Weak Stream After Surgery & Radiation...

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Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 2200
   Posted 4/16/2011 1:53 PM (GMT -6)   
Here is a note I just sent to my U-doc..Of course it's Saturday...Any of you guys hav any suggestions?

I've completed my radiation, 72Gy, 40 treatments..No problems with that, everything seemed fine so we headed for Mexico and our beach shack and have been here since the middle of February..

Suddenly, this morning, when I went to urinate/defecate, my urine was slow to start draining..it just took a long time to get going, but then emptied but not a very strong stream. Now, at noon, I had to urinate again and the same thing, slow to start, slow to drain...Up until now I was able to pee quite normally, a strong stream uninterrupted, I was able to piss out 6 feet in front of me..So this problem came on quite suddenly..I suppose over the past week, my stream HAS been getting a LITTLE weaker, but not much..Living out in the boondocks, 60 miles from any medical help, I'm a little worried what this might lead to and what is causing it..There is no pain or other discomfort associated with this..

I'm ASSUMING there might be a post-surgery "stricture" developing and I'm hoping this condition does not progress to rapidly..I'll be back in Denver in about a month and I'm hoping this will go away or at least not get worse too fast..
Yes, I know to head for the ER if I reach the point I can't pee....

Anybody gone through this??
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 2676
   Posted 4/16/2011 2:32 PM (GMT -6)   
I have not myself, but are you sure bladder is full, also are you drinking enough and are u experiencng an urge to go as well. If yes could be a uti, see urologist. I have bouts now and then about steam ,et al, but always remember what my surgeons nurse said. If you think about it lot , it actually will trigger an urge thats not justified. Drink well and postpone, if able and let the urge pass, see how that works. good luck
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

Northfoot
Regular Member


Date Joined Mar 2011
Total Posts : 66
   Posted 4/16/2011 4:06 PM (GMT -6)   
Fairwind,
I had a bladder neck contracture after my RP three years ago. I noticed a gradually diminished flow for about six months, then a rapid decrease in volume and rate. Eventually, I needed a dilatation and had to self-catheterize once daily over six weeks. Not a lot of fun, but my urologist had wanted to do the dilation months earlier, at the first sign of decreased flow. As soon as you can reach your urologist, you may want to ask for this to be done, as waiting in the ER for someone to come dilate you while your bladder is maximally filled cannot be enjoyable. Better to do it on your schedule. Good luck.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 23556
   Posted 4/16/2011 4:56 PM (GMT -6)   
Fairwind,

I am a bit concerned for you. Hoping you will report that the problem resolved on its own. Sounds like too much like some of my stricture crisises. I would be ok for a while, then with no warning or gradual lessening of flow, I would start to close up. Trust me, you don't want your bladder blocked, the pain is incredible, and if you aren't relieved by an emergency cath insertion, you can endanger your kidneys with a back up.

If what you describe continues, I woudln't assume its going to get better on its own. The danger is waiting too long, as I did once only, and it almost became a serious crisis when the urologist couldn't get inserted, even the smallest diamter catheter. It required a lot of pain and stress, and finally he managed to get a single wire through, and then just barely, got the smallest diameter catheter in place. That held me over until he could do another surgical correction.

Hope you get some good news out of this situation.

David in sC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 4/16/2011 7:08 PM (GMT -6)   
Your problem sounds like mine.  A slowly diminishing stream and eventually constant trips to the bath room because I couldn't empty the bladder totally.  I didn't wait around (fear of ER visit and cath).  Two trips to the Uro involved dilation and catheter for a few days and the third time actual surgery to correct the stricture.  Pay attention to the problem because as David can affirm, you don't want to get totally plugged up.  Not sure how good the docs are in the ER in Mexico, but my Uro always warned me to NEVER let an ER doc do the catheter - always call for a Uro.  Squid.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 2200
   Posted 4/16/2011 10:16 PM (GMT -6)   
Things seem to have stabilized, not gotten any worse..It's just that old week-end problem, the ER is the only choice. There is a good private hospital in Hermosillo that provides excellent care and service if need be. And once catheterized I can get back to Denver if need be..

Easter weekend down here can be a complete circus, everything shuts down, but not the ER...Of course, you don't get the "A" team..

I'll give it a couple of days and see how it goes..The last time I peed it was quite normal..

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 23556
   Posted 4/17/2011 8:19 AM (GMT -6)   
Fairiwind, that's good news to read this morning, I am glad to hear that. Another tell-tale sign to watch out for, if you start developing low back pain, basically at the bottom of your kidneys, a good indicator that things are slowing too much and starting to back up. Good luck
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 2200
   Posted 4/17/2011 10:45 AM (GMT -6)   
Sunday morning....Things seem to have improved, stream starting almost instantly last 4 or 5 urinations..Maybe a little stone or flake that passed? Anyway, situation not critical...

Newporter
Regular Member


Date Joined Sep 2010
Total Posts : 212
   Posted 4/17/2011 3:15 PM (GMT -6)   
Fairwind,

Happy to hear things have improved. We were all a little worried. Perhaps it is just a case of UTI.

Anyway, enjoy your holiday and vacation.

Regards,

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 23556
   Posted 4/17/2011 5:51 PM (GMT -6)   
Fairwind, excellent news
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10
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