Bladder spasm question

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creed_three
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Date Joined Jan 2007
Total Posts : 762
   Posted 3/23/2007 1:51 PM (GMT -7)   
Hello Friends,
 
I have been reading a lot about bladder spasms recently on this forum - thanks to those who have explained this complication in a way we can understand and relate to. My question follows.  
 
Is it usual to be put on medication pre-op (ie. at time of surgery) to prevent this happening? Or do most Doctors wait to see if it is a problem with post op bladder spasms, and then treat with medication? If so, how long does it take to "kick in" and ease the discomfort? Also can anyone tell me what medications are used to treat this complication in your experiences?
 
I am familiar with a medication called oxybutynin, but have only seen this used with people who have a paralysed (neuropathic) bladder and experience bladder spasms. People with certain types of paralysis are generally on this drug long-term with good effect, but I have not seen it used in the short-term for any other condition, and not sure if this is still a key drug for managing bladder spasms in other contexts. 
 
Therefore, is this medication oxybutynin, still used, and/or what alternative drugs have others found helpful in treating and/or preventing these post op bladder spasms?
 
I would appreciate any names of the medications as this is something I'd like my husband to discuss with his surgeon when he is admitted in a few weeks. We did not discuss this earlier with the Surgeon, as we were not aware it was so common (and painful), inconvenient and also an expected complication for many people after surgery. Therefore to summarise my questions again,
 
1. Has anyone got any advice on particular medications used for bladder spasm post prostatectomy? What was the name of the medication? Is oxybutynin used?
2. Are these medications ever prescribed as a preventative measure to prevent this happening,  or do you have to actually suffer from spasms before you get put on an anti-spasmodic drug?
3. Finally, is this something I should email my husband's Surgeon about now? He (Surgeon) is happy to respond to emails from patients coming up for surgery if questions arise. This is the first thing that has really come up since we last saw him which I have been thinking of emailing him about.
 
Thank you for any comments or ways to manage this complication of surgery if anyone has any ideas which they found helpful.
 
Just starting another post here, as mine was a bit lengthy as well. We have been "settling in" to the forum for a few weeks, reading and sometimes posting, but this is actually my first real question to others!! Many thanks for any suggestions and advice, and you are all in my thoughts and prayers everyday as always.
 
Kind regards, Lana (with CJ) :-)
Creed_three
Husband diagnosed 8/12/06 on his 49th birthday. 1 (5%) core of 12 positive. Gleeson 4 + 3 = 7 according to biopsy. Routine PSA (Nov 06) 3.5. Awaiting RP (open) scheduled 17th April 07.


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 3/23/2007 3:00 PM (GMT -7)   
Lana,

In my case I knew going into surgery that bladder spasms were a complication. I do not believe that there is any medication given pre op to prevent them from occurring as my urologists did not suggest any. When I woke up in recovery I had a bladder spasm and recognized it and told the recovery room nurse. She immediately gave me a suppository and a pill that stopped it almost right away. I had another one when I got to my room from recovery and they gave me another pill and it stopped. I did not have another one after that. The spasms were not really that painful. The problem for me is that the medication they give you for the spasms gives you a terribly dry mouth. The protocol at the university based medical center that I had my surgery was nothing by mouth for the first 12 to 24 hours after surgery. That meant not even ice chips and I had an extremely dry mouth. They did give me a sponge on the end of a stick and a small cup of water and said that I could swab out my mouth as long as I did not drink the water. I do not believe that you need to worry about the spasms as they can be managed very quickly if he has some.

Tamu
Diagnosed 7/6/06
1 of 10 core samples, 40%
Stage T1c, Gleason 3+3
Da Vinci on 11/01/06
Catheter out on 11/13/06
56 Years Old
Post Op Path
Gleason 3+3
Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06
No more pads as of 1/13/07


norskie
Regular Member


Date Joined Jan 2007
Total Posts : 376
   Posted 3/23/2007 7:28 PM (GMT -7)   
Lana

