After the surgery, I was able to urinate a few times a day but retained two pounds of fluid for two days. On the third day after the surgery, I was finally able to eliminate all of the retained fluid and I urinated every 20 minutes all day long. Since then, I have noticed that my urine stream is weak. It has been five months since the surgery, and lately, when my bladder is full in the morning, I am not able to empty it fast enough, and it causes pelvic pressure and pain and sometimes cramping until it slowly empties. I do not have a fever, blood in my urine or a burning sensation. I do not have a history of kidney stones and have only had one UTI, which was 11 years ago. The only medication that I currently take is atenolol in the morning. The night prior to the surgery, I was given misoprostol to ripen my cervix. The procedure required a catheter, which was removed before I regained consciousness.

Could this change in my ability to empty my bladder quickly be a result of general anesthesia or the catheter? What tests and treatment should I seek? Will this go away, or is it something I have to live with? I now urinate frequently to intentionally prevent my bladder from getting too full, but I’m not sure what else I could or should be doing. Many thanks for sharing knowledge and expertise.

DEAR READER: A catheter is a thin, flexible tube that is inserted into the body to either introduce or withdraw fluids. The word catheter is most often used to describe a tube that is used to empty the bladder. This can be achieved by insertion directly into the urethra, which leads to the bladder, or in some instances, a special opening is created within the abdomen for the catheter to be placed.

Dilation and curettage (D&C) is a surgical procedure in which a physician dilates the cervix and then scrapes the uterine lining. This is done for a number of reasons, including following abortion or miscarriage, heavy menstrual cycles or as a diagnostic tool for determining the presence of certain gynecologic disorders.

Now, to your specific concerns.

First, because of the proximity of the vagina to the urethra and bladder, your question is whether either or both were inadvertently damaged. This is fairly unlikely; however, it is a possibility that should be looked into.
Next, a catheter can cause scarring of the urethra if inserted improperly and repeatedly over time. Since you mentioned its use only once, during your surgery, this is probably not your problem, but I can’t rule it out entirely.

Request a referral to a urologist for further examination and testing. He or she can then determine whether your problem is directly related to the D&C or some other condition, such as a urinary-tract infection. While it’s uncommon, some people don’t experience any symptoms or have only mild ones that go unnoticed.

To provide related information, I am sending you a copy of my Health Report “Urinary Tract Infections.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167 Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

The insertion was done twice, both times without lubricant. One of the results was bloody urine. My poor father said “Just imagine being 82 years old and having somebody do something like that to you”. When he told his hometown doctor she just abut came unglued. A male nurse also informed him that he always “lubes the tubes”.

My father is now unable to urinate on his own because of a blockage which his urologist says may have been due to damage caused by the dry insertions. He now has to live with the catheter.

I cringe whenever I think about his experience and wonder how many other elderly people have been subjected to this kind of abuse. Please print this letter so the word can get out about this torturous practice.

DEAR READER:
I was appalled by your father’s experience and as an elderly gentleman cringe at the thought of how painful that must have been.

There is no excuse to put someone through that pain, especially an older individual who was already feeling unwell because of another condition. There is no reason in my mind why a lubricant could not have been used.

I urge you and your father to contact the hospital for an explanation of why a dry insertion was done twice and explain that his current situation is likely due to them. Doctors today are often told to never apologize to patients because it admits fault. In this situation, your father deserves an apology from the nurse and/or physician who performed the catheterizations and perhaps even the hospital that allowed it to happen twice!

I know that most people reading this would believe that legal action is best, but in most cases, this one included, it is not appropriate. Unless medical neglect is undeniable, the expense and hassle are not worth it. First, this case may have been caused by the insertions (and my hunch is that it was) but there is no proof that this is the case. Second, at your father’s age, the stress of a court case is ill advised, especially since he is already ill with a blood disorder. However, someone needs to understand what was done was wrong, traumatic and unacceptable in the future.

I have printed your letter because others need to know this is not standard practice. You stated that this is abusive behavior and I must agree.

To give you related information, I am sending you copies of my Health Reports “Blood — Donations and Disorders” and “Bladder and Urinary Tract Infections”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).