Things that have been found in the human urinary system: a radio transistor, a toothpick, and even a fish. So after prostate surgery, which signs of health and illness should patients emphasize? Here are a few:

• Volume: An adult male normally produces approximately 1 to 2 liters of it a day. When patients are over-hydrated, they produce much more. Over-hydration can easily occur at the time of surgery because of the use of intravenous hydration during and immediately after surgery. It can also happen because patient anxiety can translate into compulsive drinking (which in supine patients can also lead to abdominal distension and pain). The first sign of over-hydration: Urine that looks like tap water, clear and without any color. Conversely, under hydration manifests in low volume and a concentration of color.
• Color: Immediately after prostate and other urological surgery, because of the intra-operative use of dyes, urine can be green, blue, and various shades thereof.  However, such discolorations normally wear off quickly and the urine returns to its normal amber, apple juice color.
• Clarity: Normal urine is translucent. One should be able to read through it. Cloudiness can reflect inflammation, which can be seen with infection and with trauma, which surgery produces. Thus, cloudiness in itself is not proof of infection and must be assessed in contenxt: Was there surgery, how long ago was surgery, are there bacteria, is there a urethral catheter, is there fever or pain, and the like.
• Debris: Post-operative urine often contains small particles of white, suspended debris that reflects infiltration of inflammatory cells at the healing site and that resolves spontaneously.
• Blood: All surgery causes bleeding. The question is how much. We care about bleeding after prostate surgery  for two reasons: It can compromise blood pressure and overall stability and it can clog up catheters used to splint suture lines. In the first two or so days after surgery, blood in the urine can be a bright, red color. Generally speaking, it turns to a more burgundy or rust color after that. Clots can reflect heavy fresh bleeding or they can reflect old bleeding that finally loosened up and is passing. As shown in this image, when urine is stationery, as it often is after an overnight rest, blood can sediment to the bottom of a collection bag; here it appears as a rust-colored layer at the bottom of the bag.

Eskimos have 100 words for what we call "white." Urologists have 100 ways to interpret what others call urine. If you are a patient who's had a prostate operation, look at your urine and understand what it's telling you. After prostate surgery, if you have questions, communicate them to your "Eskimo." He can interpret things that few others can. What he interprets can keep you out of trouble. In the meantime, here are some very simple rules:

• If there is generally a little cloudiness or blood in the urine, call your doctor
• If you just out of prostate surgery and your urine is odd looking, call your surgeon
• If there is a transistor, fish, or toothpick in your urine, run to the Emergency Room