I don't know much about your question as to what medication if any you can take in recovery to eliminate bladder spasams. I did just fine those first few days but did have them after my catheter was removed. My doctor speculated that when they pulled out the catheter that they may have broke loose a scab by my bladder neck causing it to bleed and plugged the uretha causing the bladder to not be able to completly emtpy the bladder casuing the spasams. These were extremly painful and I had to my local emergency room and have the catheter put back in. I have heard of some type of drug that if your husband was to have a spasam they will give him and it knocks it out right now. In my case if I was feeling any kind of discomfort I just let them know if I was begining to have pain and they took care of getting me something that helped me relax and reduce the pain. I really didn't have anything too bad but just let them know what is going on.
norskie
Age 49, PSA 6.22 on 9-26-06
Biopsy 11-01-06, 2 of 13 cores 10% cancer, 2 other cores abnormal Up-dated 20% prostate cancerous
Gleason score 3+3=6 After Pathology report 3+4=7 some agressive 5 cells found
Da Vinci surgery 01-09-07 UW Madison
Pathology Report- cancer 100 % capsual contained 1-18-07
Catheter removed 1-18-07 suffered bladder spasms Catheter reattached 1-18-07
Catheter removed 2nd time 1-24-07
1st Post PSA Blood Test 3-22-07 <.01 Undetectable
2nd Post PSA Blood Test Scheduled for 7/5/07
Incontenence 1 Pad a day
ED back to 90-95% prior to surgery - no medication required.


norskie
Regular Member


Date Joined Jan 2007
Total Posts : 376
   Posted 3/23/2007 7:28 PM (GMT -7)   
Lana

I don't know much about your question as to what medication if any you can take in recovery to eliminate bladder spasams. I did just fine those first few days but did have them after my catheter was removed. My doctor speculated that when they pulled out the catheter that they may have broke loose a scab by my bladder neck causing it to bleed and plugged the uretha causing the bladder to not be able to completly emtpy the bladder casuing the spasams. These were extremly painful and I had to my local emergency room and have the catheter put back in. I have heard of some type of drug that if your husband was to have a spasam they will give him and it knocks it out right now. In my case if I was feeling any kind of discomfort I just let them know if I was begining to have pain and they took care of getting me something that helped me relax and reduce the pain. I really didn't have anything too bad but just let them know what is going on.
norskie
Age 49, PSA 6.22 on 9-26-06
Biopsy 11-01-06, 2 of 13 cores 10% cancer, 2 other cores abnormal Up-dated 20% prostate cancerous
Gleason score 3+3=6 After Pathology report 3+4=7 some agressive 5 cells found
Da Vinci surgery 01-09-07 UW Madison
Pathology Report- cancer 100 % capsual contained 1-18-07
Catheter removed 1-18-07 suffered bladder spasms Catheter reattached 1-18-07
Catheter removed 2nd time 1-24-07
1st Post PSA Blood Test 3-22-07 <.01 Undetectable
2nd Post PSA Blood Test Scheduled for 7/5/07
Incontenence 1 Pad a day
ED back to 90-95% prior to surgery - no medication required.


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 3/23/2007 7:50 PM (GMT -7)   

Helping to keep the journey together… for future readers.

(Direct Link ~ just click on the title below and a new window will open!  

Reminder … click on the REFRESH icon once you get there)   Hello from Creed (49 years at dx)

    

Hi Lana & CJ,

 

Prescription: Hyoscyamine 0.375 ERCAP

Take one capsule by mouth twice daily.

We started them as soon as we arrived home from the hospital. (every 12 hours)

We continued to use them for 20 days…  We had no problems with spasms and no problems with the catheter.

 

While in the hospital they used suppositories…  right before Buddy got up to walk to help prevent spasms.  Buddy did not have any spasms during the hospital stay nor at home.

 

**Excerpt from Dr. Walsh’s book:

Bladder Spasms:

This can be extremely painful.  Fortunately, bladder spasms are not very common.  The men most likely to have them are those who have been troubled by urinary symptoms before surgery (usually, men who have had BPH), who have developed a thickened bladder wall, and a “hair-trigger: bladder that is easily irritated.  In this case, the irritant is huge—the catheter—and the bladder is trying its best to push it out, with contractions.  Te spasms may happen at random, or they may be provoked by an activity, such as having a bowel movement, or after going for a walk.  If you have a bladder spasm, lie down until the contractions improve.  If you have frequent spasms, you may be helped by medication.  Nonsteroidal analgesics (such as Motrin) work quite well, because they relax smooth muscle.  For persistent spasms, tranquilizers (such as Valium) are usually able to control the problem.

