DAY 52: Cystoscope and Catheter #4

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Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25369
   Posted 1/5/2009 11:45 AM (GMT -6)   
Just got back from my dr/s visit, took 2 1/2 hours.  After the emergency room cath was put in, he said he would not put me through that again.  He did a lengthy cystoscope exam on me.  I was not prepared for that, his office once again, screwed up and failed to follow his instructions to me ahead of time.  He did use a flex scope, he said he would never use a rigid one on a male, sometimes they do on women, because they don't have to go as far and its a straight shot.  They numbed my penis first don there, didn't hurt as much as felt strange.  He went all the way to the bladder, and as he expected, there is some kind of flap or extra material where the urethra and the bladder were rejoined.  I am suppose to have an appointment in Greenville this time, this Friday, where he will either heavily sedate me or put me under he said, and go back in with a scope with tools hooked up to a screen instead of an eye piece.  He said either with a balloon or metal devices, they can stretch open the area of contention and see what is going on better, and right then and there decide if he can snip a piece here or there to get a good flow.  He did warn me, it will be a balancing act, that he knows I can't stay on a cath forever, but if he's not careful on the next step, i could end up being perm. incontinent real easy, and that was his fear when he ran into problems with my surgery.  He spent a lot of time with me, and put my mind to rest about a few things.  I just wasn't prepared to had this done this morning, but it is progress.  BTW, cath #4 is still larger in diameter then the previous 3, he said by increasing it each time, it helps the opening stay large enough when the cath is out.  He said the ER crew should have never used the coude cath on me, that weird tip is for me that still have prostate in place, and that they could have seriously injured me inserting it.  After it was out, he took it out of the trash and showed me why.  I am home resting, more shook up then hurt, as I did this appt. alone thinking it was just going to be a talking one.
 
David in SC
Age 56, 56 at DX
 
PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
 
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, ranging from 40 - 90%, G 4+3 & 3+4
 
Open RP surgery  November 14, 2008 at St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon, Non-nerve sparing, 4 days in hospital, staples removed 11/24/8, Catheter out on 12/15/8 on day 32.  Day 33, urine stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08.  After 7 hours, complete stoppage again, emergency room put in Catheter #3 early evening of day 45, still 12/29/08. New appt. to see dr. on 1/5/9 as result.
 
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes.
 
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 1/5/2009 12:35 PM (GMT -6)   
David, this diagnosis is what I and several others suspected- a flap over the opening. Fairly common in those who do have problems like you had. sounds like he has a good plan to repair it, if necessary. I think he may be over emphasiing the risks some, though. Several guys here have had that little flap removed in the past, so it isn't really that rare, except it is happening to you. tongue Rest, prepare and conquer, guy
James C. Age 61
Co-Moderator- Prostate Cancer Forum
4/19/07 PSA 7.6, referred to Urologist, recheck 6.7
7/11/07 Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/17/07 Path report: 3 of 16 PCa, 5% involved, left lobe , GS 3/3:6.
9/24/07 Nerve sparing open Retropubic Radical Prostatectomy
9/26/07 Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
Post Surgery PSA's: 3 mts-.04, 6 mts.-.04, 9 mts.-.04, 1 Year-.02.

Post Edited (James C.) : 1/5/2009 12:44:35 PM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25369
   Posted 1/5/2009 1:42 PM (GMT -6)   
James, I am happy just to have a game plan, my dr. is very cautious and an open book with me, he knows I like it that way. Been on the cath so long now, it no longer depresses me, just slows me down a bit, getting to know all the ins and outs of being on one if any ever needs to no. Getting to be an expert in the variations of leg bags and night bags, lol. What a skill.

David in SC
Age 56, 56 at DX
 
PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
 
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, ranging from 40 - 90%, G 4+3 & 3+4
 
Open RP surgery  November 14, 2008 at St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon, Non-nerve sparing, 4 days in hospital, staples removed 11/24/8, Catheter out on 12/15/8 on day 32.  Day 33, urine stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08.  After 7 hours, complete stoppage again, emergency room put in Catheter #3 early evening of day 45, still 12/29/08. New appt. to see dr. on 1/5/9 as result.
 
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes.
 
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


DoingFine
Regular Member


Date Joined Sep 2008
Total Posts : 46
   Posted 1/5/2009 2:06 PM (GMT -6)   
David

I must confess . . . after lunch I immediately checked for your post.

I am so sorry for your continued trouble.

I wondered about the ER guy. My doc gave me a card to carry in my wallet for three months post surgery asking/suggesting/demanding that no one but a urologist "recatheterize" me. He made it very clear that it could be somewhat risky.

