Intermittent Self Catheterization after Prostate Cancer

My hubby is 2 years post tomotherapy radiation and brachytherapy for prostate cancer. He is suffering recurring acute urinary retention and is looking at ISC for a long time until the scar tissue in the urethra is "retrained" to stay open. Can anyone comment on this? He is terrified of doing the ISC because he tried it once and it was incredibly painful and he couldn't do it. Is there a trick to making it less painful? Does it get less painful as time goes on? Has anyone has good long term results with this treatment? It just breaks my heart watching him go through all this and not being able to do anything to help. He was doing great in all ways until a year after the radiation and seeds when he developed severe prostatitis unexpectedly.

Thanks for the input Robert C! Dan knows how to do it technically but not how to do it with less pain. Or less fear!

I have chronic retention following my HDR treatment - almost 2 years now.

Earlier this year my Urologist had me self-cath daily for 6 weeks after taking me off of Flomax and Finest ride.

It gets easier with practice. Also, there are subtle differences in cath's - ask for a sample pack which should include 2-3 of 3-4 versions.

My advice is to 1) relax; 2) I prefer to use a hydrophilic style (lubes in it's own saline solution; make sure to follow the instructions!); 3) make sure it is the curved tip; 4) hold the penis upwards and the cath curve is pointed up the whole time; 5) go very slow; 6) when you feel an obstruction (in my case what's left of the prostate) continue even more slowly but firmly; 7) relax.

After 6 weeks there wasn't any change and so we are back to monitoring and I have a supply of caths just in case.

I feel for you. I spent 1 1/2 years dealing with endless strictures and catheters, including 51 weeks with a Suprapubic catheter.

My doctor would never allow me to self-cath. My bladder neck was so damaged, that he said I was too high risk to attempt self-cathing. I agreed. I was so traumatized by the entire thing, there is no way I could have ever done it.

In my case, after 1 1/2 years, and 6 failed corrective surgeries in the area, I had to have the major step done, and had the illeal conduit surgery, and ended up with an Urostomy.

Big step, but it ended my endless troubles with retention and the need for catheters. Hopefully your situation will remedy on its own without such a drastic step being needed like me.

Good luck

Thanks so much for the info! Never heard of the DVIU. We will be asking the doctor about that this week!

Graytech said...

LadyHutch said...
...Is there a trick to making it less painful? Does it get less painful as time goes on? Has anyone has good long term results with this treatment?...

Sorry to hear of your situation.

I developed a stricture after surgery and ended up self-cathing for 30 days. It wasn't terribly painful for me until I got to the actual scar tissue / stricture. I had to very carefully, slowly and deliberately work the cath against the blockage until I made it through. Often times it would take a minute or more of prodding, back off the pressure and turning a bit then repeat.

The only "trick" if you want to call it that was to use the one's with a curved tip. They were easier to get through the blockage than the rounded tip ones. I too was absolutely terrified at first. "... you want me to put 12" of that where???... So for me it was always more of a mental hurdle than a physical one. Once I got past the mental part it did seem to get easier.

Unfortunately self-cathing did not work for me. After 30 days it seemed like I was doing more harm than good. I would actually go into retention after I cathed due to blood clots forming where I pushed through so they had me quit. A couple months later I ended up having a surgical procedure (DVIU) to laser out some of the scar tissue which did work for me. I'm almost 2 years past the DVIU and still have good flow.

Hopefully things will improve for him quickly. Like any of this cancer crap one step at time, one battle at a time and sooner or later you will get to the other side.

tde44 said...
I have chronic retention following my HDR treatment - almost 2 years now.

Earlier this year my Urologist had me self-cath daily for 6 weeks after taking me off of Flomax and Finest ride.

It gets easier with practice. Also, there are subtle differences in cath's - ask for a sample pack which should include 2-3 of 3-4 versions.

My advice is to 1) relax; 2) I prefer to use a hydrophilic style (lubes in it's own saline solution; make sure to follow the instructions!); 3) make sure it is the curved tip; 4) hold the penis upwards and the cath curve is pointed up the whole time; 5) go very slow; 6) when you feel an obstruction (in my case what's left of the prostate) continue even more slowly but firmly; 7) relax.

After 6 weeks there wasn't any change and so we are back to monitoring and I have a supply of caths just in case.

Thanks so much for the info and advice!