 

I was signing off and saw your post!!  I’ll talk with you later…

In Friendship ~  Lee & Buddy 


mama bluebird - Lee & Buddy… from North Carolina

Link to our personal journey…>>>     Our Journey ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

2nd PSA 02-06-2007 Less than 0.1 Non-Detectable :)

Post Edited (bluebird) : 3/25/2007 5:34:04 PM (GMT-6)


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 3/23/2007 8:04 PM (GMT -7)   
Positive Thinking...... CJ.... start telling your bladder......"You are not going to have any spasms.... "

Subliminal Listening...
Lana.... start talking to CJ in his sleep so his bladder will hear your soft words... before and after surgery. Amazing.... I did this before surgery and after... on lots of different issues.... I even performed the operation on Buddy... one morning when we woke up... I did the incision line with my finger, spread the opening, and told his body what was going to be done and how he was going to feel afterwards… I got up went to work and when I came home…. Buddy said you’re not going to believe this….but….Just before drifting off to sleep the night before he envisioned the whole surgery from start to finish. Hhhmmmmmm …. Interesting for sure!!


Now I find that it's in Dr. Siegel's book... Peace, Love & Healing.
KZIZ mentioned that she had read the book years ago..... and I'm thinking maybe I read it years ago too….because so much of what I've read over the past week seems so familiar... in my own beliefs and actions.... hmmm interesting for sure. (Just got the book thanks to Courtney mentioning it in one of her posts)

mama bluebird - Lee & Buddy… from North Carolina

Link to our personal journey…>>>     Our Journey ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

2nd PSA 02-06-2007 Less than 0.1 Non-Detectable :)


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 664
   Posted 3/23/2007 9:01 PM (GMT -7)   
Lana&CJ,  I can't help you with the question about bladder spasms.  I had no problems like that.  Sometimes we borrow worries about things that never happen.  I know I do that.
 
I do have a question for Tamu.  You mentioned that you were not allowed anything to eat or drink for 12 to 24 hours after surgery.  I have never heard that one before. (I learn something everytime I log on here).  I know that I was brought a CHEESEBURGER about three hours after surgery.  I wasn't much interested in it, but I had no restrictions on diet. What is the usual?  Is a post surgery fast typical or unusual?
 
Biopsy 10/16/06
T2A,  PSA 4.7
Gleason 4+4=8 right side
adrenocarcinoma of prostate
DaVinci Surgery 01/16/07
Post op report,confirms Gleason4+4=8
no extra extension/invasion identified
age 65
golf game bad, but active
 
 


creed_three
Veteran Member


Date Joined Jan 2007
Total Posts : 762
   Posted 3/24/2007 2:44 AM (GMT -7)   
Hi Lifeguyd,


I understand that usually post-op protocols (ie. period of fasting and return to normal diet) differ both within countries (different hospitals and surgeons), and between countries. The reason for fasting is largely due to the anaesthetic after effects which can reap havoc on bowels, and at the worst, result in a bowel obstruction (which no one would want - horrible complication of any major surgery). The idea is to rest the bowel completely after an anaesthetic as sometimes the anaesthetic stops the natural process (movement) of the bowel, and takes time to come back.


On another note Lifeguyd - how long did it take you to get back to golf? My husband enjoys golf too.
Just wondered however, if this activity would be considered gentle exercise or if, like gym work, it puts stress on the sphincter too soon and we need to be careful. Could you tell me how long it took (how many weeks) for you to get back to playing a gentle, social game of golf - ie. stopping when you wanted to?

Thanks again to all for your helpful responses, Lana


Creed_three
Husband diagnosed 8/12/06 on his 49th birthday. 1 (5%) core of 12 positive. Gleeson 4 + 3 = 7 according to biopsy. Routine PSA (Nov 06) 3.5. Awaiting RP (open) scheduled 17th April 07.

Post Edited (creed_three) : 4/7/2007 3:11:02 PM (GMT-6)


Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 3/24/2007 2:46 AM (GMT -7)   
Lifeguyd,

The dietary restrictions after surgery usually have two aspects:
1. Control vomiting (Some people react to the anesthesia.). The vomitting can pull the stitching.
2. Control bowel movements. They don't want either constipation or diarhea.

The "only ice chips" routine is the most restrictive.
Usually it is clear liquids for 24 hours until they see if your passing what you take in. (including iv)
Then Full liquids to see if your digestive tract is working.

I had a hamburger 36 hours after this surgery.

Gotta go order the fresh produce. ICTHUS

Cedar Chopper
~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*
2 Years of PSA between 4 and 5.5
Biopsy 23DEC06 
Only 5 percent cancer in one of 8 samples.
Gleeson 3+3=6
Radical Prostatectomy 16FEB07 at age 54.
1+" tumor - touching inside edge of gland.
Confined:)
***************
Texas Hill Country
FRESH Produce Department Manager
Have you had your 5 colors today?