I am glad you did not suffer any further damage.

I can only wish you the very best of success this Friday, I know your doc will get to the bottom of it.

Cheers,
Rich
Age at dx: 51 Age now: 52
Great health: Riding bike 200+ miles weekly; no symptoms
First PSA: 4.7 March 2008 (bummer)
Second PSA: 4.97 June 2008
Biopsy June 2008
Positive 5 of 12 cores (real bummer) T1c
Gleason 3+3
Bone scan: 7 July negative
RRP surgery 3 Sept 2008 at the Mayo Clinic: Rochester, MN
All clear
Catheter out 22 Sept 8:30 AM, catheter back in at 11:30 (not happy)
Catheter out 30 Sept (this time for good!)
Total continence, no erectile difficulties from day one (Cialis 10mg daily)
Back on bike 15 Oct. (42 days . . . with doc's approval)
Dec. 2 2008 psa Undetectable!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25369
   Posted 1/5/2009 2:10 PM (GMT -6)   
Thanks for the kind words, Rich. From your signature, looks like you are doing great, very happy for you. I am sure I will be looking back at my own lack of progress. Just want to move forward with my recovery, from a surgical vantage, dr. said I have healed very fast and very well.

David
Age 56, 56 at DX
 
PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
 
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, ranging from 40 - 90%, G 4+3 & 3+4
 
Open RP surgery  November 14, 2008 at St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon, Non-nerve sparing, 4 days in hospital, staples removed 11/24/8, Catheter out on 12/15/8 on day 32.  Day 33, urine stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08.  After 7 hours, complete stoppage again, emergency room put in Catheter #3 early evening of day 45, still 12/29/08. New appt. to see dr. on 1/5/9 as result.
 
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes.
 
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


Todd1963
Veteran Member


Date Joined Oct 2008
Total Posts : 3211
   Posted 1/5/2009 4:46 PM (GMT -6)   
Hang in there David I believe the end is in sight
dx:06/03/06
Age at dx: 42 age now 45
Treated for sciatic nerve pain 6 months prior to dx.
Heavy amount of blood in urine Unable to urinate 
Lung x-ray for pnumonia revealed multiple lesions in each lung
P.S.A. at time of dx. 3216.14
Began lupron and casodex
Cat scan showed large mass in the pelvic area affecting the bladder multiple nodules in both lungs and lymph node envolvement.
Bone scan revealed possible bone involvment in the pelvic area
Biopsy 12 of 12 cores positive gleason 3+4=7
P.S.A.s since lupron 2946, 1274, 532, 5.01 1.23, .09
Begining jan 08 psa .o9, .25, .44, .86, .73, 1.34, 1.49. Doubling time is a little over 3 months
Cat Scan 12/12/08 Prostate normal size and shape. No tumors detected. Left lung clear of all nodules right lung showing only benign scar tissue. Lymph nodes normal
Bone Scan 12/24/08. Clean!!!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25369
   Posted 1/5/2009 4:54 PM (GMT -6)   
yeah living, least it was progress in the right direction I feel, just a little scary since it wasn't a planned event and the fact that I was alone. Must admit, when I was in the scope room, feet up in the air, waiting for the numbing jell to take affect, I was alone and scared, and for obvious reasons, vulnerable to say the least. My dignity went out the door a long time ago. lol.

david
Age 56, 56 at DX
 
PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
 
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, ranging from 40 - 90%, G 4+3 & 3+4
 
Open RP surgery  November 14, 2008 at St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon, Non-nerve sparing, 4 days in hospital, staples removed 11/24/8, Catheter out on 12/15/8 on day 32.  Day 33, urine stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08.  After 7 hours, complete stoppage again, emergency room put in Catheter #3 early evening of day 45, still 12/29/08. 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, further tests/treatments 1/9/8.
 
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes.
 
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


DJBearGuy
Veteran Member


Date Joined Dec 2008
Total Posts : 731
   Posted 1/5/2009 6:18 PM (GMT -6)   
David,

Sorry to hear you had yet another unpleasant surprise sprung on you. But, it does sound like you made more progress than you might have expected. I hope in the end it was worth it. I gather that Greenville is a fair drive away?

Interesting point about the coude catheter. I'm pretty sure that my prescription for an ER catheter was for a coude. Will have to go dig it up and check.

