Stricture Symptoms question

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compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7203
   Posted 4/3/2010 10:39 AM (GMT -6)   
I know David and Squid have had horrible problems with strictures. My understanding was that the main symptom would be difficulty urinating due to the blockage.
 
I cannot say that I have "difficulty" urinating; it's kind of the opposite.
 
I am still having the same incontinence type problems. While I don't need a pad, I am constantly fighting the need to urinate as there are constantly drops of urine in the urethra.
 
I do notice when my bladder is somewhat full (I think only the first urination in the morning) my stream is ok the first half but then as the bladder is emptying the force decreases where it is part spray and part stream (more stream than spray). Then it stops and it is drip...drip...drip for another 1-2 minutes. Then, as I've said, I'm uncomfortable and have to urinate very small amounts quite often during the day.
 
The problem gets worse as the day goes on and I suspect I am describing just regular incontinence symptoms, but I wonder if there still could be a stricture. Perhaps those of you who have had strictures can elaborate on your symptoms.
 
Incidentally, drinking water definitely helps with other symptoms (eliminates burning/irritation by about 80%-100%).
 
David-- so very sorry to read of your continuing distress. Your 6-month anniversary is not the kind to celebrate!
 
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.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 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! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

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


SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 4/3/2010 10:48 AM (GMT -6)   
My problem with strictures was a steadily decreasing urine stream. As it got worse, I would get spray going off to the side, difficulty in urinating, the sense that i was not emptying the bladder (which meant constant trips to the bathroom), and even pain in the stomach area from forcing too much to try and get urine out. Unfortunately, the only way the doc can tell for sure what is going on is with a cystoscope. During my initial scope, the Uro told me that the scar tissue was not very bad and he opened it during the procedure. He also said that I might just end up with a slow stream as long as it did not scar over completely, which unfortunately it did. My doc didn't even hesitate to scope me when I went the first time and he encouraged me to come back at the first sign of any slow down in the urine flow. I followed his instructions and the next scope found a 99% blockage. He dilated it, put in a cath, and set me up for surgery, which I had and fortunately for me is keeping it open for now. The bottom line is the only way you can be sure what the problem is is to have the Uro check it out. The sooner the better. David and others can tell you what the pain of a complete blockage is like and how the "wonderful" docs in the ER can't seem to handle the problem. I'm sure David will chime in. He unfortunately is our stricture expert at the moment, a position I wouldn't wish on anyone. 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.


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7203
   Posted 4/3/2010 11:04 AM (GMT -6)   

Thanks for the info. That's more how I envisioned it (difficulty urinating).

I will be seeing a new urologist in 3 1/2 weeks. I'm hoping she will not want to scope it. I guess it will depend on the severity of my symptoms.

 

I gather, then, that it is possible a scope could find a problem and it could be quickly fixed without the need for a catheter (good case scenario?). Am I correct?

I had BPH before the PC. The flomax really helped, but without that I had major difficulty urinating. My bladder would feel full and only a few drops would come out. It was a totally MISERABLE feeling. There were a few times I was about to go to the ER when it suddenly improved a bit.

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.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 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! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/3/2010 11:42 AM (GMT -6)   
Mel, not sure where to start. The 6 months mark of this SP was not meant to be a celebration, more a statement of fact.

Yes, a person can be scoped and dialated, without a need for another catheter, if the blockage is small and easy to fix. I have never been fortunate enough to have any of mine that easy.

Some strictures are in the urethra itself, can be close to the penis tip (not as common), halfway up, or just outside the bladder neck (probably the most common). You can also have them right in the bladder neck itself (this is where 100% of mine are). These kind are harder to deal with, and can cause more chronic scarring situations like I have.

You can also, post surgery, have a "flap", a small piece of tissue that usually pushes out of the way when you pee, but sometimes will get in the way and cause a blockage. These can usually be fixed with a scope and a blade inside the scope, and the uro will find the flap, and cut it away. If it is tiny, probably wouldn't need a cath, but if larger and if he has to cut more, then not uncommon to need a foley cath for a few days to a week, to allow healing.

With most strictures, they are often cured with one or two attempts at fixing. Usually the first attempt is done with a scope, and if that fails, a small corrective surgery like Subic just had will do the trick. While I wish Subic the best that his has been fixed, its too soon to know for sure, sometimes, it can take 6-12 months for scarring to do it work creating still another stricture. I hope that doesn't happen to him.

My shortest blockage episode took place in less than 8 hours after a cath was removed. My longest period before I had total blockage was about 4 months. As the weeks went by, my already small flow just slowly deceased, and it took more and more effort to pee.

