any tips before getting cath. removed?

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freinds
Regular Member


Date Joined Jun 2010
Total Posts : 76
   Posted 7/15/2010 3:24 PM (GMT -6)   
Hello, I had robotic prostectomy 8 days ago and will be heading back to the doctors office tommorrow to have the cathedor removed. Does anyone have any useful tips or tricks, I will be travelling 2 hours.
Also I was wondering, during the initial few weeks would I be better off drinking small quantities of water frequently or go for large infrequent quanties? Seems like just drinking the large amount and getting it out at once would be easier on the control muscles.

Sunbird
Regular Member


Date Joined Apr 2008
Total Posts : 140
   Posted 7/15/2010 3:45 PM (GMT -6)   
I had my "open" surgery on February 8th, and my catheter was in for 14 days. I took a large pad to the hospital with me, and found they were going to provide me with a Depends after removing the catheter. I decided to use my own pad and drove 50 miles back home without any leakage. I've been about 95% continent since "catheter removal" day. If I try to push out a little "natural gas," I may have a little squirt. Before I had my catheter removed, I spent about $60 for pads and Depends. I gave them away to a local nursing home. I hope they enjoyed the donation, for I enjoyed not having to wear them. I think you should increase your intake of fluids after catheter removal, and you should be doing Kegel exercises to strengthen your pelvic floor muscles. It all seems to help, and for most Pca patients, it gets better in time.
1996, Age 48, Stage III Colon Ca, Colon Resection followed by 18 chemo treatments.
 
2000, Colon Ca Metastasis to upper left lung lobe.  Lung lobe surgically removed.  24 chemo treatments scheduled.  Took 1, declined the rest.
 
9/08 PSA is 2.8, 12/08 PSA is 4.56??  Chalk it up to prostatitis due to urinary retention after Nissen Fundo Surgery.  VA docs prescribe 30 days of Septra.  Prostate feels normal.  PSA hovers around 4.1.  VA docs want prostate biopsy but can't seem to get me into the schedule.  Continue through Spring and Fall of 2009 thinking I have prostatitis.  Bacteria cultures are always neg.  PSA drops to 3.1 10/09.
 
12/09 Prostate Biopsy performed
3 of 10 cores positive, 5%, 25%, & 35%, 3 + 3= Gleason Six with perineural invasion.
 
Doc wants CT Scan due to prior Colon Ca. Findings: "The seminal vesicles are irregular & there is nodularity in the periprostatic fat such that local extension cannot be excluded.  Shotty lymph nodes in both groin measuring 2.3 cm."
 
Doc wants Endo-rectal MRI (OUCH!) Findings: Mild central zone BPH, no discrete focus of carcinoma is identified, no evidience of invasion into the periprostatic fat or seminal vesicles.  Normal size iliac chain lymph nodes.
 
2/08/10 Open RP surgery.  Findings: Gleason Six upgraded to Seven.  3 + 4, Stage pT2c, Bilateral w/perineural invasion, No pos lymph nodes,  margins uninvolved, no extraprostatic extension, no seminal vesicle extension,  39 grams, blood loss 1200 ml (didn't want a transfusion & didn't get one) nerve bundles spared bilaterally.  current age-61


vam4710
Regular Member


Date Joined May 2010
Total Posts : 89
   Posted 7/15/2010 3:54 PM (GMT -6)   
Ditto on taking a couple of pads with you.... I just got my cath out today... couple of drips and squirts depending on what I was doing so far. I drank a gatorade but not all at once, so I've been running back and forth to the bathroom. Luckly with minimal to no leaking.... been doing my kegels for the last 5 weeks now. Try and get yourself as comfortable as possible for that ride out... I drove about 45 min to the doc due to traffic and it wasn't pleasant.
Diagnosis June 1, 2010 @ age 50
PSA  1.7    Sept. 2008
PSA  2.14  Sept. 2009
PSA  2.75  April  2010
 
May  25, 2010  - Biopsy  1 of 12 cores positive;  Gleason 3+4 = 7  25%;   Stage T1c
June 04, 2010  - CT and Bone scan - All Negative
July  07, 2010  - Da Vinci Robotic Lap. Surgery
 
PATHOLOGY
Tumor involvement - 15% both right and left halves
Gleason 3+3=6
Seminal Vesicles - Negative
Lymphnode - Negative
Subcapsular perineural Invasion - Present
Bladder Neck Margin Positive (right posteriror) - 1mm Focus
pT3a-N0-MX
 
First PSA scheduled for 10/14
 
Northern NJ


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 7/15/2010 4:30 PM (GMT -6)   
One important tip -- get to the doctor's office on time! turn

If they haven't already told you, take at least a small supply of incontinence pads with you -- as you don't know how you will be regarding incontinence. After few hours you will know your likely status and then you can go shopping for more Depends or whatever. Like Sunbird, I bought a supply of products beforehand, which it turned out I didn't need.

As far as fluid intake is concerned, drink normally -- but keep your fluid intake up. If you are incontinent, I think it a mistake to restrict your fluid intake. You could argue that a small amount going out often is better exercise for those important little muscles and may be better than a larger amount less often. But try it both ways, and you be the judge of what works best for you.

