8 week post-op RP follow up. Meet the Cystoscope.

 Went to see the Uro/Surgeon today for post-op follow-up, and to get results from a 2-month psa test. Good news in that the psa remains undetectable at <0.01. [Crowd Noise] The intake nurse updated my history, and asked if there were any complaints. I told her that within the past week my night-time urination stream got very weak, and had a burning in the head of my unit. She ordered the urine tested for infection. When the Uro came in I repeated the complaint, and he said we’d better have a look.  So, checking my modesty at the door, the nurse had me remove my pants and get on the table, and cover with a drape.

 

She then lowered the table down, raised the drape, grabbed my unit with one hand and a large syringe with the other, and pumped a load of local anesthetic into the urethra. Then she clamped off the head, and said we’ll be back in a few minutes.

 

The Uro came back in with the nurse, and poked a cystoscope up my unit. When he got to the spot where the urethra was sewn together, he said, yep, scar tissue was bridging in there, and causing partial blockage. The nurse opened a package of 18” long plastic straws of varying diameters, and the Uro selected one, then inserted that in me, to try and rod me out. That hit a stop, so he withdrew, and took another that looked like a long needle and pushed that in. That one I could feel! He worked it around for a bit, withdrew it, then reinserted the cystoscope for another look. He withdrew that one, and told me to get up and take a leak.

 

Wow, what a difference! I passed some blobs of tissue, a little blood, but with the most powerful stream I have had since pre-surgery.

 

I am back home, 4 hours later, and in that time I don’t think I have leaked at all!

 

I report this to encourage you to have yourself checked out for blockage if you are experiencing difficulty with urination. The discomfort was well worth it.

 

All the best.

Roger

Roger, congrats on the zero club and wishing you a lifetime of them. Not gonna comment on the other part of your story...ouch!

been having cather in for 5 weeks now. have some kind of blockage. will get cystoscope on nov. 10 09. hope i dont have to get the reem job without painkillers. hade my surgery on sept 28 2009. hade cather out three times. just a dribble and severe pain in head of penis. hope this gets solved. sorry david i emailed you today with some insignifictquestions comparied to what your going through. that was before i knew. keep up your great spirit pluged up

hey david the doctor did not say she was going to dilliate but said ill get the scope. ill be watching out for the diliating proceder.thanks for the warning.if i can get this cather out and work on urinating things may look better up the road. neil picayune ms

Roger,

Thanks for your post. It has helped me understand my own situation better. It's not always easy to be open about such private matters.

For the first couple of weeks after getting rid of the cateters (plural) I had a very strong stream. That's what I expected what with very little left to restrict the flow. Since then it has been very gradually getting weaker, until now when it's little more than a dribble most of the time. I was thinking it wasn't a big deal, but your post has convinced me to check with my urologist. Maybe a little procedure is called for.

It's well known that different folks have different threshholds of pain. I guess I am one of the lucky ones with a fairly high threshhold. In my description of the process, I was trying to keep things light and find some humor in the procedure.

The nurse was very professional; the syringe with the local anasthetic did not have a needle to inject me, rather was pressed against the tip of my unit, to fill the urethra with the local, then a clamp was placed at the tip to keep the liquid from flowing back out. All painless to me.

The doctor used a flexible cystoscope, and it was only somewhat uncomfortable when it went in. Felt more pressure than anything else. I did feel the second device he inserted, because he was able to cut away at the scar tissue with it. That lasted about ten seconds. The whole procedure from start to finish was under 10 minutes. If I start to plug up again, I will go back for more without hesitation.

All the best.

Roger

Roger,
Sorry you had to go through that, but it sounds like it turned out for the best. I was just wondering if the blockage came on slowly or if it happened all of a sudden. My stream is weaker than before surgery, but is acceptable, just hoping it doesn't get any less (I'm 7 weeks out).

crew

The question of urinary stream after surgery can take many turnings. I add mine not to diminish the seriousness of the problems of others, but to add perspective.

Shortly after catheter removal my stream was about 25% of pre surgical normal. Now at six months I am up to about 50%-60%. Last week my doc did some urinary flow tests – you pee into a funnel and a detector measures the result. He also did a bladder ultrasound. He said that while the flow was light, the pattern – starting low, building to high and then tapering off (the bell shaped curve) was good and not indicative of a serious constriction. The ultrasound showed that my bladder was completely emptied which is also good since if urine was left it could lead to infection.

He suggested that I keep a “pee journal” He noted that during recovery there is a tendency to go more often to compensate for lack of control and that if I was still emptying frequently this could account for a low stream.

He said that corrective action could be taken but there was always some risk of opening things up too much and increasing incontinence. We left it for now and will revisit the issue in three months.