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Inability to Urinate after Seed Implants

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Posted 7/16/2007 11:20 AM (GMT 0)
If anyone has ever experienced this problem, please, let's chat.  I have never used this message board before so I hope I am doing this correctly.  My 79 year old father had seed implants 5/11/07 and has not been able to urinate on his own since.  He is desperate for a solution.  He was not informed that this could be a side effect, and since he was in the early stages of PC, he should have never had this proceedure.  If anyone out there has any support for him, please respond.  We have spoken with other experts at the Mayo Clinic and they said time may heal the problem.  He is having much difficulty with the self-cath; any advice would be appreciated.
Posted 7/16/2007 11:55 AM (GMT 0)
To JSS,

Hopefully you'll receive more replies than mine, but I just wanted to say that this is not an unusual side effect of the seed therapy. The self-cath is a pain in the neck, no question, but the side effect should lessen as time passes. Is he on flow-max or similar medication?

It is surprising that no one mentioned this potential side effect to him--I would have thought that any reasonable MD would have mentioned the possibility during the initial consultations.

As for the comment "since he was in the early stages of PC, he should have never had this procedure" I have to say "huh?" Who made this comment? Surely not one of his MD's. Unless he had some difficulties with urination prior to the treatment. It sounds like a comment made by someone who does not know what they are talking about.

I could be completely off target with each of my comments above, since you haven't shared a great deal of information about your father's pre-treatment condition or what kind of medical counsel he received. Has he had his post treatment follow-up with his oncologist? I can believe that the self-cath is going to be required for a while, but expect that eventually further treatments or a prescription such as flo-max could be of assistance.
Posted 7/16/2007 12:28 PM (GMT 0)
Thanks so much for your reply. I only wish I would have attended the meetings with my dad's physicians. I truly believe the problem resulted from him having had the surgery in Venice, FL and not in a specialty clinic. I don't know all the stats, other than he had 6 biopsies done 3/07 and one of them was positive. His Url told him not to bother with all the other testing since his PSA was low, that he could take care of him in 15 minutes with the seeds, so Dad scheduled for 5/11. Being an older man, not into technology or research, he figured this would be a quick fix so he went for it. After the proceedure, he was on the cath for a week at a time, for 3 weeks. Each time when he went in to have it removed, he couldn't urinate on his own, so they put it back in. After the third week they said he would have to self-cath himself and showed him how. They sent him home with some very rigid plastic caths and he attempted to use them for a couple of days, until he was in so much pain, with blood clots spewing out everywhere, he begged his doctor for another solution. They ended up flushing his bladder and sending him back home with an attached cath but told him he was going to have to learn how to do the self-cath because they couldn't leave the cath in much longer.

It was then that I got on the phone with Mayo in my city, and begged for an appointment for the Url and Onocls to see him. With all of his records in hand, we spent a full day at Mayo, where they do not recommend the seeds. They said this was a common side effect with the seeds and that it may or may not subside. They did not go into the would have should have could have stuff, as they are much too professional for that, but it was quite obvious they would have recommended an alternative treatment, due to Dad's age and early stage of prostate cancer. He learned that at his age, something would have most likely killed him before the prostate cancer progressed to a stage of danger. They did perscribe some much more pliable caths for him to use, and removed the bag. Dad left Mayo with hope that things would improve, but now, a month plus, later, he is at his witts end once again. He is having difficulty placing the cath, getting very little urine out, and needing to do it very often. He does take Flomax, which he has taken even prior to the proceedure. I sent him some natural progesterone cream (which is said to naturally shrink the prostate)which he rubs a very small amount on the scrotum twice a day. Poor Dad is so depressed over this entire issue, that I worry that he will take his own life. He is seeing his doctor on Thursday and I am thinking about making the 6 hour drive down to be with him, but I feel helpless. I was with him at Mayo and that didn't help. Please, if you have any advice or know of anyone who has gone through this let me know.
Posted 7/16/2007 2:51 PM (GMT 0)
JSS,

  I'm really sorry to hear about your father's difficulties. I can only relate because I, too, had the Brachytherapy implants done on May 22, 2007. I had the Iodine 125 seeds (100 of them) which have a half-life of eight weeks, meaning they get weaker and weaker after each eight week period. Kind of like fractions - a whole to a half to a quarter to an eighth, etc. Hopefully as the seeds get weaker, your dad may have less and less difficulty. Unfortunately, since the male urethra runs right through the center of the prostate connecting to the bladder behind it, thereby, giving the urethra a strong dose of radiation. Difficulty with urination and some early on blood clotting and is probably one of the major side effects. Also, nocturia - getting up frequently at night to urinate - is another. Flomax should help calm the neck of the bladder to ease this problem. I'm still having problems with the nocturia. I also have minor hypertension (high blood pressure) for which I take medication. Flomax has a tendency to lower the blood pressure in some men, so I've been a little leary to start taking it. So, that's my story. I wish I could help your dad's problem, but I can't. I'm 63 and so far my seed implantation has gone very well. However, I have my first post-Brachytherapy PSA test next month. So, we'll see. I expect a spike, but the next one and the one after are probably the key.

