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.
Prostate Diaries 
My husband just had a prostatectomy about 10 days ago. His prostate was about 4-5 times the size of the average enlarged prostate. A penrose drain was excessive urine leaking from the penrose and around it while the foley was draining properly. The penrose was removed, and he is still leaking urine from the site. The foley was changed more than once post-op and different balloon sizes were tried. Has anyone ever heard of this? I am not sure why he would still have so much urine leaking from the site with a catheter draining effectively. We were told to keep him on bed rest and allow time for healing..
LikeLike
To all: I had robotic assisted prostate surgery on July 26. After about two days I experienced leakage around the catheter. Today is Aug 13th and the leakage continues. The catheter is still in place due to (what I have been told) slow healing caused by my necessity to take 15 mg of prednisone each day. I am on oxybutinin and valium to try to control bladder spasms. My spasms are not painful and I just have an urge to “pee” which I have been told are bladder spasms. My leakage is quite significant. Drip, drip, drip but never at night. Hard to keep dry pads and clothing. Very uncomfortable. I try to exercise byn walking about 10 times per day for short distances.
Larry
LikeLike
The catheter has a balloon in the bladder that keeps it from falling out. Think of it as a small golf ball in the bladder that shouldn’t be there and the bladder, a big muscle, is trying to spit it out. The good news is that the catheter will be out in a few days or so and the spasms will cease. What you are experiencing now has no bearing on how soon you regain continence. I hope this helps and I wish you well in your recovery. JM
LikeLike
JM,
Thanks for the info. 26 days with the catheter has been difficult but he copious leakage has been the worst of the problem. Any relationship between prednisone and healing escaped my investigation prior to or after surgery. To this day I still would like to readabout that relationship…..if it indeed does exist.
Again, thank you so very mucvh for your comments.
Larry
LikeLike
I had my prostate out in October, I still have a catheter in and it will be taken out on December 27th 2012. Every time they take it out the bladder scars tissue closes the hole and i cant pass water. I have been in a lot of bad pain, and have not been given anything to ease the pain.
LikeLike
To all,
My catheter has been out now for almost 5 months. I’m still not continent and concerned if I ever will be. Not any fun at all to be changing pads every 4 to 5 hours, if not more often. My doctor has told me it might be up to a year before he would be convinced of the incontinence. That is a long time to wait. I’m doing the “kegal” exercises and hope to win this battle. Any ideas that come my way are appreciated.
Larry
LikeLike
Is there any reason at all why a small leak at the connection of the baldder to the urethra would take more than 24 days to closeup. The leakage has been confirmed by 2 cystograms, 1 after a week and the next after another week. I am now 11 days into a 15 day wait for another cystogram to see if the leak has closed. What are my options if the leak is still there?
LikeLike
Please anyone can you help us, my stepdad has cancer in the lung and has been in hospital for ten weeks now, so they put a cathter in so it easy for them I think as he knew when he wanted to pee and could ask but now when he pees it is spraying out and he is in so much pain.. Now we get told nothing they can do as he can’t have anasetic because it will kill him.. We live in small town and no urologist in town for two week.. Was told if they take it out he will not be able to pee at all now, he did have prostate cancer before and got over it but no doctor has told us if the cancer is back there.. Thank you.
LikeLike
BRENDA,
My husband had prostate surgery on 9/29/15, he still has the catheter and has had numerous cystograms, only to be told that he still has a bladder leak, and to add insult to injury, he had a blood clot pass through his heart on 10/29/15, it was a 911 call for ems and emergency transport to hospital, where he was admitted to ICU for 3 days and had to have yet another procedure to place a filter in his right groin to stop the clots from reaching his lungs and heart. I feel that the physician is lost and does not know what to tell us, my husband is giving up. He is on Eliquis and has increased risk for bleeding, which he developed 2 days after being discharged from the hospital. my thoughts are so scrambled that it is hard to focus, we know have to see a cardiologists, vascular specialist, pulmonologist and still have no plans for chemo or radiation.
