Stricture Surgery Done

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SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 3/12/2010 10:57 AM (GMT -6)   
Had the surgery yesterday. Uneventful. Long day for a 30 minute procedure. Fortunately, virtually no pain (and I am a real pain wimp). Just some bloody urine. Cath #4 is in place and is due to come out on Monday. Then the wait and see if the problem has been fixed. I'm trying to stay optimistic. Squid.
*Age 63, PSA July 2009 5.66
*Diagnosed July 2009, Biopsy: 2 of 12 cores positive, Gleason 3 + 5 = 8
*MRI and Bone Scan Negative.
*open Surgery October 22, 2009
*Prostate, both nerve bundles, seminal vessels, and lymph nodes removed during surgery.
*Post surgery Biopsy, Gleason 4 + 3; 2 positive margins
*Still slightly incontinant after 3 months - 1 pad per day (light). Dry at night. 1-2 trips to toilet.
*ED - Yes (will start Levitra possibly in January)
*30 day PSA (ultra-sensitive) .07
*90 day PSA (standard) <0.15
*01/10 - bladder neck stricture. opened during cysto exam. Cath #2 in for 5 days.
*IMRT/IGRT delayed until April pending 180 day PSA result
*03/01 - bladder neck stricture. Dilated during cysto exam. Cath #3 in place.
*03/11 - Bladder neck surgery. Cath #4 in place.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/12/2010 11:13 AM (GMT -6)   
Squid,

Was waiting patiently to see that you were ok after yesterday. Monday sounds too soon on that cath removal, the more healing time the better, but not sure what method your surgeon used. Did he scalpel with a scope, or use a laser this time, or do what they call a hard dialation with you knocked out?

When you see your doctor Monday (same day I meet with my uro/surgeon about my situation), if you are very sore feeling through the cath, see what he thinks about leaving in it a few more days to heal better. That's your call and his of course, just speaking from my many events like yours.

Hope you heal with as little pain as possible. Hope you have ditropan for spasms. Keep me posted brother, was thinking a lot about you yesterday.

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, no problem post SRT
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  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days


tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2845
   Posted 3/12/2010 11:37 AM (GMT -6)   
keeping all body part crosses for good luck and a prayer or two thrown in for good measure - wishing you (Squid) all the best -
hugs
BRONSON
.................
Age: 54 - gay - with spouse, Steve - 59
PSA: 04/2007- 1.68 - 08/2009 - 3.46 - 10/2009 - 3.86
Confirmation of Prostate Cancer: October 16, 2009 - 6 of 12 cancerous samples , Gleason 7 (4+3)
Doctor: Dr. Mohamed Elharram -Urologist / Surgeon - Peterborough Regional Health Centre
Radical Prostatectomy Operation: November 18, 2009 , home - November 21, 2009
Post Surgery Biopsy: pT3a- gleason 7 - extraprostatic extension - perineural invasion - prostate weight - 34.1gm -
ED Prescription: Jan 8/2010 - started daily 5mg cialis - girth back to normal -but not much length - will go for trimix in April when I see doc
Incontinence: 3-5 pads/1-2 clothes changes/day- finally seeing improvement - March 3, 2010 - week 14 after surgery -
location: Peteborough, Ontario, Canada
Post Surgery-PSA: to be announced - April 8, 2010
............


SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 3/12/2010 7:03 PM (GMT -6)   
David,
They did a "transurethal incision of bladder neck contracture" in the OR under general anesthesia, with a scope. The doc described it as just a slice to open it all up. I questioned as to why it won't just scar back up again and he said that can't be ruled out. Did not discuss next step. Will wait and see what happens with this one. Initially the doc said the cath would be in for one week. At discharge they said only until Monday. The last time they only left it in for four days and it scarred back up. But, that was not after any kind of surgery. They did the dilation in the clinic last week, enough to get a good sized cath in place, pending the surgery ( it wasn't a pleasant experience). Today, I am surprisingly painless. No blood since this morning, clear urine. I am having the same old bladder spasms when i stand up or move around too much. I declined the ditropan medication because it didn't do me any good last time. Believe me, I hate pain but no sense in taking a medication that doesn't work. I put the Roxicet they gave me on the shelf since there is no pain. I can use it to help me sleep if needed some other time. Will have to play this out one procedure at a time. I could probably tolerate one more trip to the OR like yesterday, but then I will probably try and get something more complex done. This really sucks!!! The doc did mention again yesterday that incontinece could be a problem after the surgery so I have to worry about that again. Hopefully he is wrong. I was almost dry. The doc said the stricture could have contributed to the good results with the incontinece. I'm going to stay optimistic and take it a week at a time and see what happens. I really would like to get this fixed and get back to sweating out PSA numbers again!!!! No caths or pain involved during that process!!! Squid.
*Age 63, PSA July 2009 5.66
*Diagnosed July 2009, Biopsy: 2 of 12 cores positive, Gleason 3 + 5 = 8
*MRI and Bone Scan Negative.
*open Surgery October 22, 2009
*Prostate, both nerve bundles, seminal vessels, and lymph nodes removed during surgery.
*Post surgery Biopsy, Gleason 4 + 3; 2 positive margins
*Still slightly incontinant after 3 months - 1 pad per day (light). Dry at night. 1-2 trips to toilet.
*ED - Yes (will start Levitra possibly in January)
*30 day PSA (ultra-sensitive) .07
*90 day PSA (standard) <0.15
*01/10 - bladder neck stricture. opened during cysto exam. Cath #2 in for 5 days.
*IMRT/IGRT delayed until April pending 180 day PSA result
*03/01 - bladder neck stricture. Dilated during cysto exam. Cath #3 in place.
*03/11 - Bladder neck surgery. Cath #4 in place.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/12/2010 7:40 PM (GMT -6)   
squid,

glad you are still doing ok. yes, i have had 2 mini ops done the way your described, plus 2 with laser instead. the laser one's produced the least post surgrey pain, but interestingly, have been the least effective. I was blocked up again within 4-6 weeks of both laser surgeries.

to give you some encouragement on the continence issue, despite the 5 surgeries to correct, the ER trip, and two emergency in office dialations, none has altered my status of being 100% continent. I have test every day this week, plugging off the cath, and seeing how I can go on my own, etc. today, only barely made it 2 1/2 hours before the pain in my bladder neck overwhelmed me. As in the other tests, even if I force a small tiny output, the strain to do it causes other problems and pains.

My surgeon is good when he does cut up there, since I dont have ED, he always cuts two slits, I believe he said at 5 oclock and 7 oclock, to help the neck drain easier into the urethra, and he said by doing so, he avoids the nerves that help control erections, so far, his handiwork hasn't messed that up.

Good luck, and as I said in the earlier post, if you would feel more comfortable leaving the foley in a few more days, its not going to hurt, might help you heal better. Its actually your choice, shouldn't matter to your doctor.

I am leaning now into leaving this suprapubic cath in place indefinitely until a more perm solution can be found, not sure I can or want to endure any more of this. After almost 5 1/2 months with one in place ,I have gotten use to it, other than changing bags, it doesnt really hurt.

Please keep me posted, or email if you wish.

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, no problem post SRT
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  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 3/12/2010 8:08 PM (GMT -6)   

Hey-- maybe we will actually get good reports from both of you on Monday.

 

Keeping my fingers crossed.

Mel


63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms. 

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities.

Next Event: First post-op PSA on 3/10/10--DRUM ROLL: 0.01


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 3/12/2010 9:33 PM (GMT -6)   
Just a curiosity.

Is the post by Salty_clark about an AUS and a sling a potential solution for strictures ?

Could they just open up the bladder neck opening surgically, big enoug to stay open and not worry about continence, then install an AUS and sling ?

As I see the several guys on here wrestling with strictures, I have been wondering what the solutions could be. There are pages and pages from google about bladder stricture repairs, but I am not seeing the dominant solution.

Wishing all you guys the best solution possible.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/12/2010 9:57 PM (GMT -6)   
Goodlife, you are right, there are other more complex surgical procedures for chronic stricture problems, but unfortunately, they all are attached with risks for incontinence or complicate healings. My surgeon and I have briefly discussed some of them, and even he is not eager to go forward at this point. They can also put in a stent, but they are probmatic too, as my surgeon said they tend to become perm and imbedded in the flesh, and when they have to be surgically removed, perm incontinence is almost a certainty.

So its kind of a catch-22 situation, there are limited things to do, but the price and risk may be too high to consider. Keeping all options open myself. Hoping Bro. Squid here gets a good result with his latest corrective surgery.

Me, doesn't seem to be working well enough to come off the cath. Too much strain and pain involved, feels exactly like it does prior to a total closure. Normally, this would flip me out and have me on edge, but I have the mercy of still having the working suprapubic catheter in place to turn back to.