Posted 7/16/2007 3:44 PM (GMT 0)
You did not mention whether you, too, are forced to deal with the dreaded self-cath. If so, any suggestions for making it easier? Thanks again JSS
Posted 7/16/2007 6:31 PM (GMT 0)
  Hi ~   jss and dad,                   W elcome to…                                       HealingWell                                                                                   and                     A    “ Special ”    Warm Welcome   to   You !    KNOWLEDGE     IS     POWER   ...   and   POWER conquers   fear   jss ~   I feel your helplessness and can’t offer much.   But ~ the first thing that came to my mind is the suprapubic cystotomy.   I found this site and have not read it completely but the 1 st paragraph jumped out at me.  I am sending it on to you.   I don’t know any specifics but something to look into….   Our thoughts are with you and your dad as you continue to search for answers…. Hopefully time will heal but in the mean time something definitely needs to be done.   Keeping you close in thoughts and prayers…. We are glad you reached out to all of us… In New Friendship ~ Lee & Buddy   http://carecure.rutgers.edu/spinewire/Research/Suprapubic.htm Partial quote from site: Intermittent urethral catheterization (inserting the catheter through the urethra) has long been the standard of bladder care for people with spinal cord injury.   In recent years, suprapubic catheterization has become popular because it is easier technique for people with cervical spinal cord injury and limited hand dexterity to do catheterization.   Suprapubic cystostomy creates tunnel from the abdomenal wall to the bladder.   A catheter can be inserted into the bladder through this tunnel.   The catheter drains urine into a bag.   The catheter is irrigated daily and can be left in place for several weeks before replacement.   It does not require catheterization every 4-6 hours and provide greater independence  
Posted 7/16/2007 8:00 PM (GMT 0)

JSS and Dad,

I'm sorry. So far, I've been very lucky with the urination. No catheterization at all. I just get up a lot and somtimes if it's been awhile since urinating, it's a little painful - but manageable. Bluebird will steer you right. Good luck!

Posted 7/17/2007 3:25 AM (GMT 0)

I have a close friend who was diagnosed about four months before I was.  He chose Brachytherapy.  For the past year, he has needed to carry a "self catheter" kit.  His urologist tells him this is a very common side affect to seed brachtherapy.  We celebrated last week when he announced that for the first time in about a year he was able to "go on his own".  So, things do get better.

I read an interesting on-line article today.  A local Urologic Oncologist had successful Da Vinci surgery this year for his prostate cancer.  His surgeon..the same who did my surgery.  Makes you feel comfortable with your choices.

Posted 7/17/2007 1:43 PM (GMT 0)
you go lifeguyd! Fore!!!!!!!!!!!! British open this weekend.
Posted 1/8/2008 6:30 AM (GMT 0)

This is my first post to this site.  I see there has been a lot of talk of men who have had the seeds implanted and then after the surgery been unable to urinate on their own.  My Dad who is 74 years old and had the seeds implanted 1 year ago today is still having to self-catherize himself and he is unable to urinate on his own.  His doctors told him that his side affects are rare and they have never heard of anyone ever having this trouble before.  I'm finding that hard to believe when I read all the postings that I have found on this site alone and everyone seems to be suffering from the same problem.  The doctors are also telling him that the only way to rectify this situation is to have the uretha cut and permanent bag placed.  My Dad is in extreme denial he believes that there must be some other way.  Aside from this problem of having to self-catherizing himself he really feels good.  His last check of PSA was 0.01 which is wonderful.   He has had numberous bladder infections involving blod clots and other serious side affects of the self catherization.   He and I are both worried that he is not helping his situation by having to use the self catherization to be able to go to the bathroom everyday.  Does anyone know of any clinical trials with NIH or any other agency that offer any hope or studies that relate to this problem?  Please send me a message if you do.

Thanks

Posted 1/8/2008 1:52 PM (GMT 0)
So sorry to hear your dad is having this problem also. Since my last post, things have not changed.  Dad punctured himself w/the self-cath about 4 months ago and this is no longer working.  He now must be cathed at the doctors office.  Every 3 wks or so they remove it and let him try "going" or self-cathing.  No go.  Your dr is not correct when he says he never heard of this.  It apparently happens 20% of the time.  DO NOT LET HIM get "roter rutered" as this will definitely make the situation permanent.  Keep giving it time and patience.  Good luck.
Posted 1/8/2008 2:10 PM (GMT 0)
I'm sorry your Dad is having this difficulty.  My husband had Brachytherapy and never experienced this side effect - he had relatively few side effect save for fatigue.  I can't offer you any advice, just some hugs to help you through this.

 

Posted 1/10/2008 11:07 PM (GMT 0)
My husband experienced no problems in the first month since Brachytherapy. He was told that urinary problems are significantly more common after seeding in men who have urinary problems beforehand. Michael had no problems at all before either so maybe that is what made the difference. My husband is not taking Flomax either. He got the catheter out the day after seeding and hasn't seen one since (thankfully!).

I'm on another list specifically for Brachytherapy, and urinary urgency is much more common than other urinary problems.
Posted 1/10/2008 11:49 PM (GMT 0)
Dad had been taking flomax for quite some time (years) prior to surgery.  Thanks for your post and good luck.  jss
Posted 1/11/2008 1:59 PM (GMT 0)
Yes, I've read and heard from my husband's doctors that urinary problems are much more prevalent post-implantation in men who have them beforehand. Has your father tried any other alpha-blockers to see if another might be more successful?
Posted 1/16/2008 8:06 PM (GMT 0)

I am sorry that so many of you are having problems going but let me tell you about my situation. I had a seed implant and all worked well for about 10 years and then i had a problem not being able to urinate.  I went to the doctor and after taking different medications which did not work i had a laser tratment which the doctor said would take care of everything.  That was a bunch of bull because it gave me more problems than i wanted.  I am now with a different urologist and he said the radioactive items has wrecked my bldder.  I guess i am writing thhis letter so any of you don't have the stupid laser tratment.  I have had a sphicter put in and the pump on that failed so now i have to have a new unit installed  to stop the constant leaking.  I now have a catheter in my belly and thats how i am going to urinate hereafter.  If you want to live you just have to get used to whatever you have live with it.  Sure beats the altenative.

Good luck to all

Jerryv

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