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Urination Complications
Urination Complications
Recently, I saw a client I had never seen before. He contacted me because of an article I wrote 4 or 5 years ago about working with clients who cannot urinate after surgery. My success (and now my students), intrigued him. Typically I cannot get someone booked in a short time period. I was supposed to have this morning off. He told me he was driving down from Vail to DIA to fly back to Dallas. So, I booked him for a 30 minute session.
He told me his story. He had an appendectomy by laparoscopy at the end of January. Then 3 weeks later he had surgery to repair a left side inguinal hernia. This was supposed to be done by laparoscopy, but the intestine was adhered to the scar tissue around the hernia. The surgeon had to 0pen him up making a vertical incision from his navel to his pubic bone. Something happened during that surgery and he had a nick in his intestine. They went back in through the same incision 3 days later. He has not fully voided his bladder since. This was almost 6 weeks ago.
They sent him to a urologist, who seemed to be great. She taught him to self-cath and then told him to do it 3 times a day and leave it out the rest of the time so his bladder would not become dependent on the catheter. They sent him for various treatments, none of which made him void his bladder. His issue turned out to be different from what I normally see in these cases. Normally something in the anesthetic shuts down or causes inhibition in the detrusor muscle of the bladder. This is not my assessment, this is what the docs have told every patient with this that I have seen.
Only a Trickle
In this man’s case, there was little to no movement in the scar and he had rock hard tension throughout his pelvis. He was able to get a trickle about every third time he tried to urinate. This another sign that his case was different. I worked on him through his clothes for about 15 minutes. He watched me intently the entire time. He said he was afraid I couldn’t help him and at the same time he was afraid to let me try because I could make it worse.
I did my best to explain what I was doing, but I could see how skeptical he was. I could feel that the tension had lessened significantly, but the real test was to see if he could urinate, so I sent him to the bathroom. He came back with a smile and said, “well, it is only a trickle, but the trickle lasted longer than it has since this began.”
We have a Stream!
I took him back to my treatment room and worked on him for about 15 minutes more, this time working through his left adductors and into his lower rib cage. Then he went back to the bathroom. He came back a few minutes later and announced, “We got a stream!” He said it was the first time this had happened since the last surgery. I offered to send him to one of our SMRT therapists/students in the Dallas area. He said, no, that he would just come see me when he flew in to go to his house in Vail. Then he said, “but, to be honest, I hope I never have to see you again, if you know what I mean.” I told him a totally knew what he meant, and I hoped that too. It was very exciting that we had the progress we did in 30 minutes!!
