Continuous Bladder Irrigation After Prostate Surgery

Continuous bladder irrigation may seem one of those scary medical names, especially if you feel nervous about your upcoming surgery. They say a tube will remain in your urethra, and name blood clots and complications. But when you understand what this procedure is, you can calm down.

It could be a bit annoying, but it is not a dangerous or painful process. When you know what happens and how to get better, you can empower yourself to be an active part in your recovery.

Continuous bladder irrigation is sometimes a required step after prostate surgery. It can also be used after bladder surgery, as in bladder tumor surgery. That’s why we have dedicated a special article to describing it and clearing doubts.

What is bladder irrigation, and why is it used?

The name continuous bladder irrigation or CBI can be broken down in three. Irrigation is the name doctors give to a flow of liquid. As a procedure, it consists of pouring water or a running liquid.

It is sometimes a saline solution but can be a solution with antibiotics during surgery. We say CBI is continuous because the flow of pouring liquid is not interrupted. And the organ that is being irrigated or infused with water is the bladder. Hence the B in CBI.

Putting everything together, CBI is the continuous infusion of irrigation solutions into the urinary bladder. This organ holds urine and has a continuous flow by itself. But after surgery, there is sometimes bleeding in the urinary tract. If we don’t accelerate the continuous irrigation flow with additional liquids, we could get blood clots. Moreover, CBI can also help patients urinate and prevent post-surgical complications.

With continuous bladder irrigation, your doctors are flushing out blood clots. In your bladder, they would aggregate and become a more significant clot. In time, they would cause obstruction or urination problems.

Additionally, CBI helps patients get rid of microscopic calculi. These bladder stones may also aggregate and create big masses of minerals. But that problem is quickly dissolved by continuous bladder irrigation (1).

In some cases, CBI is not recommended because you’re bleeding or creating bladder stones. It can be because your bladder is severely inflamed and irritated. You may have a urinary tract infection. If that’s the case, doctors may require to administer medicine directly to the bladder via CBI.

As you can see, multiple causes would make your doctor consider CBI. If you’re not sure what is happening in your case, feel free to ask. It can be either to prevent clot retention and bladder stone formation, to relieve inflammation, administer medications, or a combination of the above reasons (2).

What will happen during continuous bladder irrigation?

Traditional Bladder Irrigation uses a Foley catheter, which will be placed in the urinary bladder. The catheter used in CBI is a special type called triple-lumen catheter.

Triple-lumen means that the portion that stays out of the urethra divides into three. So, it has one entry that stays inside the bladder, and on the outside, it is quickly divided into three parts. Each one of these ports has a different use, as you will see (3).

• • One of the ports or lumens is meant to drain your urine. Through this lumen, you will be emptying your bladder into another recipient outside of your body.

• • The second port or lumen has a direct connection with a small catheter balloon at the tip. After placing the indwelling catheter, the balloon is inflated. That way, the catheter can stay in place and become fixed without causing any harm.

• • The third port or lumen is used to irrigate or pour liquid. This is how you will get your bladder filled with a continuous flow of liquid. As mentioned above, this liquid can be a normal saline solution. It may also contain antibiotics and other medications.

After placing and fixing the catheter in place, it will be connected to an irrigation flask. This is a special type of equipment that looks like a bag full of liquid. This is usually sterile saline, but other medications can be added as well. Initially, the flask is hung on a pole. Then, the doctor or nurse will clean the irrigation lumen and attach the tubing.