Immediately after surgery, you will have a Foley catheter in your bladder which will drain the urine. It is essential that this catheter stay in place while the tissues connecting the bladder and the urethra are healing.
There is a balloon on the end of this catheter which is inflated with water to prevent the catheter from falling out. It is difficult to pull out the catheter with the balloon inflated, but it is possible, so be careful! The catheter stays in place for about a week, depending on your surgery and your surgeons preference.
The catheter is connected to a bag that holds the urine. You will be given two bags when you leave the hospital. One bag can be strapped to your leg during the day and hidden under long pants or sweat pants while walking around. The larger bag can be used at night or when at home. Sometimes the catheter in the bladder causes irritation and bleeding. It is not uncommon to see some blood or blood fluid mixed with the urine. Even with the catheter in place, some urine, fluids secreted by the glands in the penis, and blood can leak around the catheter. This happens more commonly during bowel movements.
If the catheter is exiting from the penis, it is extremely important that you keep the catheter as it enters your urethra lubricated with Neosporin ointment so that it does not become dry and cause urethral damage.
You may continue to have bladder spasms after you go home. You may feel these as intense cramping pain in the lower abdomen combined with a need to urinate. These are caused by the irritation from the catheter, and should decrease with time.
Occasionally catheters become clogged and stop draining. Always make certain urine is collecting in your drainage bag. In the rare event it is not, call your physician or go to the local emergency room. It may need to be irrigated.
Catheter Removal
Your catheter will be removed about a week after surgery in our office. The balloon is deflated and the catheter slides out. Bring a Depend undergarment (Depends Underwear) with you to the clinic the day the catheter is removed and expect to wear pads for protection for a period of time until your urinary control returns. If you live a long distance from St. Louis, you may want to bring a pillow to sit on to ease catheter discomfort.
Urinary Control
Once the catheter is removed, it takes some time for the bladder to learn how to function properly again. As the bladder learns how to hold more urine and the muscles in the bladder and urethra heal, your control will improve. While some patients regain control more quickly, most men require a period of time before their control returns. By two-three months after surgery, the vast majority of men are using 0-1 pad per day. Some men will continue to have mild leakage or stress incontinence when they bend over, lift, cough, or exercise vigorously. This gets worse when the bladder is full or when they are tired or drink alcohol. Leakage is usually worse in the evening when the pelvic muscles are tired. We recommend Kegel exercises to improve urinary control, and you will find detailed instructions for doing these exercises below. We will have you set up an appointment to work on these exercises with Reggie Boon, NP.