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How to manage difficulty in passing urine after TURP?

Q: My father, aged about 80, was suffering from urinary problems i.e. difficulty in passing urine, frequency and post voidal residual urine (45 ml). Subsequently, he underwent TURP last month. PSA and other blood tests such as Urea, Creatinine, Blood Sugar, etc. were within normal limits before TURP. Urine for C/S was found negative after TURP. No malignancy was found on examination of operated material. He was better till about one month after this operation. Thereafter, he began to complain of the same problems as he had before the TURP. Again, all blood tests and USG of KUB & Prostate were done. All the blood tests were normal but post voidal residual volume was found to be about 124 ml. The urologist suggested cystoscopy to exclude BNI and stricture urethra. Accordingly, that was done and the doctor subsequently told us that he found no problem with bladder and no stricture urethra during cystoscopy. He also added that prostate was fine and there was no regeneration of prostate. But the patient was not problem-free. Recently, the problems have aggravated. He has to go to urinal once in every 30 minutes or so. Sensation of heaviness and spasm on the left side of navel are felt. The patient had never any complaint of hypertension but suddenly the BP shot to 180/110 mm of Hg last week. It was controlled by giving Tab. Benace (5 mg) once daily. Now, it is about 140/85 mm of Hg. Another urologist has been consulted. He suggested some blood tests, USG of KUB & prostate, IVP (IVU), RGU, etc. Please give your valuable suggestion.

A:It is obvious that your father does not seem to have any outlet obstruction. We should rule out bladder atony possibly because of aging bladder. What your urologist needs to do is pressure flow urodynamic test to know the status of his micturition and bladder muscle and then advise him accordingly.

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