Bladder leaks continuously after hip replacement

DEAR DR. ROACH » I am a male, 83, and my bladder leaks continuously since

I had a hip replacement surgery.

The surgeon used a catheter during the surgery, and when it was first removed, I could not urinate. I went home with a new Foley catheter. Five days later, it was removed, and I have dripped ever since. It has been over two months since the surgery, and the leakage has not abated.

I typically use absorbent underpants and pads that I must change four times a day. I also urinate 100-300 milliliters several times during the day and at night.

This is my third joint replacement in the past four years, and nothing like this happened in the previous two surgeries, or in earlier surgeries I have had.

What might have happened, and what are my options other than an inserted catheter worn constantly? I have not seen this addressed in your column, which I faithfully read.

— W.A.M.

DEAR READER » Inability to urinate after surgery is common, especially in men. However, I am concerned that the Foley catheter may have caused additional complications. Urine infection, bladder spasm and bladder contracture all are complications of having a catheter. Damage to a nerve during surgery is possible as well. It is urgent that you get in to see a urologist now.

A long-term indwelling catheter is probably not your best option.

DEAR DR. ROACH » I get severe nerve pain in my calf area due to diabetes. I saw an ad for Lyrica and found that its generic medicine, called pregabalin, is available now. I requested my primary doctor prescribe it for me. But he declined, saying that it is in the category of opioids and cannot be prescribed by him. Please let me know if this is true, that his license has restrictions on prescribing such medicines. If so, should I change my doctor?

— J.M.

DEAR READER » Pregabalin (Lyrica) is not an opioid. It works on a different receptor, called the GABA receptor, similar to how drugs like diazepam (Valium) work. However, it is a controlled substance, although it is classified as having the lowest risk for abuse potential. Some do not have the ability to prescribe controlled substances. They must apply to do so. Rather than asking for a particular treatment, you might ask for what he thinks is the best treatment for your severe calf pain.