Just got back from Uro/Surgeon's office. Nothing with me is ever easy and straightforward. He had consulted with my Rad. Oncologist that I saw a week ago (and for doc. skeptics, the two have consulted freely several times over my case, even though there is no connection between their practices). She nows admit that I got a serious case of radiaton burn going on, explaining most of the moderate to severe pains that I still have going on nearly 1 1/2 months post SRT. He aplogized for the pain I went through in early December, when he was swapping out SP caths. He said it wasn't the infection as I thought, but it was the radiation burn causing all the deep pain. See, I don't imagine these things, folks.
He did not change the cath, even though it was past time, he said my UTI was still raging, so he extended the antibiotics for that. He is going to arrange for a day surgery hopefully one day next week. At this point, he said there was no way I could endure the pain of any procedures even if sedated in his office.
They will put me under. He will go in with a scope through the penis to look from that side, and also put a scope through the SP hole, to determine how much damage there is, and find the best way to re-open my bladder neck. As suspected, the radiation basically swelled it shut. He said more than likely, I will awake with both a foley cath through the penis, and a new, smaller diameter SP cath both. Now that's a first for me, two caths at the same time. The SP would be capped off, and would be for emergency use, in case the radiation tried to close down the foley cath as it heals. He said that there would be a small chance of spending 1 night in the hospital, if they thought that it would be too painful, that way they could administer IV pain drugs. Hoping that's not needed.
He said its going to take some time for all this to heal, both the bladder neck, and the bladder wall, so its possible I may have to have the catheter(s) for 30 days or more.
I am glad to have a plan in place, but its not going to be fast or easy. He thinks the jury is out on the SRT, whether it was effective or not, he has arranged to do the next two PSA tests for me. As damaging as the radiation was to me, he still feels with my numbers it was the only sensible thing to try.
One explanation for the radiation damage: He said considering how deep and narrow my prostate bed is (that proved probamatic for surgery), that I received a very high dose of radiation for salvage purposes, 72 gys. So he thinks there must have been a whole lot more "scattering" going on causing this collateral damage.
Hang in there for me brothers, there's hope, but still got a ways to go.
David in SC
57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.33rd Biopsy
: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3Open RP:
11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09Path Rpt
: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence: 1 Month ED: Non issue at any point post surgery
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped 9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place