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"MIGRATING" HEM-O-LOCKS AFTER ROBOTIC SURGERY

User
Posted 28 Jan 2017 at 13:39

I had Robotic surgery to remove my prostate in Feb 2015, and all went well, however, even months later, I was still having blood in my urine, sometimes daily, some times weekly. I was told this was normal(?) with some people.

The situation did not improve, so about 8 months later my surgeon performed  a cystoscopy, and said he could find not a reason for the blood in my urine, though some time later he told he found a bladder stone.

About 12 months after the operation, there appeared to be piece of plastic protruding from my penis - no pain, but it didn't look right! Went to local Hospital, and found that it was a bladder stone, which was removed by tweezers without a problem. Oh yes, and still urinating blood every so often.

My surgeon told me the bladder bleeding was caused by the bladder stones, and the condition was not post-operative. 18 months on, and I was still having blood in my urine. I advised my local doctor of this, and he sent me for urine test and bladder scan. Urine test showed positive for infection, but scanned showed gas in the bladder, which apparently is very serious, and I was sent to hospital that same day for observation. Later told this was could have been fatal, however, in my case it was gas from the infection, not gangrene as it could have been. My surgeon then performed my second cystoscopy, and removes more bladder stones, which he says are causing the infection.

Anyway, still passing blood in my urine 22 months on, and another bladder infection detected. I visit my surgeon again, and he still can't tell me the cause of the bladder stones. He then says it could be a foreign object causing the problem. I asked what did he mean by that, and he said "plastic clips".

I then for my 3rd cystoscopy, and the result is, he found 2 plastic clips in the bladder with more bladder stones. Apparently, these clips are called Hem-o-locks, and are left in the body after robotic surgery. Apparently, they have been known to "migrate" to different parts of the body, in my case the bladder. This caused bladders stones to form and have bladder infections - for 22 months!!!

It's now been 1 month since the removal of those plastic clips, and for the first time since Feb 2015, I have not had blood in my urine for over a month.

Sorry, about the "saga", but just to inform people that these plastic clips are left in the body after robotic surgery, something I was never told about (nor my brother who also had the same operation). Why it took my surgeon some 22 months to find the problem, I don't know? I've checked the Internet, and have seen similar complaints about these Hem-o-locks "migrating".

And in finishing off, my PSA since the operation has been 0%, so all good there http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-laughing.gif

 

Regards

Les

 

 

 

 

 

 

 

 

 

 

 

 

User
Posted 28 Jan 2017 at 13:39

I had Robotic surgery to remove my prostate in Feb 2015, and all went well, however, even months later, I was still having blood in my urine, sometimes daily, some times weekly. I was told this was normal(?) with some people.

The situation did not improve, so about 8 months later my surgeon performed  a cystoscopy, and said he could find not a reason for the blood in my urine, though some time later he told he found a bladder stone.

About 12 months after the operation, there appeared to be piece of plastic protruding from my penis - no pain, but it didn't look right! Went to local Hospital, and found that it was a bladder stone, which was removed by tweezers without a problem. Oh yes, and still urinating blood every so often.

My surgeon told me the bladder bleeding was caused by the bladder stones, and the condition was not post-operative. 18 months on, and I was still having blood in my urine. I advised my local doctor of this, and he sent me for urine test and bladder scan. Urine test showed positive for infection, but scanned showed gas in the bladder, which apparently is very serious, and I was sent to hospital that same day for observation. Later told this was could have been fatal, however, in my case it was gas from the infection, not gangrene as it could have been. My surgeon then performed my second cystoscopy, and removes more bladder stones, which he says are causing the infection.

Anyway, still passing blood in my urine 22 months on, and another bladder infection detected. I visit my surgeon again, and he still can't tell me the cause of the bladder stones. He then says it could be a foreign object causing the problem. I asked what did he mean by that, and he said "plastic clips".

I then for my 3rd cystoscopy, and the result is, he found 2 plastic clips in the bladder with more bladder stones. Apparently, these clips are called Hem-o-locks, and are left in the body after robotic surgery. Apparently, they have been known to "migrate" to different parts of the body, in my case the bladder. This caused bladders stones to form and have bladder infections - for 22 months!!!

It's now been 1 month since the removal of those plastic clips, and for the first time since Feb 2015, I have not had blood in my urine for over a month.

Sorry, about the "saga", but just to inform people that these plastic clips are left in the body after robotic surgery, something I was never told about (nor my brother who also had the same operation). Why it took my surgeon some 22 months to find the problem, I don't know? I've checked the Internet, and have seen similar complaints about these Hem-o-locks "migrating".

