After transurethral resection of the prostate (TURP) with a three-way catheter and continuous bladder irrigation, which finding suggests the catheter is occluded?

• A. The urine in the drainage bag appears red to pink
• B. The client reports bladder spasms and the urge to void
• C. The normal saline irrigant is infusing at a rate of 50 drops/minute
• D. About 1,000 ml of irrigant have been instilled; 1,200 ml of drainage have been returned

Answer: (B)

When a three-way catheter is used for continuous bladder irrigation after TURP, the goal is for urine to drain freely while the irrigation fluid flows in. If the catheter becomes occluded, outflow is blocked and the bladder cannot empty. The body responds with bladder irritation and distention, which shows up as spasms and a strong urge to void. That sensation points directly to a drainage blockage, making it the best sign of occlusion.

Pink or red-tinged drainage can be expected after TURP and doesn’t by itself indicate occlusion. Seeing the irrigation fluid infuse at a normal rate doesn’t guarantee the drainage lumen isn’t blocked, so it isn’t a reliable clue on its own. A large amount of drainage compared with the amount instilled can occur for various reasons and isn’t a definitive sign of occlusion. If occlusion is suspected, check for kinks or a displaced catheter, ensure the drainage bag is below bladder level, and consider gentle irrigation or replacement if needed.