LikeLike
So sorry to hear this, my Husband has had prostatectomy and is now on 5th week of foley catheter which is slowly depressing him, he is so uncomfortable with it, can’t sit or walk. has to have another cystogram in 2 weeks.
LikeLike
After nearly 3 1/2 years post robotic prostate removal I am still incontinent. I think this was all decided by errors in surgery. The neck of my bladder at the point of the sphincter muscle was significantly damaged to the degree where the urine flow did not even empty into the catheter placed after the surgery. The urine simply ran down the outside of the catheter tube. I should have known there was no hope for regaining continence. This has resulted in a very significant change in my life. The surgeon and the hospital have never attempted to acknowledge any liability. And I suppose you can never expect them to do so. I strongly suspect that the surgeon I trusted to do my surgery never did so, but rather turned it over to an intern. She was the only person I ever saw during the surgery or after the surgery.
Larry Thomforde
LikeLike
I too had excessive leakage around the catheter which was left in for almost 4 weeks. 3 cystograms were done to identify a possible leakage outside the bladder. Neither the surgeon nor my regular urologist gave any indication that that “malfunctioning” catheter could have effected the heavy incontinence that is still present after almost 3 years. Went through 6 weeks off internal physical therapy that the therapist concluded as successful. This whole experience has been frustrating and often embarrassing due to leakage. An internal sphincter was suggested but nixed by myself and my urologist and it was inferred to “live with it”. An easy suggestion from someone who doesn’t have to deal with leakage. I am an active 70 year old that can’t perform.
LikeLike
Reblogged this on Prostate diaries and commented:
When the bladder spasms urine will go around the catheter. In the big scheme of things – urine getting out… Is a good thing.
LikeLike
My 61 year old husband had robotic prostate removal surgery on Friday, Oct. 28. He is having bladder spasms and taking medication for this. Each time he has a spasm, urine comes out, in increasingly large amounts. This is significantly increasing. Worried that catheter isn’t working right since so little urine in bag.
He spoke to surgeon’s nurse who said he shouldn’t be worried. Any thoughts or suggestions would be appreciated!
LikeLike
There is a possibility that there is a small clot in the catheter. I think it is fair to ask them to see you to check out the patency of catheter. Jm
LikeLike
I appreciate your advice. Thanks!
LikeLike
I am thankful for these comments. I, like others, have been experiencing bloody urine, copious leakage and these damn spasms that are quite sharp and painful …. especially at times of bowl movement. The blood has been increasing as the days go by. Between 10 pm at night and 8 am I am passing approximately 2.5 litres of fluid. I suppose that is a good thing from a kidney function point of view. At the hospital after surgery and for 3 days – no leakage. Now, 8th day in – a LOT of leakage and lots of blood and horrible odour and that stinging grinding spasm pain!
From what I have read above – this appears normal??? Yes??
LikeLike
The blood around the catheter and the spasms (your bladder doesn’t like the balloon on the end of the catheter and is trying to spit it out) are not unusual. Smell however may be an issue and you should let your doctor know about that…it may prompt an antibiotic or suggestions regarding local care to the area where the meatus touches the catheter. Things will be much better hopefully when the catheter is out. JM
LikeLike
Lawrence and all,
Prostate cancer seems so insignificant to all of those folks who have not been afflicted. Had a Federal Government official tell me that prostate cancer was a good type of cancer to have. I’m sure he meant well but it didn’t come out right or what he was trying to express. Reflecting back on my radical surgery, clearly the extreme leakage around the catheter must have been an indication that things were not placed properly at the end of the surgery. I have never regained bladder control and remain totally incontinent. I worry about how this will affect my end of life time period.
Larry
LikeLike
It is not about the catheter placement. It is about the the surgery itself. The effect of removing the prostate and its anatomical significance.
LikeLike