I had dialation done in conjunction with a flexible cystoscopy in October, as there was some narrowing at the bladder neck.
It was done with the rods, which he wriggled and levered as if he was trying to get a tomato stake out of the ground. Fairly aggressive action, it seemed to me. Some hours later I was back at the hospital as my sphincter had completely closed and not a drop of urine was passing. I required a foley catheter for 2 days. I suspect that swelling from the dilation was responsible for the blockage. Two months after the procedure, the narrowing has returned to what it had been before, so nothing in the end was gained.
Today I had a flexible cystoscopy from a new surgeon who will be installing the AMS in me in June, as he wanted to make sure the bladder neck was OK (you can't use a catheter after the AMS is inseted). It is OK, and I was able to see it for myself on his telescope. It looked like a black hole against the pink wall of the urethra, and beyond that was an ocean of dark fluid, which was the bladder. I did a kegal while he shone the light there, and saw the sphincter work perfectly. He said that the active component of my sphincter works, but it simply won't hold in passive mode. At 14 months post surgery, there's no chance of recovery from 8 pads a day at this stage, he said. I asked him how come a normal looking sphincter could be so ineffective, and why it had occurred. It looked to him as if the operation had been performed properly, he said. He went on to say that if urologists knew why some people don't recover the use of the sphincter, they'd know what to do to fix it. But they don't.
59 years old
Da Vinci surgery Jan 10, 2007, nerves spared, no cancer detected outside prostate
Pre surgery PSA 8, Gleeson 3+4=7, T1C, 3 out of 12 biopsies had cancer
Complication 1: urine favoured drain tube over catheter, extra time in hospital, catheter in for 2 weeks
Complication 2 - urinary tract infection - Citrobacter (hospital bug), 6 weeks antibiotics cleared up
Complication 3 - fungal growth on genitals (candida albicans) probably from antibiotics
Aug'07 Urodynamic study for continuing incontinence 8 pads per day; diagnosed bladder neck stenosis
Oct'07 CT scan indicated nothing abnormal; cystoscopy showed narrowing at anastimosis - dialated
Dec 07 averaging 9 pads a day, started acupuncture (no benefit after 10 treatments)
Feb'08 incontinence deemed uncurable - AUS scheduled for June
Post surgery PSA tests: all undetectable