Q: My grandfather is 71 years old recently had a prostate surgery. He had 32 mg prostate weight and 150 ml urine was left in prostate so for that he was operated. But after 15 days of removal of catheter he has no sense for urine. He is passing droplets of urine but not able to urinate properly. Is it failure of operation or after effects? Whether it is curable or not?

A:High residual urine or failure to pass urine in a person may denote outlet obstruction or a weak bladder muscle or their combination. Failure of bladder muscle to generate enough pressure to empty, results in such situation even if there is no outlet obstruction. It may occur if the bladder has remained over distended for a long time (chronic retention) or due to any disease making nerves weak (spinal problems or long standing diabetes causing neuropathy). Your grandfather may have failed surgery because of a weak bladder muscle due to any of these reasons. Way to go ahead is to check for bladder muscle contractility by doing a cystometry study (urodynamic evaluation), something like ECHO for the heart, to measure bladder pressures. The long term outcome depends upon the cause. If the bladder is weak due to long term over distension (chronic retention), it recovers in due course of time. Outcome in diabetes or spinal diseases may be suspect, and patients may have to be put on intermittent catheterisation to empty the bladder.