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Blocked urethera

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User
Posted 20 Mar 2019 at 17:10

I had my open prostatectomy in 2014, salvage RT in 2015 but over the last few months my peeing has been getting worse. 3 weeks ago it was down to a few drops so I went to A&E . 7 hours later after trying to insert a catheter without success, they pulled it out- there was bleeding but they'd punctured the blockage and I could pee again! Last week I had a cystoscopy which showed a severe stricture in the urethra suspected to be scar tissue from my OP. They said I would need a procedure which would take place fairly quickly. Then on Monday night I was completely blocked so went back to A&E at 10pm in absolute agony! They tried to insert a catheter again without success but the same result, they'd pierced the blockage and I could pee again. But, 2 hours later i was completely blocked again and in agony. This time they managed to get a catheter in and I was sent home. After 2 failed attempts to speak to the consultant's secretary,  I rang the urology department today and was told they would arrange a pre op assessment 

Anyone else had this problem?

Guy

User
Posted 20 Mar 2019 at 20:50

Guy

My catheter was "normally" in for ten days, that was because my surgeon operates on a Monday and we have a catheter removal clinic on a Wednesday. The first Wednesday was too soon so had to wait 10 days..

Thanks Chris 

User
Posted 21 Mar 2019 at 20:29

Gents

In my case the surgeon and I were reluctant to cut into the scar tissue. I lost my continence after each stretch but quickly regained it, perhaps because the stricture was reforming. When he did cut into the scar tissue I still regained my continence. The combination of surgery, RT and perhaps too much ISD has left me in a bit of a mess and a permanent SPC, it is quite rare but it can happen.

One of our members declined a dilation and copes with a flow of around 5ml/ sec.

Thanks Chris

Added I got a urine bottle and monitored my flow once it got below 5 MLS/ sec the surgeon would get me in for another stretch.

Edited by member 21 Mar 2019 at 20:33  | Reason: Not specified

User
Posted 14 May 2019 at 07:59
The consultant told me before the op that he would be dilating using 2 french (I think that's what he said and gradually increasing to 20. The op lasted about 15 minutes and there was no incision.

Size 16 catheter I was told. It's a Lofric origo and says CH14 4,7mm. I think when it gets to the stricture, it can catch on that. I've found by twists it, it will find the hole easier. I don't get any bleeding and yes, relaxing does help. I leave it in for 15 seconds as instructed

Best regards

Guy

User
Posted 18 May 2019 at 15:35

T

Might be worth putting an elastic band round the tap to prevent accidentally opening the flip flo. Hope all goes well next week. 

Thanks Chris

User
Posted 18 May 2019 at 20:01

Hi Guys, I'm a fully paid up member of the Blocked Urethra Club!!

Self Catheterisation is a breeze, I choose to do mine every 5 days rather than the suggested once a week!

(I'll post more when I know this has got through, I have switched to Apple Mac recently which has made posting impossible!)

Pablo

User
Posted 19 May 2019 at 19:25

I wish I'd used the Foley catheter as I was 7 weeks with a bag and the bladder got lazy I think, hence a bit of incontinence.  I did a 6 mile walk today with a half of bitter at the half way point with no leaks, so fingers crossed,  it seems to be getting better. My timetable has moved on to self catheterization every 2 days now. It's not always easy but just needs patience and I find by twisting the catheter when it comes up against the stricture, it helps to ease it through

Good luck to you 

Guy

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User
Posted 20 Mar 2019 at 20:10

Guy

Sounds like you care has been a bit lacking. I developed a stricture soon after my RARP  catheter removal, in my case it took about three months for the flow to slow to 0.5 ml per second. My urology department were straight on the case and got me in to perform a dilation. I was told it might take two or three attempts to sort the problem, I have had about 12 or 13 urethral procedures, hopefully you will get it sorted in one attempt. 

I found dealing with the catheter after a dilation much easier than after the RARP.

I only went into retention on one occasion and that was result of not having a catheter fitted after a dilation. 

If you need any more info just ask.

Thanks Chris

 

User
Posted 20 Mar 2019 at 20:30

Thanks Chris

I've had flow tests in the past which have been satisfactory, but to be honest, it's only really deteriorated over the last few months and then dramatically in the last month. I hadn't thought about that, that they'll fit a catheter after the dilation. How long did they leave it in?

Best wishes

Guy

User
Posted 20 Mar 2019 at 20:50

Guy

My catheter was "normally" in for ten days, that was because my surgeon operates on a Monday and we have a catheter removal clinic on a Wednesday. The first Wednesday was too soon so had to wait 10 days..

Thanks Chris 

User
Posted 21 Mar 2019 at 19:25

Gregoryg,

Sounds like a dilation or a urethrotomy may be on the cards.

I developed a stricture about a year after my RALP operation and had a urethroptomy to open up the urethra. Then about a year after that the stricture returned and I went into retention. This led to an emergency urethroptomy. I was then offered two options, to self-catherterise once a week (forever-like) or urethroplasty. I chose the former and things have been fine since.

It seems a small percentage of us are hit by this after surgery.

Hope things get sorted for you quickly.

Flexi

 

User
Posted 21 Mar 2019 at 20:00
Hi

I had a RARP just over two years ago. I had reduced flow a while later and the flow test showed about 13ml/sec. That was ok and remained stable until a couple of months ago. Now over the past couple of months it is between 5 and 7 ml daytime and far less at night. I had a follow up with my Uro a few weeks back and he offered a dilation. I have turned it down due to fear of spoiling my continence. I asked if leaving it now could make dealing with it later more difficult and he was non committal. I have a flow test next week to check for retention.

I think his talking about just stretching and only cutting if really necessary depending on what he finds under general anesthesia.

Did any of you guys get incontinence problems after dilation?

