My husband has benign prostate enlargement and is in the very early stages of Lewy Body Dementia. He had TURP surgery to reduce the constriction three years ago, just before he was diagnosed with Parkinson's and Lewy Body Dementia, and it really set him back. The surgeon was conservative and too much scar tissue built up and so the surgery really didn't make things any better. So far my husband has managed with two kinds of medication and an office procedure to dilate the scar tissue once a year or so and a condom catheter and leg bag for events where he doesn't want to have to go to the rest room frequently. He has recently started to wear the leg bag at night so he won't have to get up in the night.

Then Saturday morning he said he was having a bad morning because he had diarrhea and difficulty urinating. It took until mid afternoon before he decided he had to go to our local urgent care center, and then he had to wait nearly three hours before they even called him back. Thankfully he waited alone then called me when they called him back. The doctor recommended a foley catheter left in for a few days, and I remembered that the last time my husband had blockage they recommended that because the situation leaves behind a lot of irritation, so we agreed to that. I'm hoping to get an appointment with the urologist Tuesday to get the catheter taken out and discuss what next. The doctor at the urgent care did test for infection and didn't see any obvious signs (they are doing a culture).

It was a tough day for him and I felt badly because it was our daughter's 18th birthday and we were planning a special dinner (luckily just our immediate family). We did have our nice dinner not horribly late, but my daughter had to do some of the cooking by herself. I did all the cleaning up then went to the late night pharmacy 10 miles away for prescriptions.

My husband is going to say he doesn't want to think about surgery because this has only happened once. But I'm thinking of pushing that I'm not willing to travel with him so long as there is a risk of this happening. He doesn't want surgery partly because he remembers how difficult the recovery is, but the urologist is willing to do the surgery with a spinal anesthetic and twighlight sleep, not general anesthesia this time. My husband is also afraid of ending up incontinent--he remembers something the surgeon about being glad he didn't remove any more because that might have interfered with continence. I would rather have DH incontinent than blocked--he is already comfortable using the leg bag. And if he is going to need surgery I would rather have it done now (or this summer when I'm not working) rather than later when he is more confused and uncooperative. At present he is forgetful and gets confused easily but can still pull it together when he is around other people. He doesn't have hallucinations yet, even when the doctor gave him a shot of demerol at urgent care.

Even if he agrees to surgery he says he wants to go to a different doctor--an hour's drive away instead of 20 minutes away. He wants more of an expert. But that is going to be a lot of extra trouble, and the local doctor has a good reputation. It isn't even the doctor who did the first surgery but rather his partner--the first one moved away.

So do I push for surgery or let my husband resist it until the situation gets worse? I really don't want to go through this again.