Since July of last year, nothing seems to keep me from having my bladder neck scar over. My uro/surgeon said he had never seen anyone scar over that fast. At one point, I had a corrective laser surgery, and within 6 weeks or less, was 100% blocked. This is why I have been on a continuous SP catheter since October 1st.

When I went through radiation, it is not uncommon for the urethra to decrease in size and cause serious flow problems. Knowing my history, all sides decided that this would be the best route to take.

The trouble with ER workers, you never know what you are going to get. My local ER is but two blocks away, a small hospital, perhaps 90 beds. After we have our open or robotic surgeries, we have had our plumbing re-routed, and in many cases, there are sensitive and touchy connections. So it would be easy for a clumsy ER worker to injure you trying to put in a catheter. They typically dont do many, and probably few have dealt with post-surgery PC patients like us. My one time ER experience was a scene from the worse part of hell, one I would never intend to repeat.

Coming back to you, Mel, with all you described, I would almost suggest having your uro scope you, so that he/she can see what the urethra looks like and how the opening is looking at the bladder neck. That way, if there is a problem developing, they can deal with it before it become an emergency situation. If it is just a tight urethra situation, they can do a "soft" dialation through the scope. It will stretch your urethra back open a few sizes to make it easier to pee.

You would want at least a local sedative, demoral is what is used with my dr (100mg) 30 minutes before being scoped. If you aren't in an emergency situation and if you not having pains from an UTI, scoping doesn't hurt real bad. Dialation can hurt terribly, depending on what is going on. Unfortunately, all of my dialation attempts while not being put under, were terrible traumatic events due to complications, so I am not the best example of having them done.

If your urethra and bladder neck look fine, then your described issues might have another cause, not sure what to tell you. The more you strain, the more you wear down that bladder neck, so the pain and effort usually increases as the day goes on. In the same manner if a man goes nuts doing keagals too much. It can be counter productive.

I hope you get a solution, yours does sound like an aggervating thing to deal with too. If you have a true blockage, you will start getting a deep back pain, your bladder will hurt all inside you, and any attempt to get even a drop of urinie out will be excruciating. Sitting always made my blockages feel worse, so I would get up and pace back and forth. But there's no greater feeling of pain relief, even if they have a difficult time inserting the catheter, when that cath pokes into the bladder and immediate starts gushing out the blocked up urine, at that point, your level "10" pain will decrease within seconds.

As a final note, I hate catheters, all men here hate them. Most are lucky for it to be a one time shot of 5-14 days. But when you suffer from blockages and strictures, you would beg to have one put in, probably next to having a spinal tap go terribly wrong (about 12 years ago), a total urinary blockage one of the most painful t hings I have experienced. So dont wait too long if you even think its happening to you.

David in SC

Good luck, Subic, hope the flow stays with you.
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, 3/6 Cath #13 out - 4 days, Cath #14 out - 27 days, Cath #15 - 3/29


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7203
   Posted 4/3/2010 12:00 PM (GMT -6)   
David:
 
Thanks for taking the time to offer such a detailed response. I'll just have to see what the urologist says.
 
I still wonder if it is a stricture, but I don't seem to have a great deal of difficulty urinating. But this may be wishful thinking on my part (ie: it is just incontinence that will improve).
 
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.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 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! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

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


SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 4/3/2010 1:20 PM (GMT -6)   
Compiler - In both scope jobs I had to have a catheter for 4-5 days. I think the doc wanted to give it a chance to heal and say open.

David - Thanks for the "confidence" in my recent surgery keeping me open!!!!!! Actually, it took four months to close up initially and then after the first scope it was only a week or so. I am enjoying the flow but will just wait it out and hope for the best. I like the flow but hagte the stress incontinence. Wish there was a happy median. My biggest worry is my upcoming PSA and the decision as to whether or not I need radiation. My uro thinks that radiation will affect my scarring problem so it will be a hard decision. 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 : 25380
   Posted 4/3/2010 2:05 PM (GMT -6)   
Subic, you can be assured that salvage radiation will cause you trouble with your stricture issues. My uro felt strongly about it in advance, but the radiation oncologist tried to play it down. In the end, that's why we did the SP catheter, as a pre-emptive strike, as my uro knew how serious it would be if I had an emergency blockage in the middle of radiation treatments. Don't refuse radiation if you end up needing it, it might be your last curative tool, but if needed, then make sure you, your radiation dr. and your uro work hand in hand like I did, to make sure there wouldn't be a problem in the middle of it.
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, 3/6 Cath #13 out - 4 days, Cath #14 out - 27 days, Cath #15 - 3/29


SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 4/4/2010 3:12 PM (GMT -6)   
My Uro and Rad Onc are friends and close. Hopefully we will work out the whole mess and make the right decision. 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.


logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5815
   Posted 4/4/2010 7:50 PM (GMT -6)   
compilier, if you go to a uro talking about a stricture, even if the uro know the symptoms don't fit, you WILL be scoped. IMHO You have what, I'm guessing, the vast, vast, majority of prostectemy patients, have, urine in the uretha, which will dribble a long time after urination, and can be resolved with a lot of shaking. You have only 1 control,as do women,pelvic, it is not only during menstruation, that women wear pads.. As I posted before if you do not wear pads, and squirt, very ocassionally, you are by definition 99% CONTINENT. Im 5/1/2 p/op and still deal with the dribble but not as bad. As far as having to go alot, as my surgeons nurse told me, the more you think about it, the more you will want to go. I bet, and I say this cause I WAS a lot like you, that you are micromanaging every little sensation down there to see if it,s the BIG ONE. Take this post in the spirit in which it is posted, to help your anxiety. Its been there since you started posting and this disease will do that , but we do have a will, that , with effort can overcome alot of the STUFF we put on ourself. Good luck my braddah
age 66 First psa 4/17/09 psa 8.3, 7/27/09 psa 8.1
8/12/09 biopsy 6 out of 12 pos 2-70%, rest <5% 3+3
10/19/09 open rrp U of W Medical Center, left bundle spared
10/30/09 catheter out. continent from the jump.
pathology- prostate confined, only thing positive was the report.everything else negative
9% of prostate affected. gleason 3+4, I suppose thats a negative
After reading pathology myself, gleason was 3+4 with tertiary 5, 2-3 foci That is a negative, but I am a positive !!
Ed an issue but keeping the blood flowing with the osbon pump
8 week psa 0,o

" Hypocrisy is vice's homage to Virtue " read it in Bartlet's book of quotation years ago stuck with me, can't remember who said it.


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7203
   Posted 4/4/2010 8:08 PM (GMT -6)   

Logo:

Yes, technically, the fact that I wear no pads seems to mean I'm continent. Physicians love to quote such statistics. But my P/T does not consider my situation to be continence. It is incontinence, and frankly I agree with her.

This weekend, things have improved in that I am only bothered by this situation about 60% of the time, compared to 95% of the time. It is not my psychological reaction; the situation is improving. But it has gone back and forth so we will see. Ultimately, I might just have to live with this as a nuisance, period.

Incidentally, you make a good point about not going to see the urologist with the self-dx that I have a stricture. Also, I made this appointment 3 months ago because I want to have a local urologist in case of problems.

 

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.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 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! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/4/2010 8:34 PM (GMT -6)   
Mel, adding on to logo's theme,

If you have or had a stricture issue, it isn't going to resolve itself, and it generally gets worse and worse over time. As the diameter of the opening decreases, you would have more and more difficulty in starting a stream and maintain one. So that's probably good news to you. Of course, only a good uro with a scope can actually have the right tool to look up through your urethra and tell what is going on.

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, 3/6 Cath #13 out - 4 days, Cath #14 out - 27 days, Cath #15 - 3/29


logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5815
   Posted 4/4/2010 10:54 PM (GMT -6)   
I will defer the point to your doctor and and will agree that it is a form of incontinence. I believe that form will go away farther out in tim. as mine did.
age 66 First psa 4/17/09 psa 8.3, 7/27/09 psa 8.1
8/12/09 biopsy 6 out of 12 pos 2-70%, rest <5% 3+3
10/19/09 open rrp U of W Medical Center, left bundle spared
10/30/09 catheter out. continent from the jump.
pathology- prostate confined, only thing positive was the report.everything else negative
9% of prostate affected. gleason 3+4, I suppose thats a negative
After reading pathology myself, gleason was 3+4 with tertiary 5, 2-3 foci That is a negative, but I am a positive !!
Ed an issue but keeping the blood flowing with the osbon pump
8 week psa 0,o

" Hypocrisy is vice's homage to Virtue " read it in Bartlet's book of quotation years ago stuck with me, can't remember who said it.


tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2842
   Posted 4/5/2010 12:57 AM (GMT -6)   
-blather - part one -
In the last week (4 months past open RP) I have found it more and more difficult to pee and to feel like I am emptying my bladder. The decline in urine flow volume started about a month ago - thinking of the optimum flow as "pee like a horse" ... when now it is spraying and thin stream.

I am leaking more during the day - had to change underwear twice yesterday since it sprayed to the side when I moved - the main part of the guard was still dry. Not great volumes - maybe about an ounce of two - but noticeable.... This is also in conjunction with me becoming more active with my artwork, the garden and the good weather...

Feeling pressure / hardness in the bladder area - woke me up at 1:00am - tried to pee - just a little trickle... at times I feel I tried to kegel too much - have the muscles tight so I could get to the washroom and feel like a human again. - but not able to get them to relax and open up.

