.

Bladder spasms are usually due to infection, stone or catheter irritating the bladder. They need removal of the underlying cause, and if severe, use of bladder relaxant medicines. But in your case, the first priority for you is to be able to pass urine completely without any residual, so one you are able to do that, and if bladder spasms persist, you can ask your doctor to add bladder relaxant medicine. Urolift was supposed to make you pass urine more easily, instead, you went into retention twice, so that in my book is treatment failure. If you fail voiding trial again, go for endoscopic prostate surgery. Take care.

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