Any thoughts on just managing as is please?

Cheers

Bill

User
Posted 21 Mar 2019 at 20:29

Gents

In my case the surgeon and I were reluctant to cut into the scar tissue. I lost my continence after each stretch but quickly regained it, perhaps because the stricture was reforming. When he did cut into the scar tissue I still regained my continence. The combination of surgery, RT and perhaps too much ISD has left me in a bit of a mess and a permanent SPC, it is quite rare but it can happen.

One of our members declined a dilation and copes with a flow of around 5ml/ sec.

Thanks Chris

Added I got a urine bottle and monitored my flow once it got below 5 MLS/ sec the surgeon would get me in for another stretch.

Edited by member 21 Mar 2019 at 20:33  | Reason: Not specified

User
Posted 21 Mar 2019 at 21:00

Thanks for the responses. It never really occurred to me that this might cause incontinence but because I had a complete blockage,  I guess I have no option 

 

User
Posted 21 Mar 2019 at 21:07
Thanks Chris

Yes I have read your posts etc. Sorry your outcome was not as good as mine and that you have had it tough.

Thanks for your previous help as well and good luck in the future.

Guy

Good luck with your out come

Cheers

Bill

User
Posted 03 May 2019 at 12:59

Had my dilation carried out last week under a general and still with a catheter. I went to the health centre today when they removed the catheter and taught me how to self catheterise. All was good but now dribbling when walking /standing which is what I feared might happen. I have to give a presentation tonight in front of about 150 people - I might have to wear a mac!!  

User
Posted 03 May 2019 at 13:23
Nip to your local Anne Summers shop for some latex underwear!

Seriously, I hope you get sorted eventually.

Cheers, John.

User
Posted 06 May 2019 at 13:05

Hello, pleased to read the postings, my urethra has been playing up, only dribbles when trying to pee, I’m in for a general operation next week. It’s never ending, robotic surgery, radiotherapy & now this, I’m wearing Tena now to stop the embarrassment when I’m out & about. I must say the NHS were very prompt in getting me in for the operation less than a month after been diagnosed, no complaining there.

User
Posted 14 May 2019 at 07:07

An update 10 days after the catheter removal. Self catherisation is not easy - I've done 10 so far on a daily basis. As from Thursday I go to every other day, then weekly and eventually even monthly depending on how things are going. My flow is tremendous, best for many years. Incontinence is now pretty minimal, still wear a Tena pad if walking somewhere, but very small leakage now, so fingers crossed!

User
Posted 14 May 2019 at 07:34
Gregoryg - pleased to here your heading in the right direction.

Do you know what method of dilation was used please? I know of one that uses a balloon and another that uses progressively larger rods. Was it just a stretch or was there an incision?

Hope you achieve full continence soon.

Cheers

Bill

User
Posted 14 May 2019 at 07:37

G

Sounds like you are back on track. When you say ISD is not easy, do you mean it is difficult getting the catheter in ? What size and model of catheter are you using, there are numerous types of catheter and some are definitely easier to use than others. Being relaxed is also helpful. Are you getting signs of bleeding after you remove the catheter and how long do you leave it in for.

Thanks Chris

User
Posted 14 May 2019 at 07:59
The consultant told me before the op that he would be dilating using 2 french (I think that's what he said and gradually increasing to 20. The op lasted about 15 minutes and there was no incision.

Size 16 catheter I was told. It's a Lofric origo and says CH14 4,7mm. I think when it gets to the stricture, it can catch on that. I've found by twists it, it will find the hole easier. I don't get any bleeding and yes, relaxing does help. I leave it in for 15 seconds as instructed

Best regards

Guy

User
Posted 14 May 2019 at 13:46

Greg

The lack of blood is a good sign, I don't think I was ever blood free. I think the 16 you mentioned is the length, the "14" after the CH denotes the size of the catheter. The French your surgeon mentioned is a sizing system where fr1 is equal to .33mm diameter. fr2 means a diameter  of.66mm and fr20 would be 6.66mm dia, sad that I know so much about catheters.

He probably used s curve dilators to stretch the stricture, on one occasion had a full dilatation whilst fully awake and without any anesthetic, not recommended but just about bearable.

Hope you do not have to have it repeated.

Thanks Chris

 

User
Posted 18 May 2019 at 15:20

Hi everyone, had my cystoscopy yesterday, fitted with a Foley catheter without bag, my bladder will control when I want to urinate. I just flip lever & out it comes, strange at first, it’s strapped to my thigh & much easier than previous with the bag. I’m wearing long shorts so I lift the trouser leg & away I go, that said I’m back to the hospital next week to have it removed & self catheterisation begins. Not looking forward to that but encouraging what Greg has said about the procedure, the journey continues.

User
Posted 18 May 2019 at 15:35

T

Might be worth putting an elastic band round the tap to prevent accidentally opening the flip flo. Hope all goes well next week. 

Thanks Chris

User
Posted 18 May 2019 at 20:01

Hi Guys, I'm a fully paid up member of the Blocked Urethra Club!!

Self Catheterisation is a breeze, I choose to do mine every 5 days rather than the suggested once a week!

(I'll post more when I know this has got through, I have switched to Apple Mac recently which has made posting impossible!)

Pablo

User
Posted 19 May 2019 at 19:25

I wish I'd used the Foley catheter as I was 7 weeks with a bag and the bladder got lazy I think, hence a bit of incontinence.  I did a 6 mile walk today with a half of bitter at the half way point with no leaks, so fingers crossed,  it seems to be getting better. My timetable has moved on to self catheterization every 2 days now. It's not always easy but just needs patience and I find by twisting the catheter when it comes up against the stricture, it helps to ease it through

Good luck to you 

Guy

 
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