I recently underwent a bowel resection and hysterectomy for rectal cancer (Stage 3). The tumor was located where the rectum and colon meet. A few days after surgery the folley catheter was removed. I was unable to urinate, so the catheter was put back in. This process went on several times until I was finally discharged from the hospital with a catheter. It has now been almost three months since surgery and I am self cathetering. The only time I feel the urge to urinate is at night while sleeping or when my bladder is very full. If my bladder is very full I can urinate a little while having a bowel movement or pushing as if I were going to have a bowel movement. Any information that you provide on my chances of having full bladder function would be helpful. Also is there any treatment for this condition? By the way, I am a 34 year old female.
[Editor's Note: Though this question is not on a topic that we usually address in this forum, one of our staff did provide an excellent answer and therefore it is being posted.]
Dear Michelle,
After a resection of a colon cancer particularly in the area that you describe, the symptoms are related to denervation of the bladder. The nerves that once went to the bladder were cut to remove the mass. This is a known complication of pelvic surgery and can have various outcomes. It sounds like the doctors have shown you how to perform clean intermittent catheterization of your bladder to help your bladder rehabilitate. An over distended bladder will never resume adequate functioning. Therefore it is important for you to drain the urine at least 5 times per day. This will also reduce the chance of infection and renal problems.
You should know that it is entirely possible that you will not regain the ability to spontaneously urine. As you said, straining and valsalva maneuvers will help, but catheterization is the only way to make sure the bladder is completely empty. You should never allow your bladder to become distended for more than 500 cc. You should also know that if you push down on the lower portion of you abdomen just above the pubic bone, you may be able to help yourself urinate (called “a crede maneuver”). This, however, should not be your principle way of urinating..
It is unfortunate that complications occur, however, if the surgery was a success and the cancer was removed that is the most important outcome. I know I did give you many suggestions for a cure, but I tried to explain why this has happened. Only time will tell if your spontaneous bladder function will return.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Neurogenic Bladder
