Can’t Urinate After Prostate Removal?

Recently, we received a call from a patient who had undergone laparoscopic radical prostatectomy and had already been discharged. He reported being unable to urinate—a rare concern following this type of surgery. Fortunately, a local hospital in Shizuoka promptly placed a urinary catheter. Since then, his condition has improved, and after the catheter was removed yesterday, he has been urinating well with almost no leakage. We were relieved to hear that his recovery is progressing smoothly.

Now, you might be surprised to hear about urinary retention after prostate removal. In fact, it’s extremely uncommon. After radical prostatectomy, the more typical issue is urinary incontinence, not difficulty passing urine. Cases of immediate postoperative urinary retention are rare and only occasionally reported in the medical literature.

So, why does this happen?

In rare cases, urinary retention shortly after surgery may be caused by urethral edema (swelling), temporary narrowing at the bladder-urethral anastomosis, or a small hematoma (blood collection). In such situations, forcing urination is not advisable. Instead, the safest and most effective approach is to reinsert a urinary catheter and wait for the inflammation and swelling to subside naturally.

According to the literature, conservative management with catheter reinsertion is the standard of care for such cases (Tewari et al., 2007; Campbell-Walsh Urology, 11th edition).

It’s also worth noting that postoperative symptoms such as urinary leakage or difficulty urinating are typically temporary and improve over time. In this case, the patient regained stable urination early on and had minimal leakage, making this a particularly favorable outcome.

This experience reminded us once again that successful surgery is not just about removing disease—it’s also about supporting patients through recovery and maintaining their quality of life (QOL) by addressing even the smallest postoperative issues with care and attention.

Kameda Medical Center