This weeks testing hasn't gone well at all. Was hoping for more than this, after 2 surgeries 6 weeks apart.

Thanks for your concern though

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, no problem post SRT
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  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 3/12/2010 10:18 PM (GMT -6)   
David,

After being incontinent for 8 months, I certainly would have no desire to experience permanent incontinence, but at some point, it seems that the pain, permament catherization, and all the other things that we read, would make the risk of incintinence seem a more attractive risk, than the current situation.

And, with the AUS, it would seem the incontinence could be fixed as well.

Just thinking outloud should I have to cross this path. I have tried to be one thought ahead of this PC stuff, so that I can make better decisions should these things occur.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/12/2010 11:22 PM (GMT -6)   
Goodlife,

Your general ideal has some merit, and definitely thinking outside the box is always a good start. I think if the only choice was to agree to be incontinent long term, or on a SP cath long term, I would still choose the SP. There are lots of non-PC patients that live for years with SP catheters for a variety of reasons, neurological disorders leading among them. Now if we were talking about a foley catheter, through the penis, no way would I want one long term/forever, I think the longest I had one of them was close to 60 days or so, and it was hell.

All I am thinking of telling my dr monday, is let's leave well enough alone for now. Until we can find a specialist, even out of area, that can give some fresh thinking to a new solution. Just can't go through any more cycles of what I have been through. I have been now dealing with steady stricture/blockage issues since July of last year, been one thing after the other.

If my dr and I decide this makes sense, I will still have to change the SP cath out on a 4-6 week interval, to keep down UTI's etc. As a nurse, I believe he could easily teach my wife to do the swap. With the SP, if you know what you are doing, its out with the old and in the new in about 2 minutes or less. The hole can close very fast, so you have to have everything lined up to do the swap. But since he comes to his outer office 2 blocks from my house every Monday, I could always have it done there.

I want a better solution, a working solution, and I am willing to be patient to find one, so taking a time out might allow that to happen.

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, no problem post SRT
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  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days


SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 3/13/2010 11:24 AM (GMT -6)   
David, my uro seems to be on the same page as yours when it comes to discussions of stents and all of the other surgical type repairs being done for strictures. It seems there is no single good answer right now. Some of the more complicated ones induce severe incontinence and ED. I'm hoping not to have to deal with those. We shall see. I understand your feelings about the SP cath. There is no way I could handle a Foley for an extended length of time. I am a rookie compared to you - my longest was for three weeks after my biopsy related infection. That was three weeks too long. Surprisingly, the Foley they put in Monday is a lot more comfortable (if there is such a thing as a comfortable Foley) than the one they removed. Hard to understand sometimes. I will discuss with the Uro about leaving the Foley in for a couple of more days on Monday. Squid.
*Age 63, PSA July 2009 5.66
*Diagnosed July 2009, Biopsy: 2 of 12 cores positive, Gleason 3 + 5 = 8
*MRI and Bone Scan Negative.
*open Surgery October 22, 2009
*Prostate, both nerve bundles, seminal vessels, and lymph nodes removed during surgery.
*Post surgery Biopsy, Gleason 4 + 3; 2 positive margins
*Still slightly incontinant after 3 months - 1 pad per day (light). Dry at night. 1-2 trips to toilet.
*ED - Yes (will start Levitra possibly in January)
*30 day PSA (ultra-sensitive) .07
*90 day PSA (standard) <0.15
*01/10 - bladder neck stricture. opened during cysto exam. Cath #2 in for 5 days.
*IMRT/IGRT delayed until April pending 180 day PSA result
*03/01 - bladder neck stricture. Dilated during cysto exam. Cath #3 in place.
*03/11 - Bladder neck surgery. Cath #4 in place.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/13/2010 12:15 PM (GMT -6)   
Squid,

I guess because you are on the same path as me, you seem to understand the most what I have been going through. I have had those that hint that my dr. might not be on top of this game, but as you compare to your own dr., you know what I have learned, there are only limited procedures and beyond that, risky surgeries for what ails us.

My longest foley run was the 63 days from my initial open surgery. You mention that this one is more comfortable, perhaps its a small diameter one, that can make a big comfort factor and can determine how severe the spasms will be. Also, perhaps they put less fluid in the balloon end of it. Just glad that you are more comfortable.

