Q: My 85 years old father underwent tumour surgery. After that, the doctor put catheter for five days. On the 5th day, the doctor took out catheter for three hours but my father was unable to urinate. Then the doctor put the catheter again. After another week, my father himself pulled out the catheter. After that he was able to pass urine but with putting much pressure on the abdomen. We took him to another doctor, who told us that a surgery is needed and there is no medication for it. My father's prostrate gland is of 68 gm. Is it necessary to undergo surgery? Will he be all right after the surgery?

A:Apparently your father had a successful voiding trial and he is currently passing urine after removal of catheter. What needs to be done is to test his flow rates with uroflometry so that it could be judged whether his flow parameters are within acceptable range. His bladder too needs to be tested for residual urine to see whether he is able to empty his bladder satisfactorily. A residue of more than 100 ml is a clear indication of insufficient emptying. If he has maximum flow rate of more than 15 ml/sec and bladder emptying is effective as judged by residual urine in bladder, he does not require surgical intervention. Some benefit may be provided with medication too. Large residual urine, stone formation in bladder, recurrent infections, bleeding with urine, presence of back pressure changes on kidneys and recurrent episodes of retention of urine are clear indications for surgery.