IMRT - Question on full bladder and equipment malfunction

Not sure what to tell you about the full bladder thing.
HW member Purgatory, can chime in on that issue.

Yup, you need to call your RO to understand what happened.
Is this salvage RT or primary with your prostate still in there? The needs for a totally full bladder change slightly if you still have the prostate according to my RO. He still wanted me to have a "as much as I could comfortable hold for an hour but don't worry able getting it exact as the machine can do some corrections." I just drank one bottle of water before the daily treatment. If you have the marker implants and they are using those to target the prostate the machine can better avoid the bladder.

Still, what you were told is a bit odd and should be followed up on.

Andrew

I know that there are different opinions about the "full bladder", evidenced by what members have posted in the past, so the first thing to do is confirm what you should be doing with the RO.

Be sure you understand  - Are they saying "you don't need to" as if it would be nice, but not required? Or that they advise against it? Is there anything in your patient forms about it?

My CT scans, xrays, and all IGRT sessions were done with the full bladder.

My RO REQUIRED the full bladder for all prostate patients, and that was her specialty. You had to sign a form saying you understood the medical reasons, and had to initial in each day on the check in sheet. There were water coolers (covered with "have you had your water" signs) with the right sized cup just in case. If there was a delay for some reason, and you just couldn't hold on any longer, you peed, then drank another round and waited.

Even with all that, I have some bladder neck and colo-rectal burns that emerged as issues 18 months after treatment.

I was a "full bladder" guy. The techs told me to be "comfortably full" but there was no need to be full to the point of desperation. They told me it made the daily CT scan imaging & alignment easier with a full bladder. I had a couple of tough days with equipment delays. One time, I was on the table when the system went down. After 45 minutes they moved me to the other machine. I had to let off some of the pressure. They told I could let "just a little out." That was when I knew I had done a good job with Kegel exercises .. starting a stream for a few seconds, stopping it, and then going back on the table .. yowww!
SC

My RO required 32 oz of water before each treatment and if the CT scan showed the bladder not full you had to drink some more before treatment. He drew a picture of an empty bladder and a full bladder and where both sit in relation to the prostate. An empty bladder sits on the prostate and a large portion, maybe 25% is in the radiation field. When the bladder is full, it pulls away from the prostate and just a tiny portion was in the radiation field.

thanks Everyone - I will discuss with Dr. tomorrow and will just drink a lot anyway before i go in.

This is Salvage Radiation that I am talking about.

You are very incorrect on this point, TA.

Some of the other purposes of having a full bladder, is to protect the bladder walls themselves, and to protect the rectal wall from damage.

This has been told to me by several radiation oncologists that have been approached by my attorney's in my ongoing malpractice claim against my RO and the radiation center.

This was also confirmed by the other RO's that I had interviewed with prior to my salvage radiation.

Almost without exception here at HW, the men that have underwent salvage radiation were either required to have a full or nearly full bladder. In some cases, they were not allowed to be zapped until the operators knew that they had met the requirement.

For our new friend Burgess, as I advised him, he needs to clear this up with his RO before getting his next zap.

Before mine ever started, I asked my RO about my empty bladder due to the catheter, and her famous words, "Don't worry about it, I got that covered". She didn't have it covered, and I was severely damaged and disfigured as the result of her "error." But at the point, I was in a doctor-patient relationship, and the onus is still on her, and her words have come back to haunt her.

When I first reported being burned, it was dismissed as my imagination. For those here long term, you all remember my daily accounts, and how the pain got worse and worse with each treatment. My RO never once stopped the treatments to investigate the burning.

David in SC

Yes Sir on the full bladder and empty bowel. After the treatment I would RUN to the first empty bathroom.

 

---

TA,

My IGRT was adjuvant to the prostate bed after my surgery. I got the same discussion: keep the bladder out of the way to avoid damage.

No water, no treatment.

TA,

Mine was IGRT with Calypso. I don't know the model of the equipment, but is was just as the "daily pre-CT" version was coming out. My techs all wished they were somewhere that was putting in that equipment.

And yes, I had the same water rules for all sessions, preparatory and actual.

I started SRT in December 2009, just 3 months after surgery. My radiation was delivered via the TomoTherapy Hi-ART machine. 70Gys delivered in 35 treatments.

There were those here that questioned whether or not I was going to the treatments with a full bladder. I had not received any directions to do this. On the day of the 3rd treatment I was scheduled to visit with my RO. I raised the question and he said it was not required. So I didn't worry about it.

My appts were usually first thing in the morning so I probably had some degree of fulness from my morning coffees.

I am now almost 3 years post treatment and to date I have no effects from it. No change in continence (fully continent) no change in bowel activites, no change in anything except ED. At almost two years I had normal erections about 75% of the time.

Don't know if it was the machine or the mapping done by my RO. I do know that my RO is now the head of UCLA Radiation Oncology, so I figure he must have known what he was talking about.

Just like everything else in this crappy Pca jungle, there is no one correct answer to anything about treatments.

FWIW,

Sonny

Full bladder from my RO for my SRT...20-ounce bottle on the trip in was the recommendation.

By the end of the first week or so, you get in the rhythm of what will work for you. There were times I peed a few ounces while in the waiting room just to be "comfy full." Was in torment on the table a few times when things went long and even emptied my bladder on the table one time as soon as the second/final revolution of the machine finished.

Tech said no big deal but just try not to pee when the radiation arm was directly underneath as urine salts are not all that compatible with a multi-gazillion dollar piece of equipment.

..