And in finishing off, my PSA since the operation has been 0%, so all good there http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-laughing.gif

 

Regards

Les

 

 

 

 

 

 

 

 

 

 

 

 

User
Posted 28 Jan 2017 at 13:54

Hello Les and welcome to the site.

Thanks for the info, I'm sure some will find it useful.

Hope you are feeling better now and that you're healing well

We can't control the winds - but we can adjust our sails
User
Posted 28 Jan 2017 at 14:09

There are a few members here who have had clip migration problems - look at the profile for ColwickChris

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 28 Jan 2017 at 15:32
Les

As Lyn said I have had three clip migrations, the first was three months post op and the third was 15 months post op. Clip one was just lying in the bladder but two and three were in the urethra wall. I often felt that a clip would pop out when urinating but it never did. I did pass a kidney stone a few years before all the prostate problems started,not a nice experience.

I think the chances of a clip migration is about 1 in 500 so to get three is unusual. I never seem to get a straight answer when I ask how many clips are still in there.

Without my stricture problems I may well have been in the same situation as yourself. Clip migration is fairly well documented,one other thing to note is that the clips cannot be seen by xray,MRI or ultrasound scans, some CT scanners can pick them up.

I hope your recovery continues without any further problems.

Thanks Chris

User
Posted 28 Jan 2017 at 20:19

Did i have clips. ?? Not a clue , they were never mentioned. I had laproscopic but by hand instead of robot. Then again I've not had a single day pain-free in 19! months post op. Still wish id stuck to my guns and not had it.
I so hope things improve for you but at least you seem clear which is the main thing

User
Posted 04 Aug 2024 at 13:02

Hi Les, i feel for you and what happened. I had prostatectomy 4 years ago and had infections constantly and then e-coli for a year. I was misgiagnosed with a bladder stone. I suffered for 38mths before g.a and investigation and then removing a 17mm bladder stone containing a clip.

I have the same op booked for 3 weeks time to remove 2 more the surgeon couldnt get out last time. Ive been told if they are sticking up or into something causing my pain i will then require major cold blade surgery.

The BMC recomends that hem o lok should be refrained from being used.

Because of the misdiagnosis after many scans ive been lucky enough to have a solicitor take on my case for pain and suffering and misgiagnosis. I didnt know about the clips or i would have said and to have 3 further surgeries because of it is disgusting.

Im glad my life was saved from cancer but aftercare has been awful. It seems effort is made to keep me alive for me to be killed off slowly with pain and sloppy service afterwards. Its only now after the ecoli infected stone/clip is gone that im finally recovering 4 yrs late! Get in touch if you want solicitor details. Good luck with your recovery.all the best Les. Ryan

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User
Posted 28 Jan 2017 at 13:54

Hello Les and welcome to the site.

Thanks for the info, I'm sure some will find it useful.

Hope you are feeling better now and that you're healing well

We can't control the winds - but we can adjust our sails
User
Posted 28 Jan 2017 at 14:09

There are a few members here who have had clip migration problems - look at the profile for ColwickChris

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 28 Jan 2017 at 15:32
Les

As Lyn said I have had three clip migrations, the first was three months post op and the third was 15 months post op. Clip one was just lying in the bladder but two and three were in the urethra wall. I often felt that a clip would pop out when urinating but it never did. I did pass a kidney stone a few years before all the prostate problems started,not a nice experience.

I think the chances of a clip migration is about 1 in 500 so to get three is unusual. I never seem to get a straight answer when I ask how many clips are still in there.

Without my stricture problems I may well have been in the same situation as yourself. Clip migration is fairly well documented,one other thing to note is that the clips cannot be seen by xray,MRI or ultrasound scans, some CT scanners can pick them up.

I hope your recovery continues without any further problems.

Thanks Chris

User
Posted 28 Jan 2017 at 19:24
Thank you for adding to my education on PCa and prostatectomy. Something else to watch out for, but hopefully it won't prove to be a problem for me.

Ulsterman

User
Posted 28 Jan 2017 at 19:39

I might be wrong but I thought that the clips were only used in laparoscopic / robotic RP. Did you have open RP Walter?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 28 Jan 2017 at 20:19

Did i have clips. ?? Not a clue , they were never mentioned. I had laproscopic but by hand instead of robot. Then again I've not had a single day pain-free in 19! months post op. Still wish id stuck to my guns and not had it.
I so hope things improve for you but at least you seem clear which is the main thing

User
Posted 28 Jan 2017 at 22:41
Lyn - Robbie the Robot, as they affectionately call it here, did my operation.