You have mentioned ditropan, I still take it 3x a day, but between you and I, don't think it does anything either that or I have become immune after consuming literally hundreds of tablets of the stuff. When a spasms comes on, nothing is going to stop it, and you have to fight through it until it subsiides. I notice that a wet spasms, where a tiny bit leaks, is much less painful and shorter in length then those deep dry spasms, that leave me feeling burned inside, especially since my radiation ended.

BTW, is the subic part of your name from subic bay, RPI? If so, been there millions of time during the war, even though we flew out of Sangley Point NAS, RPI

David
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, no problem post SRT
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  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days


SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 3/13/2010 2:07 PM (GMT -6)   
David, funny how you mentioned the "wet" spasms as being not as painful. I have noticed the same thing. No spasm would be the best, but nothing we can do. As far as people wondering if we cover all the bases as far as treatment, you and I have both done research and we both seem to have trust in our uro's. My doctor will not have a problem with getting opinions if needed in the future. He has already done a consult with another uro to make sure we are heading in the right direction. As far as Subic, yes that refers to Subic Bay. I am a retired 28 year Navy vet. Spent the last 11 of my last twelve years in the Navy at Subic Bay/Cubi Point. I also did tours there from 67-69 and 72-74. Brought home a permanent souvenir, my wife, who has been great during this whole process taking care of a *****y, complaining old man. Well, not old at 63 - just feeling old. That includes taking care of my IV anti-biotic after post-biopsy infection and redressing my incision twice a day for almost three months after part of the incision got infected after my open surgery. It helps to have the loved one who is willing to go through this ordeal with us. Squid.
*Age 63, PSA July 2009 5.66
*Diagnosed July 2009, Biopsy: 2 of 12 cores positive, Gleason 3 + 5 = 8
*MRI and Bone Scan Negative.
*open Surgery October 22, 2009
*Prostate, both nerve bundles, seminal vessels, and lymph nodes removed during surgery.
*Post surgery Biopsy, Gleason 4 + 3; 2 positive margins
*Still slightly incontinant after 3 months - 1 pad per day (light). Dry at night. 1-2 trips to toilet.
*ED - Yes (will start Levitra possibly in January)
*30 day PSA (ultra-sensitive) .07
*90 day PSA (standard) <0.15
*01/10 - bladder neck stricture. opened during cysto exam. Cath #2 in for 5 days.
*IMRT/IGRT delayed until April pending 180 day PSA result
*03/01 - bladder neck stricture. Dilated during cysto exam. Cath #3 in place.
*03/11 - Bladder neck surgery. Cath #4 in place.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/13/2010 4:03 PM (GMT -6)   
wow, squid, at the time, i almost brought home a pretty PI woman, quite a few guys in our squadron did. i was in VP-17, flew out of sangley point NAS, cavite city, across from manila. we flew marketime missions south china sea in P-3 orions. would fly in c-47 to subic for supplies and other reasons often. once missions were complete, we would refuel and sometimes stay over night at both cam rah bay in SVN or Utaphao in Thailand. I was there in 71 and 72. small world.

been on just the existing SP cath only since a week ago when my wife removed the 2nd cath, the foley. when both were in place, were having the most pained level spasms at the rate of 1-3 per hour, or anytime i stood up after being seated. now its more like 5-6 per day, just had one recently that about knocked the life out of me, lol. was holding onto the walls.

be real interested in what my uro/surgeon says next, other than the disapointment that i know he will show.

hope you are doing ok.

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, no problem post SRT
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  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days


SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 3/14/2010 10:55 AM (GMT -6)   
I'll be interested in what your doctor recommends next, since I seem to be following your path. By the way, there are scratch marks on several of my walls and my desk placed during spams!!! My last duty station in the Navy was VP-1 at Barbers Point, Hawaii. I went there to retire after the volcano blew up and threw us out of the Philippines. I wonder if impurities in San Miguel beer could be the hidden cause of our problems. I drank a lot of San Miguel figuring it was good for my health!!! Squid.
*Age 63, PSA July 2009 5.66
*Diagnosed July 2009, Biopsy: 2 of 12 cores positive, Gleason 3 + 5 = 8
*MRI and Bone Scan Negative.
*open Surgery October 22, 2009
*Prostate, both nerve bundles, seminal vessels, and lymph nodes removed during surgery.
*Post surgery Biopsy, Gleason 4 + 3; 2 positive margins
*Still slightly incontinant after 3 months - 1 pad per day (light). Dry at night. 1-2 trips to toilet.
*ED - Yes (will start Levitra possibly in January)
*30 day PSA (ultra-sensitive) .07
*90 day PSA (standard) <0.15
*01/10 - bladder neck stricture. opened during cysto exam. Cath #2 in for 5 days.
*IMRT/IGRT delayed until April pending 180 day PSA result
*03/01 - bladder neck stricture. Dilated during cysto exam. Cath #3 in place.
*03/11 - Bladder neck surgery. Cath #4 in place.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/14/2010 12:19 PM (GMT -6)   
Hey Squid,

