constipation horror

on 23 July 2022 I was admitted to Royal Surrey County Hospital, Guildford for a robot-assisted radical prostatectomy (RARP). This went well and I 'came to' in the adjacent ward, already fitted with a urine catheter. The surgeon came to see each patient chat things over and also, "would we be agreeable to do the catheter removal ourselves on 1 August?"

Constipation complications

Constipation is a common side effect of this operation and 'you should be back to normal in about 2 weeks.' I got home on 24 July 2022 and began taking 'Laxido' each night as directed. To begin with, I was still opening my bowels but this soon stopped and I got some Glycerin Suppositories, these improved the bowel openings so I felt reassured that everything was going according to plan.

Prostate cancer treatment and constipation

In accordance with my plan, on 1 August 2022, I went ahead with the (TWOC) Trial without the catheter that I volunteered for. I removed the urine catheter myself and then received a phone call from the Nurse checking that it had been removed ok and that was I urinating. Well, I was doing a few drops so I thought ok I was urinating! but from this point, my constipation started getting steadily worse, whether it was a coincidence or whether this links to the catheter being removed, I can't say but I believe that to be the case.

All bowel movements just stopped. I continued taking Laxido each night and Glycerine suppositories, which previously had produced great results, now had no effect, in fact, nothing had any effect and I was getting pain in my waist.

On the nights of 2, 3, and 4 August 2022 my waist, first left then right gave me the most awful pain because I couldn't take Ibruprofen because of my high blood pressure and I couldn't take codeine because of the side effect is commonly constipation, all I was left with was paracetamol and this dulled the pain for about ½ hour, leaving me with 3½ hours of sheer agony. I had noticed that the trousers I wore I could no longer tie with the belt! too painful. couldn't even do the trousers up at the top.

rReleif that never came

On 3 August there was no change, despite 3 Laxidos in one morning and several glycerine suppositories, nothing worked and I wasn't getting an inch of sleep. on top of that I had a full-fledged urinary tract infection, and with the catheter gone, I was going little and often with an awful stinging pain each time. when I lay in bed all I could feel was a penis that felt like a knife was inserted. I had to spend the night in my lounge contending with a drop, drop, drop from my waterworks in the loo, because that is all it would do, just a few drops of urine, that was it was until the next time, which would be about 10 minutes later.

On the first night of 2 August my wife stayed up with me all night and massaged my waist left and then right, when awful stomach pains were there, my stomach felt like a concrete block and I just felt altogether awful.

I was in such agony with the pain that I phoned 111 for medical advice and ended up with a local GP phoning me at about 4.30 am, he arranged a priority appointment for me at the GP surgery that morning. I attended and provided a urine sample, later I was phoned by a GP who stated that the urine sample had not proved positive but from what I had told him he suspected that it was a urinary tract infection and prescribed antibiotics.

Possible answers?

I was still suffering enormously from continuing constipation, there just seemed no end in sight and constipation just seemed untreatable, and extremely painful and debilitating. I had no appetite and had just stopped eating. on 4 August 2022 I got a phone call from another GP and she picked up on my description of urination, I told her, "I just go 'drop drop drop' and then that's it" she said, "Have you actually had a real pee since you took the catheter off?" then it hit me, actually NO! I hadn't, it had all been very little, very often and incontinent urination into the crotch pad. She told me the bladder wasn't emptying and was actually fighting for space with the stomach! Could this be why constipation went into overdrive?

She told me to head to A+E immediately (Accident & Emergency) as she diagnosed urinary retention and stated, "The catheter must be refitted!" I said "Oh no!" as that was the last thing I wanted to hear, nevertheless, I got a taxi to take me to A+E immediately (Accident & Emergency) arriving at 6 pm.

At 2 am the next morning after going through all the proper hoops and nursing checks, I ended up with a Urology Doctor standing there, with a brand new catheter, the scan had shown my bladder was retaining 400cc he told me, and I discussed with him that this "urinary retention" was present already, before the operation and described to him the situation where the previous year, I had to get a scan of my crotch, at a time where my bladder was full. (I explained to him that) I had arrived at the medical center desperate to urinate and told the receptionist who was indifferent, I then used the toilet and urinated but I then found that the scan staff told me my bladder was in fact still half full (after I believed it to be empty). After hearing that story, he then got a nurse to do a new scan and told me that he was diagnosed with Urinary Tract Infection and was prescribed antibiotics. the second scan showed 35cc less and he said, "If I fit this new catheter to you now, what is the plan going forward? Do you have this for the rest of your life? " I certainly didn't want that but what was he going to do then?

He decided the catheter did not have to be refitted, citing "bladder training" and the Urinary Tract Infection (which would soon be stopped by the anti-biotics). Bladder training is in fact the same as 'Pelvic floor exercises' which I had started a month before.

Finally feeling better

The next thing that happened to me was I was admitted to an 'Ambulatory Emergency Centre' at the same hospital where a nurse thankfully applied me an Enema. This worked within 3 minutes and I felt so much better! my bowels opened continuously! wow, what a result! a few hours later I was discharged and my son drove me home, with my thoughts concentrated on "what will happen next?" I started on the antibiotics

That night I lay on my bed and my penis was just so painful I couldn't actually lie on the bed, I had started the antibiotics, but no results yet! I had to spend the night in my lounge watching old TV shows and continuing with the 'drop drop drop' urine routine, at least I had no constipation pains at all and hey My trousers now did up with the belt no problem!!

The next day I suddenly noticed that about lunchtime, It wasn't 'drop drop drop' anymore it was a whole stream of urine, not strong, but a whole stream and I had control, I could put oomph into it, not by much, but a bit! the stinging wasn't so bad and now if I lay on the bed my penis just felt ok! on top of that, that evening, my bowels were opening normally, my god I hadn't been so happy in a very long time!

Constipation recommendations

MY RECOMMENDATIONS TO ANYBODY HAVING A robot-assisted radical prostatectomy (RARP):
1. you are going to have constipation. my tips are to switch to plain water NOW. just drink plain water, 8+ cups a day, no other drinks, this is just for 2 weeks! when you eat your food, chew it to destruction, make it easy for your stomach.
2. have Laxido and Glycerine Suppositories in your place of abode, you could easily need them
3. get light exercise each day e.g. go for 20 minutes. 30-minute walk make sure you do this each day
4. check the type of food you're eating, it should generally be cereals e.g "All bran, Fruit and fiber" anything that is roughage orientated, no take away food, no microwave meals, fruit, vegetables, soup, stuff like that
5. at the end of the day, if you're losing sleep don't be afraid to phone for medical assistance

those 3 nights that I had constipation reducing me to abject misery, were the worst in my life, sadly it was also in tandem with a Urinary Tract Infection that made it even worse! I am now on the mend and hopefully ... will never see such a nightmare again