Most of the today's uro visit was pretty routine. I was his last appointment of the day, he often schedules me that way so that he can spend ample time. Hadn't seen him since November. Spent a full hour with him, and when I left, all the lights were off and one of his office staff was patiently waiting for us to get through.
On the good news, my stoma looks good 1 1/2 year later, he was pleased with that. We talked about my April PSA test, he doesn't mind that my Oncologist is now taking that duty over, as long as he keeps getting copied on the results.
He looked at the little lump that has developed in the past few months, and as I thought, he believes its just some kind of benign cyst or crystalized something or other. Said we would keep an eye on it in the future, just in case.
Now for the not so good part. He agrees with my Oncologist about me being at high risk for bladder cancer, due to the faulty SRT experience. I am going to need a day surgery in the next few weeks, its the only way he can get up inside my bladder at this point to take a look around. He warned me in advance, that there was an equal chance that the blaldder neck is so sealed shut after all this time, that he may have to abort the procedure if he can't safely break through the closure. If he can't, it will leave me in a bad situation, as there woudln't be any other way to inspect the bladder's interior wall.
Also, if he does get through, he may take samplings of the walls to test, and unfortunately (and I knew this was coming), I will have to have a foley catheter for a few days to a week, to allow an outlet for any bleeding or debris. I can't hardly stand the thought of that, thought with my Urostomy, that I would never have a cath again, this will be number 22 if it happens. Also, there is a risk, that I could end up with perm. ED from the procedure, which troubles me since I don't have any presently.
If cancer is found, and it was on the surface of the walls, he said he could surgically remove the areas through the penis. But if it is found and it is more substantial, it would involve a long and complex surgery to remove the bladder. He's strongly hoping that won't be the case, looking at a 8 hour or more surgery, and he said that removing a radiation damaged bladder is risky at best, and could cause severe rectal damage in the process. Also, even if cancer was found, I would not be able to have any radiation to clean up the cancer, because of the previous damage done to my bladder.
This is the one time that I really need a break, or good luck, or a miracle, that there is no cancer found. If you pray, could sure use a special one for this. The operation will be scheduled sometime in the next 2-3 weeks. Unless things get complicated, shouldnt need to spend the night in the hospital, but there is a chance of that. What I need after undergoing this, is a clear signal that my bladder is cancer free. He said that anyone that has had their prostate removed and then had radiation, is at high risk, but since my radiation was done wrong and did so much damage, that its like 10x more likely the risk for bladder cancer at some point.
This whole thing is heavy on my mind tonight. There is a lot at risk here. Can't believe I will have both the stoma and a cath going at the same time. It's a nightmare in my mind, even if its just for a few days. Normally, they would simply go up me with a scope, and often, bladder cancer is detected by blood in the bladder, but since my bladder's input sides and out put has been sealed off, there wouldn't be any other way of investigating for cancer.
He also agrees that with my current sympton of increasingly painful bladder spasms, something has to be causing them, again, we are talking about a bladder that is non-functional. He gave me some Visicare, to hopefully help in the meantime with the spasms, but he said the med was designed to work with a working bladder, not a non-working one.
If this takes place, it will be my 9th PC related operation since this all began late in 2008. Hard to believe. Well, this is the latest, I am going to have to toughen up my mind and emotions as I prepare for this next step. Not getting any easier over time. I really, really need a break this time. I told him I still felt traumatized from all the previous catheter experiences, and he said he really could understand that.
David in SC