Ulsterman

User
Posted 29 Jan 2017 at 03:53

Thanks for your comments. I have not seen my surgeon since the removal of the plastic clips in Dec 2016. My next appointment with him is in 3 weeks, so I do have a few questions for him about the clips. 

Sorry about your pain Chris. I must admit, although I've had these bladder stones and infections, there has been no pain or discomfort. The only tell tale sign has been blood in the urine.

Les

 

User
Posted 29 Jan 2017 at 11:58
Hi Les

Many thanks for 'heads up' on this. I did pass some object as I peed into a glass container post ralrp ie removal of catheter. for about 3 weeks. Mainly to monitor output and colour of urine. I noticed a white object about 1mm by 2mm . Hardly visible. Unfortunately I didn't keep it. I dismissed it as just 'debris'. I don't know exactly what is used where as no medical/surgical knowledge . I did find this article. And images. So worth a read https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3272559/

I'm unclear what clips or sutures are used to connect urethra to bladder. I would have thought not 'holc' . I did have a massive pains . Excruciating ie. 9.5 out of 10 scale. Which I put down as bladder spasm at the time. Like a knife stuck in and twisted. I was sweating prefusely for about 2 mins. I went to a&e . However I passed zero blood and have had no complications since. I do get some unexplained aches, mild pains etc etc .most weeks. All part of the nerve damage. . Rebuilding. Very mild 1 out 10 pain. I just ignore. I have been very fortunate with good flow and bladder control. Again thanks for posting and all the best

Gordon

Edited by member 29 Jan 2017 at 12:04  | Reason: Not specified

User
Posted 30 Jan 2017 at 05:29

Hi Gordon

I too had "objects" pass on occasions when urinating. My flow was weak, but then all of a sudden a stronger flow with the sensation of what was causing the weak flow just "spurted" out. I agree with my doctor that it would have been small pieces of calcium/stones, but not a plastic clip. Though in saying that, I did read one article on a forum where one person said he actually urinated a plastic clip.

Thanks for the link on the Hem-o-Locks, that was one of the sites I visited after I had my clips removed. On that site, the person had 4 clips removed (there was a photo of them), whereas I had 2 removed. I describe them to being similar in shape and size as a maggot. My 2 clips are currently in a jar at home, along with a couple of bladder stones also removed with the clips.

I see you suffered severe pain. I must have been lucky, for I had no pain whatsoever, apart from some expected post-operative pain immediately after the operation. Both my surgeon and local doctor kept on asking me about pain, but I kept telling them wasn't any, just blood in the urine.

 

Regards

 

Les

 

 

 

 

User
Posted 04 Aug 2024 at 13:02

Hi Les, i feel for you and what happened. I had prostatectomy 4 years ago and had infections constantly and then e-coli for a year. I was misgiagnosed with a bladder stone. I suffered for 38mths before g.a and investigation and then removing a 17mm bladder stone containing a clip.

I have the same op booked for 3 weeks time to remove 2 more the surgeon couldnt get out last time. Ive been told if they are sticking up or into something causing my pain i will then require major cold blade surgery.

The BMC recomends that hem o lok should be refrained from being used.

Because of the misdiagnosis after many scans ive been lucky enough to have a solicitor take on my case for pain and suffering and misgiagnosis. I didnt know about the clips or i would have said and to have 3 further surgeries because of it is disgusting.

Im glad my life was saved from cancer but aftercare has been awful. It seems effort is made to keep me alive for me to be killed off slowly with pain and sloppy service afterwards. Its only now after the ecoli infected stone/clip is gone that im finally recovering 4 yrs late! Get in touch if you want solicitor details. Good luck with your recovery.all the best Les. Ryan

User
Posted 05 Aug 2024 at 00:14

I will be interested to see how things progress for you. I vaguely recall there had been a directive about where to use and not use the clips and also recall something about not using the clips in robotic kidney surgery. 

Again I recall reading that the clips themselves cannot be detected by normal imaging methods apart from a CT scan with a particular setting. 

Although you haven't specially mentioned negligence, alot of people immediately think leaving the clips in is negligence,but in medical terms if leaving the clips in is a routine procedure it may not be classed as negligence. The timing and wording of the BMC directive may be quite relevant. 

I understand your comments about aftercare, my salvage treatment to eradicate my cancer was only partially successful and caused rare damage to my bladder.

Look forward to hear how you get on.

Thanks Chris 

 

 
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