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Why can't I hold my pee after surgery?

MORE FROM THE LAB: Subscribe to our weekly newsletter Urinary retention is a common complication that arises after a patient has anesthesia or surgery. The analgesic drugs often disrupt the neural circuitry that controls the nerves and muscles in the urination process.

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Two years ago, Lori Dager, R.N., spotted a troublesome trend: More and more patients had to be catheterized before heading home from the outpatient surgery center where she worked.

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The reason: postoperative urinary retention (POUR), an inability to urinate after having anesthesia. “I just know we were catheterizing patients, who sometimes had near a liter of urine, which is not good for the bladder,” says Dager, who works in the post anesthesia care unit (PACU) at the East Ann Arbor Surgery Center.

“It’s traumatic being catheterized and it extends the stay at PACU.”

Urinary retention is a common complication that arises after a patient has anesthesia or surgery. The analgesic drugs often disrupt the neural circuitry that controls the nerves and muscles in the urination process. This can lead to abnormal storage of urine because patients often don’t feel like they have to urinate despite having a full bladder. Distention of the bladder stretches its muscular wall, called the detrusor muscle, and can permanently damage the bladder in as short as one to two hours. Which is why Dager recently completed an evidence-based practice project designed to curtail instances of POUR. Her project has since prompted a change in recovery room protocol, which is being rolled out at other PACUs in Michigan Medicine after early efforts showed a decrease in POUR cases. The results were shared with colleagues at the American Society of PeriAnesthesia Nurses national conference in April in Indianapolis, via a poster presentation titled “Making the Bladder Gladder; Decreasing POUR in the Ambulatory Care Setting.” “I gave it a catchy title because there are about 100 posters at the national conference and ‘Bladder Gladder’ helped make it stand out,” Dager says. “POUR is not something all nurses are tuned in to, so raising awareness will help with the prevention aspect.”

Dager says her findings will hopefully prompt more research in this area.

Her mentor, Denise O’Brien, D.N.P., R.N., will also showcase the work at the International Conference for PeriAnaesthesia Nurses in Sydney, Australia, this year.

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What makes a man get on hard?

During sexual arousal, nerve messages begin to stimulate the penis. Impulses from the brain and local nerves cause the muscles of the corpora cavernosa to relax, allowing blood to flow in and fill the open spaces. The blood creates pressure in the corpora cavernosa, making the penis expand and creating an erection.

my.clevelandclinic.org - Erection & Ejaculation: How Does It Work - Cleveland Clinic

What is the anatomy of the penis?

The penis is made up of:

Two chambers called the corpora cavernosa, which run the length of the organ and contain a maze of blood vessels shaped like cavernous spaces (like a sponge). The urethra, or channel for urine and sperm, which runs along the underside of the corpora cavernosa. Erectile tissue, which surrounds the urethra, two main arteries and several veins and nerves.

The shaft, the longest part of the penis.

The head (glans), which is at the end of the shaft.

The meatus, or opening at the tip of the head where urine and semen are discharged.

How does an erection occur?

When the blood vessels of the corpora cavernosa relax and open up, blood rushes in through the cavernosus arteries to fill them. The blood then gets trapped under high pressure, creating an erection. An erection begins with sensory and mental stimulation. During sexual arousal, nerve messages begin to stimulate the penis. Impulses from the brain and local nerves cause the muscles of the corpora cavernosa to relax, allowing blood to flow in and fill the open spaces. The blood creates pressure in the corpora cavernosa, making the penis expand and creating an erection. The tunica albuginea (the membrane surrounding the corpora cavernosa), helps to trap the blood in the corpora cavernosa, sustaining the erection. Erection is reversed when muscles in the penis contract, stopping the inflow of blood and opening outflow channels.

How does ejaculation occur?

Sexual stimulation and friction provide the impulses that are delivered to the spinal cord and into the brain. Ejaculation is a reflex action controlled by the central nervous system. It is triggered when the sexual act reaches a critical level of excitement. It has two phases.

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