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 3/24/2007 6:34 AM (GMT -7)   
Lifeguyd,

I did not know about the nothing-by-mouth restrictions following surgery until they told me that I could not have anything when I asked for ice chips. They said that they were aggressive at preventing any complications. Apparently this university medical center has noted that when you first get up to walk after surgery that many men will get sick of their stomach. I did get sick of mine for about 10 seconds and then I was okay. My surgery was at 7:45 AM and I was finally allowed a cup of coffee at about 6:00 AM the next morning. They then kept me on a liquid diet until I was released at 2:00 PM that day. They told me to stay on a soft diet until my BM's returned to normal so I had chicken soup that day. I had no problems with gas or returning to normal BM's.

Tamu
Diagnosed 7/6/06
1 of 10 core samples, 40%
Stage T1c, Gleason 3+3
Da Vinci on 11/01/06
Catheter out on 11/13/06
56 Years Old
Post Op Path
Gleason 3+3
Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06
No more pads as of 1/13/07


kziz
Regular Member


Date Joined Feb 2007
Total Posts : 242
   Posted 3/24/2007 10:36 AM (GMT -7)   
Creed-three, Kurt was given Detrol following surgery to help the bladder not spasm. He did have bladder spasms the first night and was given 3 different pain pills to help. When we left the hospital the next day, we were give a prescription for detrol. He was told to take it, one a day, as needed. I had him take it the first three days to prevent more spasms and then we backed off. He didn't have anymore spasms while taking it daily, but did feel like he was getting ready to 2 days after we stopped so he took one then, and no major spasms.

As for diet, Kurt was allowed ice chips for an hour after getting to his room. After the first hour, he could have sips of water. Then after another hour it was on to Jello. Again, taking it very slow. The first night he was brought soup and could eat as much jello or pudding that he wanted. The next day, we were released on a liqiud diet to be upgraded to soft and from there as he felt like it. He didn't have his first BM for 5 days, 3 days after eating relatively normal diet. I never thought I could get so excited about him having a BM and no pain!! Good luck to you. Courtney
Kurt & Courtney
47 year old
Great Health prior to dx
Dx on 1/29/07
PSA 4.1
Gleason 3+3=6, both lobes
Stage T2c, I believe
Tumor involves 20% of cores, both lobes
Live in OK
Da Vinci scheduled 3-14-07 in Austin
Post-Op  Gleason 6, Stage t2c nx mx  YAAAAA HOOOOOO! 


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 664
   Posted 3/24/2007 1:36 PM (GMT -7)   

Thanks for all of the answers about post op diet.

Lana

You asked about exercise.  My doctor knew I was anxious to get back to playing golf.  He told me absolutely no golf until after the sixth week post op. Quite frankly I was not even thinking about it until the 5th week.  However at the end of six weeks I cautiously played 9 holes.  I have built up since then and this week I played Four 18 hole rounds on a very difficult  course. I live on the fairway so golf is a big part of my life.  Even if my skill level is not so good... redface

Things do get better every day.  I  still squirt now and then, and have significant erectile problems, but I'm real happy to see the sun rise every morning.


 
Biopsy 10/16/06
T2A,  PSA 4.7
Gleason 4+4=8 right side
adrenocarcinoma of prostate
DaVinci Surgery 01/16/07
Post op report,confirms Gleason4+4=8
no extra extension/invasion identified
age 65
golf game bad, but active
 
 


Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 3/25/2007 1:38 PM (GMT -7)   
Hi Creed,

We haven't been through surgery yet, but were given a prescription bladder spasm medication to fill before surgery. It is Detrol LA 5 Mg capsules. But it is to take at home after the surgery to prevent bladder spasms, not before.

Tanya
Significant other diagnosed: 10/30/06
PSA: 3.7 (up from 3.4 prior year)
Gleason: 3+3
Biopsy: 1/10 positive, 5% cancerous, right apex.
Da Vinci Scheduled: 4/10/07


creed_three
Veteran Member


Date Joined Jan 2007
Total Posts : 762
   Posted 3/25/2007 8:09 PM (GMT -7)   
Thanks again to everyone who posted, for these very helpful responses to my questions - greatly appreciated. kind regards, Lana
Creed_three
Husband diagnosed 8/12/06 on his 49th birthday. 1 (5%) core of 12 positive. Gleeson 4 + 3 = 7 according to biopsy. Routine PSA (Nov 06) 3.5. Awaiting RP (open) scheduled 17th April 07.

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