bladder neck contracture post op

God bless you is my comment.

Does this happen often to people?

My boss had to learn how to catheterize himself also. He had done HT followed by seeds. He said that the process of putting in the catheter and removing it alone wasn't a big deal.

I guess the thing that has been bothering me is reinserting that catheter again. What I am getting so far is that it is not as bad as it looks.

it's an ugly thought, but like I said, my boss joked about. Said it wasn't a big deal.

Yobiks, I'm very sorry to hear you've been having these problems. I hope this latest procedure settles it once and for all.  I broke into a sweat just reading about your latest experiences. 

Post Edited (clocknut) : 4/16/2011 9:27:14 AM (GMT-6)

yobiks,

if you know my journey, it was one of extreme stricture issues that were never totally solved. i was on a total of 21 catheters, i spent about 1 1/2 years on them, including my last stint of 51 continuous weeks with a suprapubic catheter in place. I had two emergency dialation procedures in the uro's office, 2 ER visits, and 6 corrective day surgeries. in the end, once my bladder was bypassed for life and a stoma created, i will never have to worry about strictures or caths again. it was a terrible process.

my uro said some men can handle the self-cath routine, and some can't. I was one of the cant group. I had too much damage al lthe time at the bladder neck, and he was afraid i would injure myself self-cathing, and I am not circumsiced, which can make it a little more diffiuclt.

unlike my story, i hope yours has a happy ending.

david in sc

When a woman is catherized, its a short trip, but much more difficult to insert. With men, regardless of penis length, it's a much longer path, though with curves involved, and the entrance point is easier to access in most cases.

My uro is not big on self-cath for post Prostate Surgery guys, for the reason stated above, the juncture of the urethra and bladder neck has changed greatly from your pre-surgery state. My doctor believes, that after a dialation, keeping a cath in place for weeks, or longer in my case, allowed better healing and prevented closure in general, and to avoid me hurting myself in the process, making things worse. My case was extreme, I admit, and doctors choose to do things their own way of course.

Two times as the result of severe strictures, I had to have two caths in me at the same time. Sounds amazing, but true. I had the suprapubic catheter coming out of my skin to the left of my navel, to urinate with. And a regular foley catheter in my penis to try to keep the opening, open. The longest I wore two was for 15 days, and there is no way to describe the pain.

Most stricture events can be cured in 2-3 attempts, i.e. Pigeon Flyer and Subic Squid here. Once they were finally fixed, no more problems. In a smaller percentage of men, it becomes a chronic condition, and difficult to control.

My record from being closed to open to back to being 100% closed was less than 30 days, despite having a laser correction as a day surgery. In that short of time, my body scarred the opening completely within weeks. My uro said he had never seen that happen so fast. He showed me photos before and after, and it was incredible that it could have closed so quickly.

And back to self-cathing, the catheters are tiny in diameter compared to a regular cath, and many doctors will give the patient lydacine gell to numb the opening to take to edge off of inserting the cath. That can help a lot if you have to do that.

I wish you the best overcoming this situation, and hope that it is short term, and not chronic.

David in SC

Squid, good to see you, I was sure you wouldn't mind me invoking your mighty name.

david

I can only try to answer the first part of your question. I think the daily catheterization (for me once daily times two weeks, then once every other day x 2 weeks, then once every third day x 2 weeks) was not to clean out scar (catheter too soft to do so) but rather to slightly maintain dilation of urethra. As for scarring initially, my catheter came out 2 weeks after surgery with difficulty. Maybe that was a warning that I would scar heavily down the line.

yobiks,

What Northfoot said. You need to google "Clean intermittent self-catheterization (CIC)". You also need to talk to your uro and ask "what am I doing this for?" I suspect it is an attempt to keep the urethra stretched out as, Northfoot noted. I had a stricture occur about 8 months after my IMRT and I read up on it and thought I would have it lasered or cut, but my uro (bless him) felt that a dilation might work as well as more drastic measures IF the I followed through. Any way a dilation, 3 weeks with a Foley, followed by CIC 3x/day for 3 weeks, 2x/day for 3 weeks, 1x/day for 3 weeks, 1x/week for a few months. After 4 years, I still do it once a month just to make sure everything is open. I'm spozed to give him a call if I can't get an 16F up there. So far, so good.
CIC is no big deal. It isn't painful and only takes a few minutes once you get the drill down. You do have to keep it clean, soap and water clean, you even reuse the catheters. Hell, I did it in the field pheasant hunting. Like many things, it really will not limit your activities unless you you allow it to.

Best....

Surely it must help to mold and smooth the surface. There were several other issues ie stone and stitch that had to be taken care of- that is why he went in with the laser.

Of course, Paralleli, just giving general cath advice, doctor's orders always best.