I am coming up to my first post-op PSA results - April 8 - and one thing that has happened to me before , is to get so tense and nervous, everything freezes up ... that may be the case here.... I feel the urge to pee but not urgency.... haven't worked out the best position to get into a pee-meditation mode - feel the need - feel the urge .. but that is when the communication stops - I just stand there.. (or sit, whatever..)

I had difficulty controlling my bladder at times (and controlling bowel movements) before the surgery - due to the effects of scoliosis and degenerative bone disease.. also some ED issues - due to position of damage to spine .....

Silly dumb question time ( will look up Gray's Anatomy - the book not the TV series) and see exactly where the bladder is ... when feeling the belly - just below the navel to the left of the scar ( open RP)... it feels hard and warmish.... my internal instinct is to self-catheter to drain the bladder...

Don't know if my doctor is open on Easter Monday... don't really want to go to Emergency.... will work on relaxing the muscles ... tried to kegel and the muscles are not responding at all....

Not a vent - just blathering....


hugs
BRONSON
.................
Age: 54 - gay - with common-law spouse of 13 years, 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: Feb 2010- 3-5 pads/1-2 clothes changes/day- March 3, 2010 - week 14 after surgery -finally seeing improvement - March 29- incontinence better - 1-2 pads a day - one pad at night
location: Peteborough, Ontario, Canada
Post Surgery-PSA: to be announced - April 8, 2010
............

Post Edited (tatt2man) : 4/5/2010 4:52:11 AM (GMT-6)


tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2842
   Posted 4/5/2010 4:50 AM (GMT -6)   
blather - part two -
good morning -
got back to sleep around 3:00am ( up at 1:00am) and slept 'til 6:30 - had a dribble pee this morning but at least something is going out... will call doc, etc. this morning and go from there ....
I have a urine bottle in the 3rd floor master bedroom - only one bathroom in 3 storey home (2nd floor) - normal night time amount is 16 -24 oz ..for the last two nights it has been around 12 oz.

hugs
BRONSON
.................
Age: 54 - gay - with common-law spouse of 13 years, 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: Feb 2010- 3-5 pads/1-2 clothes changes/day- March 3, 2010 - week 14 after surgery -finally seeing improvement - March 29- incontinence better - 1-2 pads a day - one pad at night
location: Peteborough, Ontario, Canada
Post Surgery-PSA: to be announced - April 8, 2010
............


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/5/2010 5:45 AM (GMT -6)   
Bronson, you definitely need to get to your uro asap. He/she can also put a bladder scan up to you and see what is going on in your bladder. After our ops, the size and position of our bladders can change a lot from person to person, even the angle at the bladder neck can change ,causing problems. Not a doc, but sounds like you are slowly closing up. Don't even think of self-cathing unless your dr. orders you to and instructs you, you could seriously injure yourself in your new "plumbing" without realzing it. Let me know what happens.

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, 3/6 Cath #13 out - 4 days, Cath #14 out - 27 days, Cath #15 - 3/29


tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2842
   Posted 4/5/2010 6:47 AM (GMT -6)   
Thank you David - I trust your advice - will do my relaxation exercises today and call the doc tomorrow morning (he is off today)- thanks - BRONSON
.................
Age: 54 - gay - with common-law spouse of 13 years, 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: Feb 2010- 3-5 pads/1-2 clothes changes/day- March 3, 2010 - week 14 after surgery -finally seeing improvement - March 29- incontinence better - 1-2 pads a day - one pad at night
location: Peteborough, Ontario, Canada
Post Surgery-PSA: to be announced - April 8, 2010
............


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7203
   Posted 4/5/2010 7:27 AM (GMT -6)   

Bronson:

Very sorry to hear that. It is so frustrating as these things seem to happen even months after surgery.

This certainly sounds like a stricture. David is giving you good advice.

This is one of the reasons I am trying to establish myself with a new urologist as one never knows what emergencies occur.

Good luck to you. I'm kind of hoping this is maybe some kind of spasm or something that might slowly resolve on its own.

 

12 oz. doesn;t sound too bad, does it (just for overnight)?

Mel

 

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.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 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! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/5/2010 7:47 AM (GMT -6)   
Well, it's not fair comparing output of urine from one that can urinate to one that cannot without a catheter. Last night, I emptied the big bag (night bag) for the last time around 11pm. Got up this morning at 0730, found the bag filled slightly over the 1.5 liter mark of a 2 liter bag. That was more than I outputted all of yesterday, including night bag time and leg bag time during Sunday. I can never find a rhyme or reason to my output.
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, 3/6 Cath #13 out - 4 days, Cath #14 out - 27 days, Cath #15 - 3/29

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