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Leaky anastomoses

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Posted 9/22/2015 7:43 PM (GMT 0)
My RALP was 11 days ago by a highly experienced surgeon. Apparently I have a problematic anatomy, and the anastomoses was difficult, and the connection is still leaking urine into my abdomen. I will keep the catheter and drain another week at least. I'm demoralized, but also anxious: What are the implications for long term recovery given a leaky re-attachment? I'm assured the leak will go away (no guarantee when), but will I have problems down the road? Scar tissue more likely? Strictures? LUTS? Any persistent catheters out there that came out all right in the end?
Posted 9/23/2015 3:04 PM (GMT 0)
Guys - someone must have a suggestion for TheNative.
Posted 9/23/2015 11:17 PM (GMT 0)
I have nothing to add... But hopefully someone will be by soon to give you an answer
Posted 9/23/2015 11:17 PM (GMT 0)
Wish I had something to offer. What does the surgeon say?
Posted 9/24/2015 1:14 AM (GMT 0)
I am certainly not expert on the long term implications of an early on leaking anastomosis. But my gut feeling is no problem. This is not to say you won't be- or maybe not- a longer time to getting dry than the average. You might be, I was for totally different reasons. I was told that my giant prostate would likey make me a good bit slower to continence, but still just as likely to end up pretty dry, and I think that turned out true. It might be similar for you, i.e. the drawn out healing of the anst. and/or longer cath exposure might draw full recovery out, but I don't know. But, I'm thinking that the usual factors related to regaining continence probably are quite different from factors associated with a leaky anastomosis.

But I might be wrong. One factor I have decided- based on my own journey- associated with continence issues is(long lasting though ever slighter) bladder spasms associated with the bladder irritation caused by surgical trauma and/or a couple of weeks with the catheter. Could all of this be amped up in your case? Maybe. But I really don't know, so I'm not much help. Sorry.
Posted 9/24/2015 4:35 AM (GMT 0)
Wish we could be of more help, but seems like you've got something going we don't know much about. Hopefully you doctor is right and there aren't too many long term problems,
Andrew
Posted 9/24/2015 5:27 AM (GMT 0)
Native, no experience or knowledge on your situation, so I don't have much to offer. If you can be patient and trust in your surgeons comments, hopefully he'll prove right and it will clear up.

But if it's really bothering you mentally, maybe you should consider getting hold of the surgical notes, and tests that diagnosed the issue and bringing them to another urologist for a second opinion. Just to be complete.
Posted 9/24/2015 10:43 AM (GMT 0)
Hi Native

Sorr you have this problem, and sorry that between us we have not come up with much in the way of help (and interesting that you have lead to a sub-thread about you not getting replies, ie we really care about trying to work out how to help!)

Now. In case there are people wondering what anastomosis is, well guys who have had surgery will all have had it, it means joining the two ends of the urethra back together (the word is also used for joning any two bits of tubing in the body back together, eg veins, arteries, bowel, intestine as well as geito-urinary ones.)

And chances are that anyone who did not have their catheter removed one week after surgery was also leaking. (I've seen a website somewhere that says leaking through the join after a prostatecomy is quite common, so on that basis I would not worry too much if it happens to you! It says it can be due to things like the size of the prostate, age, size of the patient etc)

One week after my surgery I was given a cystogram with a spacial fluid that would show up on X-ray to see if my join was leaking. Mine was not so I went off to have the cath removed. The other guy having a cystogram that day who had surgery the dame day as me was leaking and had to wait another week.
But I've heard of guys (here) who have had to have their caths left in for lije a month of six weeks as it took their tissue longer to heal.

I'm no doc, but I think leaving the cath in to help the join heal is quite normal, as is leaving the drain in to help make sure the urine in your abdomen gets removed. (and remember that urine is quite sterile while sill inside the body!)
Yes it may mean that you take longer to get dry, but you should still get dry:

However, as you are clearly a bit worried, I think you should talk to the docs and they should take their time to go through this with you in a bit more detail.

And try googling: anastomosis leakage urine, I saw there were a number of useful hits.

Alf
Posted 9/24/2015 3:48 PM (GMT 0)
I endured 54 days until the leakage healed up. Doc told me to wait... And wait... And... Finally healed up. Long-term, I blame some very minor incontinence on having the catheter in so long. Other than that, no problems.
Posted 9/24/2015 10:04 PM (GMT 0)
I remember asking my urologist the question about leaking anastomosis and he said it isn't a problem, that it will heal. Luckily urine is sterile!
Posted 10/4/2015 4:32 PM (GMT 0)
Quick note to thank everyone who responded. Catheter stayed in another week, but everything seemed to heal up so that on Day 18 I was liberated from it. I have since talked to a friend whose catheter stayed in 7 weeks. Now I feel like a wimp for complaining about 18 days!
Posted 10/5/2015 2:56 AM (GMT 0)

TheNative said...
Quick note to thank everyone who responded. Catheter stayed in another week, but everything seemed to heal up so that on Day 18 I was liberated from it. I have since talked to a friend whose catheter stayed in 7 weeks. Now I feel like a wimp for complaining about 18 days!

Don't feel like a wimp. I was 12 days---brutal with bladder spasms. Couldn't wait to get it out.
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