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Few Catheter issues post op

User
Posted 08 May 2023 at 00:05

I had my RALP done two days ago, all good so far, but having some issues I could do with help.

The support socks, my feet are really hot in them. I was thinking of cutting the feet part off and keeping the leg part, would that be a bad plan. I am moving around, some walking, gently up and down stairs.

The nurse said that it was important to wash the catheter area, I pulled foreskin back, washed but now it won’t go back! The penis had been very stubby after the op but recovered a bit, however with the relatively large inserted pipe it just refuses to return to its normal position. It’s actually more comfortable when lying down but much more sensitive when walking or sitting, I’ve read it could cause problems, not sure how to fix it.

I had a leg back from the hospital, is it okay to use that for the whole 10 days. I was sent away with a pack which had 7 overnight bags and one leg bag which is different to the hospital one, seems a different make and connection tube not as long so would be positioned on my knee which obviously is no good.

 

 

User
Posted 08 May 2023 at 20:10

Hi Glover. Where you position the leg bag is probably down to personal preference but I actually preferred it just above the knee as opposed to just below. I recall being given a second leg bag and told to change it after the first week. I think I would ask the hospital about using a bag any longer than intended. I do vaguely recall that my foreskin was more difficult to return with the catheter inserted. All I can suggest is tying a bit of lube (KY or equivalent) to see if that helps it on its way. Unfortunately a shorter penis seems to be one of the consequences of RP. I can only imagine that the compression stockings cover the feet for good reason. It seems odd that your feet are hot in them. I was wearing mine late February so perhaps that made a difference. Are you sure you don't have any foot inflammation or swelling that might be causing the hot feeling?

User
Posted 08 May 2023 at 20:30

Thanks for the reply Chris, I’ve resolved some of my issues, the foreskin I’ve returned, tricky problem but if anyone else has it, start at the base of the penis and begin to pull the skin back at the base, once all done, then begin to pull up from near the bell bit, that worked for me, I was just trying to pull it up holding the penis mid way. Amazing this journey, never in a million years did I think I’d be describing this problem, but they all matter!!!

I’ve been given a number to call to order more bags so I’ll ask for a leg bag rather than above the knee, just what I’m used to.

I think the stocking issue is just not being used to wearing sock to bed, love them off my feet and all seems fine, I’m doing injections some hopefully all will be okay.

 

 

 

 

User
Posted 08 May 2023 at 20:38

Glover , the leg bag should be changed every 7 days, after surgery some hospitals issues non draining bags with the idea that you fit a new night bag each night. The idea of a new bag every night is to reduce the risk of infection. Most catheter equipment is interchangeable between different makes. I have a permanent catheter and wear it across the knee.

The foreskin not returning is a potential problem, not major but it will quickly get irritated. I had it happen twice. The second time I was still in hospital the nurse got some ice ,put it a surgical glove and used it to cool the penis and reduce the swelling, for clarity I don't mean put it inside the glove , use a sandwich bag if you have one

The first time I was at home and my urology nurse told me to use a bag of frozen peas to reduce the swelling.

 

Once the swelling has reduced use some lube to get the foreskin back over the head of the penis. Instilagel or hydrocaine are designed for use with catheters and contain anesthetic antiseptic and lubrication, kygel comes a poor second in my opinion, but if needs must. Try and avoid using petroleum jelly or vaseline, Google it for reasons why not to use it.

If you can't get the foreskin back over the head call a district nurse , my foreskin came up like a balloon and took many months to reduce back to its normal size.

Thanks Chris 

 

Looks like I was still writing when you replied.

Edited by member 08 May 2023 at 20:41  | Reason: Not specified

User
Posted 08 May 2023 at 21:21

Thanks Chris, yes I must have replied before you but useful information with this issue as I couldn’t find anything on the search. 

I did for the first time see s very small amount of blood on the catheter tube at the penis entry, hopefully this should not be a problem if it doesn’t get worse, been 4 days since my RALP so early days, still not had a bowl movement yet, was not given any laxatives to take with me but have been lightly using them, might need to up the use a little, having fairly high fibre diet which normals makes me go, fingers crossed for tomorrow. 

User
Posted 08 May 2023 at 21:45

Glover, a small amount of blood and urine bypassing the catheter is frequently mentioned. I started talking senna tablets after surgery, I asked my GP for advice and was told to double the dose shown on the packet. Be careful not to go overboard and finish up with diarrhoea. 

On about day five after surgery I got an excruciating abdominal pain which resulted in getting paramedics out and an ambulance ride to hospital. A few hours later I came home and later that day pure relief as that first motion happened. Remember no forcing. Pain killers and an upset to a normal eating routine won't help.

Thanks Chris 

User
Posted 08 May 2023 at 23:06

Thanks Chris, I think I will try Senna tomorrow or similar.

The other issues is the constant feeling I need to wee with this catheter fitted, didn’t notice it first few days but now my mind is fixated by it! I’m sure it’s just in my head as obviously need to pee has gone, I’m almost wanting to get up and go to the toilet. 

