Brachytherapy Side affects - catheter 6 weeks and counting

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JackR
New Member


Date Joined Dec 2008
Total Posts : 5
   Posted 12/4/2008 3:49 PM (GMT -6)   
I am in a small percentage of Brachytherapy patients that have required a catheter post treatment. I'm now at 6 weeks and have tried three times to void without a catheter (no success).  Any similar experiences?  How long do you go before you look at urethera surgery.

mactrain
New Member


Date Joined Oct 2008
Total Posts : 7
   Posted 12/4/2008 11:40 PM (GMT -6)   
JackR:

After Brachytherapy I had a terrible time with urination. I finally got where I absolutly could not urinate!! Had to wear a foley catheter for four days. This occurred about 16 weeks after the procedure. The solution for me involved learning to catherize myself. After approximately 8-10 weeks of self-catherization (4-5 times a day), I was cured. This took place about 4 years ago. Now I am proud to say that I can "pee like a race horse!!".

You have to park your dignity at the door and learn this procedure. As it was explained to me, continued inability to completely void results in a badly stretched bladder that will not completely empty. Self catherization will allow you to completely empty your bladder and it will regain its elasticity. Talk with your urologist and learn the procedure. It worked for me.

When I first learned of this procedure, I couldn't believe that men actually did this to themselves, but look at it this way-It's much better than having an uncaring stranger do it to you in the emergency room of your local hospital. Of course, I couldn't have done it without my wonderful wife assisting me by boiling catheters and providing moral support.

Good luck,
Paul

JackR
New Member


Date Joined Dec 2008
Total Posts : 5
   Posted 12/5/2008 9:28 AM (GMT -6)   
Thanks Paul. I agree with your comments about needing to empthy the bladder (infection concerns also). So self-catherization certainly would be an option. Where you able to urniate some amount after your 4 day catherization and then used self-catherization to ensure you emptied your bladder?? I am still completely blocked so self-catheriization would be my only way to get relief. That might be concerning but will discuss with my Urologist. After 6 weeks, I have figured out what I can and cannot due with the catheter leg and bed bags.

mactrain
New Member


Date Joined Oct 2008
Total Posts : 7
   Posted 12/5/2008 10:11 PM (GMT -6)   
JackR- After my time with the leg-bag I could urinate, but not very well. It was only after I decided to adhere to a very strict schedule of self-catherization that I finally got the results I was Looking for. I know how you are feeling . Not being able to pee normally is a miserable feeling. I had a lot of trouble with UTI's during this time. My family MD gave me a prescription for cipro with refills as needed. The procedure is easily learned and very effective in achieving the desired results. At my worst, I was retaining approximately 640 ml of urine after I got through peeing. I must have sloshed as I walked!!

I went to my urologist in October and found that my PSA was 0.2, down from 6.3 at diagnosis in 2004. I presently have no problems peeing, ED is not a problem and the other side-effects (nausea, hot flashes, insomnia and irritibility) are gone. I will never take being able to pee normally for granted. Get with your urologist and develop a plan that will ultimately succeed in achieving your desired goals. Follow the plan faithfully and get back to a more normal life. PC is definitely the pits.

Good luck,
Paul

JackR
New Member


Date Joined Dec 2008
Total Posts : 5
   Posted 12/23/2008 12:30 PM (GMT -6)   
Paul, an update.  I started Self Cath this week.  I have a little stream in the morning but this quickly disappears so SC is my only way to get relief.   You mentioned a schedule.   I'm seeing the need to SC anywhere between 1.5 and 3 hours---probably alot to do with fluid intake and just when I get a urge.  The nights are long----getting up about 3-4 times and then having trouble getting back to sleep so hopefully that will all smooth out.  
How did you get on a schedule??   Did you control fluid intake to get on a schedule.  I think if I could void in between SC's I might be able to get on more of a schedule but for now, I staying close to home.
Sounds like after your efforts, things have turned out well for you.  I'm hoping for the same results!!
Have a Happy Holiday and thanks for the infomation and support!!   Thanks ---Jack

Paralleli
Regular Member


Date Joined Jul 2008
Total Posts : 123
   Posted 12/23/2008 4:34 PM (GMT -6)   
Jack:

I had IMRT and about seven months after radiation treatments were over starting having problems urinating. My Uro did a cystoscopy to see what was going on up there. Not the most fun procedure, but I believe it is one of the best ways to “get a look”. Anyway, he found a constriction in my urethra caused by scar tissue from the radiation. The Uro then performed a dilation and had me in a Foley for 28 days. After the Foley was removed, he started me on a course of self-cath in order to keep the constriction opened up. I started with 3 times a day for a few weeks, then 2 times a day, then once a day….you get the idea. After a year of this, I now do the self-cath twice a week or so. So far this has worked well for me and I’ve no problems with my bladder draining, frequency or urgency.

Has your Uro taken a look up there to see what’s going on? If not, maybe he should. The dilation, followed by keeping it open with the self-cath has worked well for me. I’m surprised I don’t hear of more fellows doing this. It is a problem more associated with radiation treatment I guess.

