Clips and the after effects

Littlec, I am one of handful in this site who experienced similar issues. It is supposed to be a 1 in 500 event ,but I suspect it is more frequent. My first one was found in the bladder the next lodged in the urethra joint. I have seen where one guy actually passed one while urinating.

They are called hem o lok clips and made of a polymer that is not easily spotted by imaging methods. I seem to recall a CT scan on a particular setting may see them. Once they calcify I believe they can be seen 

Not heard of the stent in the bladder neck ,sounds a good idea but I believe the bladder neck muscle help control our urine.

I formed a scar tissue stricture and went back into theatre 13 times to try and sort it ,I also did some self dilatation with various size catheters.

A search in this site or Google will bring up lots of clip info, try  hem o lok, or hem-o-lok , or hem-o-lock

Thanks Chris

Edited by member 17 Feb 2025 at 11:55  | Reason: Not specified

Littlec , my surgeon was a bit vague but mentioned there were probably around 8 clips left in during surgery. They did introduce some directive about the clip use in kidney surgery. For anyone not familiar with RARP, the clips are deliberately left in,it's not negligence.

Unfortunately further treatments damaged my bladder and I was fitted with a suprapubic catheter, so that stricture never got sorted. Fortunately I loved the whole general anesthetic experience. 

Just a word of advice on the self dilatation / catheterisation,be very very gentle.

Thanks Chris

Bill, I used the coude tip catheters which where curved and slightly tapered. I also used another type that had a balled end , I wonder if the original poster was refering to those. The stent sounds interesting. 

Thanks Chris

Regarding the self catheterisation, I am prepared to continue as prescribed, but find it difficult to contemplate lifelong insertion bringing with it all the possible complications. So I have to admit if they came up with a less invasive alternative I would go for it.

Chris raised a point about the need to allow the muscle at the bottom of the bladder to work unrestricted. That’s interesting as I believed that muscle was no longer in place after a prostatectomy. Perhaps mistakenly I thought the only control left was via the pelvic floor muscle?

Regarding the catheter insertion I appreciate the advice about being relaxed and slow insertion. My urethra is still sore after the clip removals so I hope it will get better, however the painful bit is the entry into the bladder which does cause some pain, albeit short lived.

I think i remember reading that the sphincter at the bladder neck is removed with the prostate and the one below the prostate is brought up and becomes the only sphincter. In normal anatomy you keep the upper one at the bladder shut subconsciously the lower squeezers shut when you consciously stop yourself peeing. That's why you need to train you pelvic muscles to keep it shut post prostatectomy. I stand to be corrected if wrong though.

Cheers

Bill

Littlec,  My reference to bladder neck muscles is as described below. The sphincter or sphincter muscle is removed along with the prostate, the terminology can be confusing.🙂 It is my understanding that the bladder neck muscles may or may not remain in place depending on spread and individual anatomy. I could of course be wrong.😃😃😗

• Bladder neck muscle:

  This is a group of muscles at the bladder outlet where the bladder connects to the urethra, playing a role in maintaining urinary continence by providing structural support and resisting pressure from a full bladder.

   

  Urethral sphincter:

  This is a specialized muscle located at the bladder neck and the beginning of the urethra, actively contracting to close the urethral opening and prevent urine leakage. 

   

  Thanks Chris

Edited by member 18 Feb 2025 at 22:51  | Reason: Not specified