Post catheter bladder spasms

Hello, new to the forum. Have learned a lot browsing through and finally thought I would post my question since I didn't find anyone else in quite the same situation (that I could find). Really appreciate the community, seem like a very helpful group of folks.

I had a Davinci RP a little over three weeks ago. Margins are clear and I am very thankful! Have follow up blood work in another 4 weeks or so.

Overall my recovery has been pretty good, but having some issues that maybe someone here had experience with... After the catheter was removed (over 2 weeks ago) I did well for a day but then started to have some excruciating bladder spasms, mostly at night but occasionally in the day time. They put me on B&O and also Oxybutynin, 5mg 3X per day. That got it under control, and now I am just on the Oxy, but it seems like last 3-5 days in the afternoons I am not peeing at all... going 4 hours or so and then just a trickle for another 3-4 hours before finally going well again. I don't know if this is a sign of the drug working or a sign of growing urinary retention. I called the physicians assistant and also talked to the on-call Urologist and getting a little different advice. I'm wondering what you all think. The PA says I should probably stick to the 3X per day Oxybutynin to avoid the spasms and just let them know if I stop peeing, but the Uro seems to think dropping to 2x per day now might be better if I am starting to pee less frequently. I certainly don't want to suffer urine retention and go get a catheter, but the spasm pain is the worst pain I've ever felt and I'm inclined to stick to 3X per day because although urine slows it comes back. Any thoughts on this? Does this sound like a burgeoning retention issue or just the Oxy causing less frequency (in addition to stopping the spasms)?

Thanks Pratoman

Appreciate that. Yeah I mentioned the idea of a half pill for one of the doses and the Uro said it would be like not taking a dose at all (that seems odd to me) he seemed to suggest there isn’t much precision with the Oxy. Apparently it is only a choice between a 4x4 (3x) to the head or a stick (2x) and not much in between. I don’t know.

fiddlecanoe, did they have you on anti-spasm meds like the Oxybutynin? Did you have bladder spasms to deal with or did your retention just happen? How long before it wasn't an issue?

Thanks, it sounds like the retention is as bad as the spasms I had (excruciating). Today I decided to just drink a lot more water and force the issue - either I'll end up going in for a catheter or I'll pee... and I started peeing a lot more. Maybe I've just been avoiding the water a little bit. (it's hard for me to drink a gallon of water a day as I'm supposed to though). So, for now I guess I'll keep taking 3x per day of the Oxy. WIll probably still call Monday morning and see if they have any suggestions. I peed almost 200ml 5 times every 25 minutes by 2pm and that after drinking a 1/2 gallon throughout the day. Seems odd. But at least I'm peeing.

milt, staying hydrated may be part of your answer: While I never had spasms, I did learn that the better hydrated I kept myself, the less I dripped. I think it gives the bladder something to push against and keeps the muscles toned. I suspect it may be similar with the spasms.

What I do for hydration is easy: You know that 1 liter mug you got at the hospital? I have one at home and one at work. In the morning, I load it up with ice and water and sip through the day. I like to do 2 a day at work. I do lighten up after dinner, so I sleep through.

I didn’t have this problem during or after RALP, but I know people who did. The catheter balloon depending no how long it was in 7-10 days maybe, can cause some real irritation of the nerves at the bottom of the bladder. It can take a little while for them to de-sensitize, more than 2 weeks for sure. Trying to keep the caffeine, liquor low if possible can help. The oxy can of course too, and keeping hydrated will help to re-connect the sensation for those nerves about when bladder is full and need to void.