Once the catheter is out will this feeling persist? I’m sure it will take time to adjust, any drinks to avoid. Sorry I know people on here have much bigger issue to deal with tun this. I’m also really surprised how often I fill the leg bag, sometimes after an hour it’s full, the larger night bag seems to be about 3/4 full in the morning, is this about normal, seems my body just doesn’t want to retain any fluid at all! 

User
Posted 08 May 2023 at 23:34

I get a feeling of wanting to urinate when I have an infection, there is alot happening in the bladder at the moment. Urinating is quite a complicated system,the catheter could be causing the constant feeling of needing to urinate.

Anybody's guess how you will be post catheter removal, some guys are dry from day one. You may not have any warning of wanting to urinate in the early days.

Most people say avoid caffeine and fizzy drinks, my district nurse tells me to drink two litres of water a day irrespective of whatever else I drink.

I sometimes urinate 200ml overnight sometimes around 1200ml. Never really found a pattern.

 

Thanks Chris 

User
Posted 09 May 2023 at 15:45

I’m a couple of weeks ahead of you having had my op mid April. Willy was like a button for the 1st few days post op and foreskin peeled back. Painful and worrying that Willy had gone! Post catheter removal foreskin slipped back into place of its own accord after a couple of days. I was too scared to try and force it back as it was swollen and painful. Willy has recovered but not to previous size which I understand is a side effect surgeons never mention. I’m on silendafil which has so far had no effect but early days and the nurses did say it would take time. I have also been prescribed a pump but told not to start using it until after I’ve seen the surgeon (scheduled for week 8 post op). One side effect of ‘wee Willy’ is that when peeing sometimes due to size it dribbles down and wets trousers as no control. Something I need to work on! Can’t believe I’m putting this down in writing something I would not have considered a couple of months ago. Good luck with your recovery. The one thing I’ve learnt is take it slowly.

User
Posted 09 May 2023 at 16:03

Hi,

Regular use of the pump, when you are permitted it's use, may well help with length and girth in time thats what i found. For me it was about a year of taking weekly Sildenafil before having an impact. At 18 months now it does work as an event drug.

As you say it can be slow in recovery. I wish you well in continuing to recover 

User
Posted 09 May 2023 at 19:43

It may not be talked about as much as it should but I think a lot of men find it less messy to pee sitting down post-op

Normal to lose 1"-2" in length , depending on the size of your prostate and therefore how much your urethra has been shortened. Good penile rehab and a bit of luck means this may not be permanent although it often is. Our surgeon had a patient who lost so much length that he was never able to pee standing up again 😔

Edited by member 09 May 2023 at 22:06  | Reason: Not specified

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

User
Posted 09 May 2023 at 21:57

It’s something I may have to think about if there’s no improvement in technique. I now know what I must have felt like as a toddler potty training !! My worry is how I’m going to cope in work when I go back - will probably have to have a change with me. A few weeks to improve continence before that becomes an issue. 

User
Posted 09 May 2023 at 22:07

Time and gravity will help everything drop a bit lower - as will gentle pulling and then the vacuum pump when you are allowed

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

User
Posted 10 May 2023 at 13:23

Once I get my incontinence in check (patience I’m only 4 weeks post op) then sounds like a new chat up line to my wife ‘do you want to pull and pump - purely medicinal purposes only’! 

User
Posted 15 May 2023 at 13:35

Thanks for all the replies, just an update.

Had the catheter and clips removed today, 10 days after RLAP, both painless and mild discomfort at most for me. So far no leakage and flow like I’ve never seen it before!. I drank about two litres of water and one coffee, I’ve been peeing way too much, probably been about 8 times since this morning, I think my bladder does not hold much urine before I get the urge to wee, something I’ve suffered for a long time, hopefully once I’m back to normal living and drinking less this will settle.

I had one nerve bundle spared, not sure about ED yet but I’ve been prescribed 20mg Tadalafil, one tablet twice a week, 3 month supply given. How long should I wait to see if I can get an erection? Should the nerves be given a chance to recover, the nurse just said refrain from sex for while but nothing about doing some pre testing!!

I was a little confused about staging, after my MRI and biopsy I was told my stage was T3a NO MX gleeson 7 (3 + 4), but they weren’t sure if the cancer had breached the prosate gland, however after seeing the surgeon, he wrote and said it was T2 and even showed me the scan which showed it inside the wall. Now that the surgery has gone ahead and only one side nerves were spared does that mean that my initial T3 staging was correct or are the nerves still within the prostate? Would it be that my chances of re occurrence are greater with only half spare? The surgery team did say they got all of it but im just concerned it breached, I’ve got an appointment in a few weeks to discuss this but I always leave feeling a should have asked more questions when I see the consultant. They used Nerosafe when they did mine so the Samples would have been tested while doing the procedure so would have know the nerves positive before removal. 

User
Posted 15 May 2023 at 14:48

Hi Glover,

I was T2 and only had one set of nerves spared, and not breached, 18 months ago. Ongoing PSA tests have all been 0.006 I.e. undetectable. At this stage you can accept your surgeons response regarding staging.

As for the ED, having some nerves spared, medication will be helpful in the healing process, but could well be a while, and the use of a vacuum pump required for penile rehabilitation. 

P.

 
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