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Bladder neck stenosis

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User

Posted 23 May 2018 at 20:48

hi all as some will know I have a bladder neck stenosis which basically means the opening is greatly reduced. This was a result of my RP. They were going to operate in 2013 but after a chat on the op table we decided not to. Since then even though I have a rediced flow it’s not been a problem.

Five years on and I need an op on my nose. I’ve been made aware that GA can relax the bladder and I, as others may do, may need a cather to get me peeing after the GA. I managed to convince them I needed a plan as a catheter would not fit in my bladder. So I saw the urologist on Saturday who agreed there needed to be a plan. Had the camera up on Monday and the Urologist confirmed I would need a suprapubic cathetar.

So at least I had a plan but then he informed me there is a chance I may not regain full bladder strength so I may need the bladder neck opening. I explained I was told this could lead to incontinece and he agreed.

So decision time. Do I go ahead with the nose op which, through a chain of events, could leave me incontinent or do I forget the nose op. I’m really tempted to live with my nasal problems

unfortunately this side effect was never mentioned before my RP

Bri

User

Posted 23 May 2018 at 22:42

Bri

I can't say I remember my SPCs affecting the bladder strength, but your guy has the knowledge of many patients. I did regain my continence after the dilatations, not as perfect as it was 3 months post RARP. That was all before SRT.

Post SRT with a semi permanent SPC in , continence has sufferrd badly and the last dialatation and cystoscopy was a disaster but that is due to the adverse effects of the radiation damage.Even with a SPC in I get spasms and frequently leak.

I assume the SPC would be short term and they do heal over in a matter of hours once removed. I would ask for a flip flow valve on the SPC to keep the bladder working as normally as possible.

Guess it is a choice of QOL.

Best of luck with your decision.

Thanks Chris

User

Posted 24 May 2018 at 06:47

I think I’d leave my nose alone faced with all that. What I don’t understand is if you’ve had the camera up , then how come a catheter won’t go ? I had a cystoscopy and it was sheer bl****dy agony rammed up there. I nearly pulled the nurses arm off. Good luck

User

Posted 24 May 2018 at 09:10

Hiya Bri,

Personally I would certainly be considering if I could live with the nasal problem, along with the prognosis of any further deterioration. It's a bugger of a decision mate. Hope it works out for the best whichever path you take.

Paul

User

Posted 24 May 2018 at 09:33

With a stricture they can normally get the camera up to the top of the urethra where the joint has been made but not through the joint /scar tissue / stenosis/ anastomosis.

So they can see the hole but it is too small for a catheter, my last surgeon said mine was like a pin hole, yet I was still passing urine quite well.

Thanks Chris

Edited by member 24 May 2018 at 10:30 | Reason: Added second paragraph

User

Posted 24 May 2018 at 21:22

Cheers Guys, Chris J my urethra is fine and the camera passes fine with no probs until it gets to the bladder neck. The urologist said it is about 25% of the size it should be. So a catheter won’t fit in
ColChris it’s the GA that could leave my bladder weaker not the SPC.

I forgot to mention that the urologist did say as I get older the bladder will get weaker anyway so I may need the bladder opening up at some point.

The problem with my nose is that I have polyps as well as a broken nose. So most days I can’t breathe though my snout it also effects my voice etc
But I don’t fancy being incontinent or ending up with the problems Chris has had

Bri

Edited by member 24 May 2018 at 21:23 | Reason: Not specified

User

Posted 28 Jul 2018 at 20:15

There are quite a few abreviations many of which I do not understand. However, I have/had similar problem to you.

I am 56 years old. I have a nasal defect caused at birth.

I had a nasal surgery in the 1980s but last year I had more nasal surgery which has made beathing easier.

For the last few years I have had a reduced urine flow which was solved last month with an incision to the bladder neck.

I have also had several general anathestics (GAs) for the above operations plus some for kidney stones (which indirectly is how my PC was diagnosed).

None of the GAs (except obviously the last one) affected how much urine I could pass.

For the bladder neck incision I was incontinent for only a couple of hours after which my bladder was able to cope with a wider neck.

From my experience I would recommend that you have the nasal operation. Yes it is a risk, but so is everything. I found that difficulty in beathing caused difficulty in sleeping and me using nasal sprays which the ENT specialist was extremely unhappy about.

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