Towards the end of the second week, I was getting good, I thought, at switching from leg bag to night bag. You must really have that down to an art at this point...you could get a 3-way valve from the hardware store and hook up a second leg bag, for extra long trips. smilewinkgrin
DJ

Age 53
PSA 2007 about 2
PSA 2008 4.3
Diagnosed September 2008.
Biopsy: 6 of 12 cores positive
Gleason 4+3 = 7
CT and Bone scan negative
Da Vinci surgery at City of Hope December 8, 2008
Radical prostatectomy and lymph node dissection
Catheter removed on 7th day, replaced on 8th day, removed again 14th day following negative cystogram
pT2c
lymph nodes negative
microscopic margins
next PSA 1/22/08


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25369
   Posted 1/5/2009 7:18 PM (GMT -6)   
Hello DJ,

In the end, happy I made some progress in the right direction. I can't lie, my weiner, scrotum, haunches, all very sore from today's procedure. But had quality one to one time with my doctor, he never tried to hurry me or my endless questions or concerned, despite having a very full lobby. No, Greenville is only 10 miles from my house, and his main office there is usually a 20 minute drive. His office here in Easley, a satelitte affair, is 4 blocks from my house. He said if he does the bigger procedure where I will be put under, he wants to do it at his main office, in case he needs something special.

I have had 3 types of leg bags, this new one is my fave, the emtpying end of the bag has a little lever that you just lift up to empty, and close to close, it has an elastic strap with buttons to attach, not hard for me. The previous one, had a simple plastic cap that just pulled off when you needed to empty, if you dropped the cap in the toliet, you would have to fish it out, it also had latex straps that really pinched the hairs on my leg, the other type, had horrible velcro straps that kept coming loose no matter what, and a twist nozzle on the exit end that took me two hands to open and close. So you can see, there are differences.

When I take a shower, I always have the big bag with the long hose on, I leave the bag outside of the shower curtain on the floor, and carefully move around the shower. They make a nifty shower plug,where you plug off the cath while you shower, then you put the bag back on, no need to worry about water leaking under the shower curtain, but I never bothered to ask for one or to buy one.

It's not exactly legal or even polite I suppose, but I have emptied the leg bag with ease in the grass or even in a parking lot if the need required, feel like some old hound dog taking a piss!

Hope you are feeling good today.

David in SC
Age 56, 56 at DX
 
PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
 
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, ranging from 40 - 90%, G 4+3 & 3+4
 
Open RP surgery  November 14, 2008 at St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon, Non-nerve sparing, 4 days in hospital, staples removed 11/24/8, Catheter out on 12/15/8 on day 32.  Day 33, urine stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08.  After 7 hours, complete stoppage again, emergency room put in Catheter #3 early evening of day 45, still 12/29/08. 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, further tests/treatments 1/9/8.
 
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes.
 
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


DJBearGuy
Veteran Member


Date Joined Dec 2008
Total Posts : 731
   Posted 1/5/2009 8:12 PM (GMT -6)   
David,

Too bad the scoping process was uncomfortable. I hadn't heard or been told that it would be. But then, people tend to leave out that part of the experience.

I didn't know there were so many types of leg bags. I had the one with a twist nozzle and the annoying latex straps. My wife once had one with a push-pull nozzle which was very bad, it often opened up if just bumped slightly. Got rid of that one in a hurry. I did like the big bag valve as it was very securely on or off.

Work went surprisingly well today. I didn't start to tire out until around 4 pm or so. Went to the bathroom only slightly more than usual.

I checked my paperwork, and it does say "Insert 16 French/5 ml coude catheter", although, as your doctor said, I have found in Wikipedia that the coude is for guys who still have a prostate. Curious. Fortunately I am not that far away from the hospital where I had my surgery done, so I just went there and they knew what to do.

Also, you're the second person I've read on the forum who has reported that a robotic approach would have had to be abandoned. That makes me wonder. City of Hope will proudly point out that they do only robotic prostatectomies. Maybe they just don't take certain cases?

P.S. HW.com is really really slow right now.
DJ

Age 53
PSA 2007 about 2
PSA 2008 4.3
Diagnosed September 2008.
Biopsy: 6 of 12 cores positive
Gleason 4+3 = 7
CT and Bone scan negative
Da Vinci surgery at City of Hope December 8, 2008
Radical prostatectomy and lymph node dissection
Catheter removed on 7th day, replaced on 8th day, removed again 14th day following negative cystogram
pT2c
lymph nodes negative
microscopic margins
next PSA 1/22/08


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25369
   Posted 1/5/2009 9:21 PM (GMT -6)   
So what happens at City of Hope if they get into a man and find out it's beyond the scope of robotics? I believe what you are saying they say, do they just close up the person and abort and reschedule somewhere else with an open. I am sure you would qualify for your robotic, but I think I would ask outright, what if something goes wrong. According to my dr/surgeon, it's not always cut and dry on the robotic stuff, they can only know so much ahead of time as we all have learned. The pre-surgery pathology is at best, a good estimate of what they will be dealing with, but until they get inside you, they don't know for sure. Just my take on it.