VP-17 was actually stationed at Barber's Point, I spent nearly a month there waiting to join VP-17, which was already in the RPI.

I am doing my last "plugged the cath test" today Sunday. First time since my wife has been home to observe. It's only been about 1 1/2 hours , and already the pain is building. Start getting stomach ache, t hen the pain builds from the bladder neck and slowly creeps up the inside of my bladder. The only pee I did, was as before, very strained and painful. Now nothing but hurt, not even a drip.

I see the dr. at 2 PM tommorow. As usual, I will give him a written report first of what has happened since my last surgery ,including a diary of the tests this past week. He loves g etting my techical reports, he reads them before he even comes in the exam room, and already knows what has or hasn't worked, how I am feeling, if I need any prescriptions. He said he wished half his patients could communicate well.

By nature, I am a very compliant patient, but not a stupid patient. Its my responsibility as a patient, to communicate to my doctor. He's not some kind of mind reader. If one just sits there, and never asks questions, or tells the dr. accurately how one is feeling, just makes the dr. job all the harder. Just my take on it.

It will be a miracle if I can make this test last to the 3 hour mark, hurting too much, and when I end it, will hurt the rest of the day.

Boy, while my wife was at work last night, had some whopper "dry" spasms, one lingered on for at least 10 minutes, like after shocks.

Had me on the pain edge real fast.

Hope you are healing well, and that your last fix is a fix for you.

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, no problem post SRT
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  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 3/14/2010 12:32 PM (GMT -6)   

David:

Are we allowed to say "darn it" on HW?

This is so frustrating just reading this, so I can imagine how you must feel.

Mel


63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3 was about 75 (way above the 35 threshold). That led to:

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms. 

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities. Suddenly got MUCH better on 3/10/10, almost overnight. Still some urgency but no pads about 90% of the time.  As of 3/12/10--completely continent!

First post-op PSA on 3/10/10--DRUM ROLL: 0.01 Next PSA in late May.


SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 3/16/2010 5:16 PM (GMT -6)   
For now the surgery is working. I actually have a gush of urine rather than a trickle now. Can almost empty my bladder instantly. No pain. The problem is, as the doctor warned me, incontinence has gone back to the level I had right after surgery - lots of squirts and leaks. I have to work that problem all over again. Hopefully that will be the least of my worries. Squid.
*Age 63, PSA July 2009 5.66
*Diagnosed July 2009, Biopsy: 2 of 12 cores positive, Gleason 3 + 5 = 8
*MRI and Bone Scan Negative.
*open Surgery October 22, 2009
*Prostate, both nerve bundles, seminal vessels, and lymph nodes removed during surgery.
*Post surgery Biopsy, Gleason 4 + 3; 2 positive margins
*Still slightly incontinant after 3 months - 1 pad per day (light). Dry at night. 1-2 trips to toilet.
*ED - Yes (will start Levitra possibly in January)
*30 day PSA (ultra-sensitive) .07
*90 day PSA (standard) <0.15
*01/10 - bladder neck stricture. opened during cysto exam. Cath #2 in for 5 days.
*IMRT/IGRT delayed until April pending 180 day PSA result
*03/01 - bladder neck stricture. Dilated during cysto exam. Cath #3 in place.
*03/11 - Bladder neck surgery. Cath #4 in place.
*03/15 - Cath #4 out. Great urine stream.  Unfortunately, incontinence back to post surgery level.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/16/2010 7:22 PM (GMT -6)   
Squid, my friend,

Sounds like a good report, I haven't been able to pee like you described since the days before my open surgery, happy for you, and hope its the last time you have to deal with this for a long time. At this point, a little leaking is probably something you can deal with, hopefully that will be short term for you.

Best to you

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, no problem post SRT
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  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days

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