When the prostate is removed, the bladder is separated from the urethra (the tube that runs through the penis which men void through). After the prostate is out, the doctor then sews the two areas back together. It takes about 7-10 days for this to heal. A catheter is placed through the tip of the penis in urethra, past the junction of the bladder and the urethra, which has been sewed together, and then into the bladder. A catheter (foley) stays in the bladder by a balloon at its tip. The balloon keeps the catheter from falling out and is about the size of a golf ball.
The bladder does not like the balloon in there. It perceives it as a foreign body and wants to “spit” it out. It does so by contracting as it would to make urine. This is a bladder spasm and can result in the loss of urine around the catheter alone, or associated with excruciating pain. This leakage around the catheter with or without pain is relatively common and is of no real medical consequence.
Blood that seeps around the catheter and appears at the tip of the penis is common as well and is nothing to worry about.
As a urologist, what we worry about is when clots form in the bladder and block of the foley and prevents the free flow of urine. Now that is an issue. Urine or blood around the catheter is just part of the deal when you have to wear a catheter for a period of time for any reason.
If you don’t have spasms or leakage, just consider yourself lucky. I had a bladder spasm to high heaven and I have never had pain like that before. It was something else…my friend.
Question: Urine leaks around catheter after prostatectomy. Is this normal?
January 14, 2011 by John McHugh M.D.