タグ: ProstateSurgery

– A Rare Case of Postoperative Urinary Retention –

4月 3rd, 2025

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
“Record-Breaking Surgery Day at Kameda General Hospital”

2月 19th, 2025

Saturday, February 15, 2025, marked our busiest surgical day yet!

A huge thank you to the anesthesiology team, nurses, co-medical staff, and ward team at Kameda General Hospital for their incredible support.

On this day, we performed three radical prostatectomies:

✅ Two nerve-sparing procedures – one using robotic surgery, the other with laparoscopy

✅ One non-nerve-sparing procedure – unfortunately, preservation was not possible

Nerve Preservation in Prostate Cancer Surgery

Whenever we perform radical prostatectomy, we always consider nerve preservation.

During surgery, we carefully observe:

🔹 The color difference between normal prostate tissue and cancerous tissue

🔹 The firmness of the tissue – infiltrated tissue tends to be harder than normal

🔹 The surgical margin – ensuring complete cancer removal while preserving function

While some cases are straightforward, in more advanced cases, distinguishing cancer from normal tissue becomes difficult. When that happens, the disease is often already in a progressed stage, meaning nerve preservation is no longer an option.

Why Is Nerve Preservation Important?

Most people associate nerve-sparing surgery with erectile function, but it also plays a crucial role in urinary continence.

The best nerve-sparing outcome is when post-surgery function remains unchanged from pre-surgery.

If recovery takes several months, it usually means the nerves sustained some level of damage and are slowly healing.

This is why precise surgical technique is critical—preserving nerve function from the start leads to the best possible recovery.

Surgical Precision Matters

Minimally invasive techniques, whether robotic or laparoscopic, allow for:

✅ Better visualization during surgery

✅ Careful tissue handling to reduce damage

✅ Improved functional outcomes for both erectile function and continence

By refining our techniques and advancing our understanding of nerve preservation, we continue to push for better outcomes for our patients.

タグ: ProstateSurgery

– A Rare Case of Postoperative Urinary Retention –

“Record-Breaking Surgery Day at Kameda General Hospital”