Went to my appt. this AM with my uro surgeon. They injected 100 mg of Demoral into my hip and had me sit for 45 minutes for the drug to take effect. The nurse then prepped my weiner for the scope with a lot of lydocaine gell, and had to sit another 15 minutes.
Dr. got the scope up me with easy, the pain killer really helped there. It was a little uncomfortable, but bearable. He was amazed once again, the dialation and laser opening he did on January 19th was almost sealed shut again. He was just barely able to get a wire through the opening. If you remember, the first 3 weeks after the surgery I had a foley cath in my penis along with the SP cath, so that the foley would help keep it open. Two weeks ago, he removed the foley and left a fresh SP in place. So it closed up that much in just two weeks.
Next he tried to dialate me back to a large enough size to get a foley back in place. First rod went up the wire with some pain, but bearable. Second rod was very painful (despite being sedated). He said let's try one more, the 3rd rod felt just like someone was hammering a metal spike up my weiner. He had the nurse hold my penis so that he could contol the insertion of the tub better. The 3rd tube was becoming stuck, couldn't get it further in or back it out, so they shot some liquid up the scope, and painfully removed the rod. That ended this attempt.
The dr. left the current SP cath in place (#12), and said that I will have to still another corrective surgery, as early as next week. He said that there is still so much damage post radiation at the bladder neck, that there is no way to dialate fully enough with me being awake.
This next time, he wants to leave the SP in place, but cap it off, and after the surgery, see if I can pee on my own, and if not, my wife could easily re-activate the SP from home. If this next mini surgery doesnt work or last, he said we will have to discuss more serious solutions, which could include re-doing the bladder neck to urethra connection (which he is not really wanting to do) as there would be a lot of risk of perm. incontinence and ED where there no ED currently. Another possibility is to have to have a perm cath (SP type) and just let the bladder neck be closed for good. Not a lot of good options out there.
There are 2 other complex ops that can be done, but he's afraid that my situation is chronic ,not temp, and one could go through all that and still have strictures a few months down line.
So I was wrong, thought for sure that I would be leaving with a new cath, #13, but he decided that if he has to operate next week, no point replacing it today.
We were both disapointed, but it is what it is. The radiation damage has made a bad problem even worse to deal with.
Doing the best I can, but you have to admit, this seems like an eternal problem. And I still await for my next post SRT psa test number, in April. That is actually a greater concern to me.
David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path 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 43 days, 1/19 - Corr Surgery #4, Caths #11 and #12 in at the same time, 2/8-Cath #11 out - 21 days