Post-Op Urinary Retention Is Terrible — And More Common Than You'd Expect
I’ve had a total of eight surgeries with little to no complications following each one. I think everyone gets a bit anxious before an operation, but I don’t think anyone anticipates post-op complications following a routine one. When I went in for my last surgery, a partial hysterectomy, I sure wasn’t expecting to wind up in the ER that same night.
I remember waking up from my procedure in excruciating pain. I’ve had three c-sections and would consider those operations rather painful, but the pain I felt then was minor compared to what I felt in the recovery room the day of my hysterectomy. At one point, I even told my nurse that it felt like my bladder was about to explode. Because, well, that was how it felt.
She seemed annoyed with me, annoyed that she had to keep reminding me that I had already tried using the bathroom several times. “You don’t have enough urine in your bladder to go. The pressure you’re feeling is from your abdominal surgery,” she said rashly. And I believed her.
My pain was never manageable while I was in post-op. I was beyond restless. I couldn’t find a position to lay in that would bring me any relief. And still, I felt like I really, really needed to use the restroom. I didn’t feel ready to leave at any point in time, but before I knew it, I was in the middle of being discharged and in too much pain to argue. The kind of pain that makes you do and say as little as possible to make it better. I thought maybe lying in my bed at home would make the pain more manageable, and I left without putting up a fight.
Later that night, I found myself even more miserable despite taking the maximum amount of pain medication allotted. Finally, I made the call to head back to the ER and found out that my bladder was full. Really, really full.
It turned out that I had Acute Post-Op Urinary Retention (POUR). I never thought I’d find myself begging for a catheter, but there I was, begging my sweet nurse for a catheter. Within moments, I instantly felt relief. Imagine not peeing for 13 hours after you’ve been pumped full of fluids and finally being able to relieve yourself. Yeah, it felt like that.
I could finally find a comfortable position to lay in, and I no longer had that God-awful pressure and pain that I had been feeling all day. My nurse even said, “I bet you are feeling better!” when she saw my catheter bag filling to the very top. I ended up needing a catheter for a week and a straight catheter (a disposable catheter that is used one time and placed by the user) for three days after that. And let me say, I have a newfound respect for folks who require catheters regularly.
I ended up with a UTI and a yeast infection, which is not uncommon for those requiring a catheterization, but is still miserable nonetheless. The catheter never felt comfortable, and I always had some small amount of pain when wearing it. In addition, I had to worry about kinks in the tubing and where to hang my catheter bag while I was sleeping.
I can’t tell you how much reassurance I needed from my husband during that time. Squatting over the toilet with him while I held the straight cath and a mirror while he pointed a flashlight at my urethra was not precisely how I had planned on spending my recovery. I was humiliated, and it’s not something you feel comfortable talking about other than with those who are closest to you.
If nothing else, my experience was a humbling one. But it wasn’t until I was going through it that I realized just how common this complication is.
According to a medical journal in NCBI, the prevalence of post-op urinary retention in patients can range from 5-70% and is most “significant in spinal anesthetics, followed by epidural anesthetics followed by general anesthetics.” Post-Op Urinary Retention seems to be highest after pelvic surgery, with an even higher occurrence in gynecological procedures. It is a common complication following orthopedic surgeries like spine surgeries where nerves can be damaged or irritated that control urination.
And although my experience made it blatantly clear that I was experiencing acute urinary retention, one study indicated that 60% of participating outpatient surgical patients did not have any retention symptoms despite having a full bladder. These statistics only impress how important it is to raise awareness of this common post-op complication.
Following any outpatient procedure, patients should notify their care provider of acute (brought on suddenly and usually severe) retention symptoms like:
- An inability to urinate or no urge to urinate at all 8 hours after surgery
- A painful urge to urinate
- Swelling in your lower abdomen
- Pain in your lower abdomen
Acute urinary retention is always a medical emergency and can sometimes have subtle symptoms. It’s a good idea to keep a log of when you have urinated and if you are feeling the urge to urinate while in the early days of recovery. Unlike acute retention, chronic urinary retention may have much less noticeable signs such as:
- Difficulty when starting to urinate
- Feeling as though your bladder is not completely emptying
- A weak stream or a stream that starts and stops
There are many specifics to look out for following a surgical procedure. Monitoring your urine output and frequency should be one of them. Even if you aren’t in any pain, it’s best to contact your doctor if you feel you are retaining urine in any way. If ignored, it could create long-term bladder or urinary tract damage.
The cause of my post-op urinary retention was likely due to the type of surgery I underwent. I don’t want to say that I was lucky that I was in so much pain when I had post-op urinary retention, but it might just have been my saving grace.
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