David in SC
Age 56, 56 at DX
 
PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
 
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, ranging from 40 - 90%, G 4+3 & 3+4
 
Open RP surgery  November 14, 2008 at St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon, Non-nerve sparing, 4 days in hospital, staples removed 11/24/8, Catheter out on 12/15/8 on day 32.  Day 33, urine stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08.  After 7 hours, complete stoppage again, emergency room put in Catheter #3 early evening of day 45, still 12/29/08. 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, further tests/treatments 1/9/8.
 
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes.
 
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


DJBearGuy
Veteran Member


Date Joined Dec 2008
Total Posts : 731
   Posted 1/5/2009 9:26 PM (GMT -6)   
David,

Yes, that's exactly what I'm wondering. I didn't know enough before my surgery to ask that question. I might ask when I next see them, even though it's a moot point for me now.
DJ

Age 53
PSA 2007 about 2
PSA 2008 4.3
Diagnosed September 2008.
Biopsy: 6 of 12 cores positive
Gleason 4+3 = 7
CT and Bone scan negative
Da Vinci surgery at City of Hope December 8, 2008
Radical prostatectomy and lymph node dissection
Catheter removed on 7th day, replaced on 8th day, removed again 14th day following negative cystogram
pT2c
lymph nodes negative
microscopic margins
next PSA 1/22/08


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25369
   Posted 1/5/2009 9:43 PM (GMT -6)   
DJ, obviously a moot point now, but for people still deciding right now, just something to think about, and another thing to put on the "let's ask the doctor/surgeon" question list. I wish I knew even half of what I have learned from this site now, as I did at the time I was first dx with PC, I probably would have had a lot more questions to ask. I made a lot of decisions from reading Dr. Walsh's infamous book on the subject.

David in SC
Age 56, 56 at DX
 
PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
 
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, ranging from 40 - 90%, G 4+3 & 3+4
 
Open RP surgery  November 14, 2008 at St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon, Non-nerve sparing, 4 days in hospital, staples removed 11/24/8, Catheter out on 12/15/8 on day 32.  Day 33, urine stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08.  After 7 hours, complete stoppage again, emergency room put in Catheter #3 early evening of day 45, still 12/29/08. 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, further tests/treatments 1/9/8.
 
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes.
 
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 1/5/2009 10:20 PM (GMT -6)   

    Purg, Sorry your troubles continue.  I can feel for ya.  I had one "FLex" cystoscope and three contigen injections where they have to use a "rigid" scope to place the material.

    Good Luck,  KW


    43 at Dx and Surgery (RRP)
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, 2006 - Nerves on right side saved. All Lab's clear. 
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00.
    ED workable and usable with Viagra.
    Feb. 20th, 2007 - Feb. 4th, 2008  Cystoscope, Two Collagen injections,Second Opinion Consultation for Incontinance at OU Medical Center, Bio-Feedback training, Chiropractic, Accupuncture  to try to resolve ongoing incontinance (4-6 pads a day)  All PSA's 0.00.
    Feb. 22nd, 2008 - Surgery to install the AMS AdVance Male Sling.
    March 27th, 2008 - Sling not working, Little or no improvement.
    April 18, 2008 - Collagen injection.  Back to using 4-6 full pads a day within a week.
    May 14, 2008 - Another collagen injection to try to Band-Aid the leaking for our June cruise.  Will start making conusultation appiontments for AUS after we return.
    July 14th, 2008 - AUS consultation with Dr. Morey at UT Southwestern (Dallas).
    July 30, PSA 0.00.
    Aug. 22nd, 2008 - AUS Surgery by Dr. Morey
    Oct. 6th, 2008 - AUS Activation by Dr. Morey
     


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25369
   Posted 1/6/2009 8:04 AM (GMT -6)   
kw, i have read of the horror stories of the rigid ones, my doctor says he never uses on a male patient, so I flinch thinking you went through that. ouch.

david in sc
Age 56, 56 at DX
 
PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
 
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, ranging from 40 - 90%, G 4+3 & 3+4
 
Open RP surgery  November 14, 2008 at St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon, Non-nerve sparing, 4 days in hospital, staples removed 11/24/8, Catheter out on 12/15/8 on day 32.  Day 33, urine stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08.  After 7 hours, complete stoppage again, emergency room put in Catheter #3 early evening of day 45, still 12/29/08. 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, further tests/treatments 1/9/8.
 
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes.
 
First PSA Post Surgery  Scheduled now for 2/9/9
 
 

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