Best of luck

Paul
53 yrs
PSA 4.8
T1c – Gleason 3 + 3
IMRT 1/07 thru 2/07 (42 treatments)
PSA 6/07 – 0.76
PSA 12/07 – 0.36
PSA 6/08 – 0.72


mactrain
New Member


Date Joined Oct 2008
Total Posts : 7
   Posted 12/23/2008 10:10 PM (GMT -6)   
Jack R,

Regarding getting on a schedule for SC, I decided to SC upon waking, at lunch, at supper and before going to bed. I also voided during the day when I felt the urge. My bladder was so stretched out of shape that I just couldn't completely empty it. Being self-employed as a consulting forester (being outdoors) allowed me to pee when Ineeded to and also allowed me to be at home when I need to SC. Of course, we're all different and have to develop a plan that works for us. I had a friend who had to have the "roto-rooter" treatment. I will pray that you work with your uro and develop a plan that works dor you. Have a great Holiday season and whatever you don't give up.

Paul

JackR
New Member


Date Joined Dec 2008
Total Posts : 5
   Posted 12/24/2008 10:48 AM (GMT -6)   
Paul, thanks for the update. I had my seed implants on Oct. 23rd so I guess I'm just getting started on this journey. Both my Oncologist and Urologist decided to leave the catheter in place as they thought the initial problem was swelling of the Prostate. During the last 60 days, we pulled the catheter (3 different times) and I did not have a good stream. Last week the Urologist suggested we try SC so I have started doing that now. I have seen a slight improvement in my stream so that is encouraging but I still need to SC about every 3-4 hours. The plan is to continue that process for some time---more wait and see. The urologist is optimistic and said we will not even discuss any type of surgery for at least 6 months. Just to many additional side affects that come into play with that is his view. My job allows me a lot of flexibility so can work from home a great deal which is ideal for the number of times I currently need to do the SC. Hopefully I will get into a situation where I can use SC to supplement my own stream but for now, I need to stay real close to home. I'm going to try a schedule of every 4 hours and see if I can get into some sort of schedule. That will help me plan some activity. Thanks for the information and encouragement and you have a Happy Holiday also. THANKS!! Jack

lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 674
   Posted 12/24/2008 12:44 PM (GMT -6)   

A tale of two brachy treatments.

By coincidence, two close friends were diagnosed at about the same time that I was.  They both had gleason six compared to my 8, and they both chose to have brachytherapy.  Since we have our prostate cancer in common, we have shared our treatment and recovery more than others might.

Bob came out of his brachy implant and was asked to use a catheter for a short period of time.  He had few follow up urinary difficulties.  The other, "Ken" did not have a catheter after the procedure, he has had a two years of varying problems.  For about a year, Ken carried a self catheter kit and used it with relative ease.  Even during a round of golf, he has been able to duck into the men's room and do a quick self catheter.  After two years, he no longer needs to do that.  He did little to prepare for his self cath, and seemed to get it done quickly and easily.

I don't know if any of this helps, but at least it lets you know that we can have different outcomes and often things work out ok in the end.


PSA up to 4.7 July 2006 , bump noted during DRE
Biopsy 10/16/06
stage T2A  -  Psa 4.7
Gleason  4+4=8  right side
DaVinci Surgery  January 2007
Post op confirms gleason 4+4=8
No extension or invasion found
No continence problems
PSA 90 day (-.01)  , (6 month -.01) , (9 month +.02) , (1 year +.02) ( 18 months +.02)
ED still a problem, minor succces with bi-mix
plaque buildup due to injections 
 
 
 


mactrain
New Member


Date Joined Oct 2008
Total Posts : 7
   Posted 12/24/2008 1:40 PM (GMT -6)   
JackR:
Good to hear that you're seeing encouraging results. It will continue to improve with time. Don't make the same mistake that I made-I quit when I got where I could sleep through the night without getting up to pee several times. I was shocked when I went back to tne uro and found that I was still retaining 400 ml or so. That's when I got serious with SC. I religiously did it 4 times every day and did it 5 times on days that I could manage it. I believe that you'll begin feeling much better after a period and will ultimately be good as new!! I'm convinced that 2009 will be a much better year for you as you work to whip this demon. Don't ever give up!!
Paul

divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 12/24/2008 7:46 PM (GMT -6)   
Jack, The one thing to remember if you have constriction due to radiation...and scar tissue build up....is....if you have a blockage and have to go to the ER, be very sure to tell the person that is doing the new catherization that you may have scar tissue build up. An ER person gave my husband a fistula by putting the catheter in the wrong place. That is not what you want to have.....Best wishes, Diane
Husband Pete
dx Jan 2001 gleason 4 + 3 PSA 16.5
Seed implant and conformal radiation and Lupron from Jan 2001 to Jan2002
2005 Dec PSA began to rise from .5 to 8 within 6 months
Salvage surgery at MSK 9/06 Dr. Eastham
Fistula operation 2/07 MSK Dr. Wong
Many cystoscopies and ER visits with strictures
Catheter for one year....Catheter taken out Sept 07..
Total Incontinence since then....
PSA .52 3/08
AUS Operation at MSK Sept 8 2008 Dr. Sandhu
Activated Oct 28th Dr. Sandhu..MSK
Some difficulty with AUS arising Nov 10 2008
Meeting with Dr. Sandhu to discuss AUS problems and new PSA test Dec 11, 2008
PSA .6 12/08
Waiting to see if AUS gets better results
Complete hip replacement surgery coming up Jan 9, 2009


JackR
New Member


Date Joined Dec 2008
Total Posts : 5
   Posted 12/25/2008 10:14 AM (GMT -6)   
Diane, thank you for the advice----always something new in this process. I'm hoping that self cathetization will eliminate the need for another full time catheter but I'm only 60 days into this journey. Good luck to you and your husband.
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