Good luck for tomorrow at let's hope all goes swimmingly well :-)
Pre-op:
Age 63 at diagnosis, now 65.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve-sparing open surgery on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Post-op:
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
PSAs:
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
19-month: 0.09 (maybe)
25-month: 0.2 (yes, bummer)
27-month: 0.2 (not up; glad about that)
ED:
After a learning curve, Bimix injections (0.2ml) worked well. From 14 months, occasional nocturnal erections. At 18 months, "graduated" to just the pump.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 7/15/2010 5:08 PM (GMT -6)   
Definitely take some pads with you in case they dont offer you anything, and wear briefs to hold the pads if needed, not boxers if that is what you are use to wearing

Do not restrict your fluids, that is important to your body and your healing, its counterproductive thinking if you drink less, you will leak less, all you will do is dehydrating yourself and making things worse.

In most cases, having the cath removed feels creepy but rarely hurts. The though of it is worse than the removal, so try not to get too freaked out.
If the nurse/dr slowly retracts the fluid from the balloon, instead of just draining it instantly, it tends to go easier. Also, I have had many removed by standing up as it is removed, gravity helps in that case. I just had my 18th catheter removed this morning, and it didnt hurt, none of the other 17 ever hurt either, so good luck.

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, 4/8 .04, next one:  July
Latest:  7/9 cath #6 - 41 days, 8/9 2nd corr surgery, 8/9 cath #7 - 38 days, mapped  9/9, 10/1 - 3rd corr. surgery - SP cath, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 ,Cath #11 - 21 days,  Cath #12 - 41 days, 3/2- Corr Surgery #5, Cath #13 - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, Cath #17 - 39 days, 7/2 - Corr Surgery #6, Cath #18 - 13 days, Cath #19 still in place


DS Can
Regular Member


Date Joined May 2009
Total Posts : 195
   Posted 7/15/2010 5:12 PM (GMT -6)   
Hello friends,
I hope your catheter removal is a nonevent milestone for you.
I was having pain at the tip of my penis before the catheter removal.  When the nurse extracted the catheter I had a tremendous amount of pain that was not easily relieved.  The nurse gave me some topical lidocaine to help numb it.  I took the remainder of the tube home and used it occassionaly for the next few weeks.  I would suggest to up your water intake for the first day.  You want to keep things working.  I had gone for a walk in the afternnon and then not drank much for the next few hours and later that night the urethra was kind of stuck shut.  It took some soaking and poking to get it opened up again. 
Be sure to empty your bladder often, and especially when you won't be able to access a toilet for a while.  You don't want to stretch the stitching.  A bladder spasm caused by trying to hold it is not a fun experience.
I hope that you are pad-free soon, keep healing,
Dan
PSA Jan'07:1.2,  Jan'08:1.9,  Jan'09:2.5
BIOPSY Feb'09  PCa DX, age 52
Right: 3+3=6, 3/6 cores 10% involved,PNI-Y
Left:  3+3=6, 1/7 cores <5% involved,PNI-N
LARP April 9,2009 nerve sparing. Final pathology:
GS 3+4=7, Margins uninvolved, 2 lymph nodes negative
Catheter 8 days, Last pad May 2,2009
latest PSA: April 8,2010 <0.1
 
 


jacknoon
Regular Member


Date Joined Sep 2009
Total Posts : 27
   Posted 7/15/2010 5:34 PM (GMT -6)   
Don,t tence up when they go to pull it out,,,,just try to relax

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6894
   Posted 7/15/2010 7:14 PM (GMT -6)   
My cath removal was absolutely painless. It just fell out.

On the other hand, I blew out a Walgreens pant with a backup pad in a 9.5 mile trip home, and went straight to a pant + 8 booster pads per day. Took about 10 weeks to come down to 6 per day.

I've learned to shop the sales and coupons.
 
Take an underpad for the car seat, just in case.

Post Edited (142) : 7/15/2010 7:17:18 PM (GMT-6)


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7197
   Posted 7/15/2010 7:26 PM (GMT -6)   
Uh... tell them to  pull, not push
 
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.

Update: since late March all is well in that area. I would say 99.9% continent (a spurt here and there, maybe 5 spurts per week). As of 6/22/10, I would say I am 100% continent, but I do have (controllable) significant urgency.

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

Second post-op PSA on 6/21/10--0.02--Not too bad!


fertree
Regular Member


Date Joined Jun 2010
Total Posts : 118
   Posted 7/15/2010 10:19 PM (GMT -6)   
As you already figured out, everyone is different. I said "ouch" when it came out, and had about 10 minutes of stinging. By the time I got to the car, the stinging had stopped. When the catheter came out, I started dripping, and I was amazed that as hard as I tried, I couldn't make it stop. I had brought a Depends which I immediately slipped on. For me it was 10 pads for the first couple of weeks, then about 6 pads for about 6 more weeks, then, suddenly in the middle of week 10, the leaking dropped dramatically to 3 pads in a day. I am now at the end of week 10, and it's amazing how different it is from a few days ago. So, if you are dry right off the bat, congratulations. If not, just wait it out. Good luck!

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 7/16/2010 5:27 AM (GMT -6)   
John was very nervous about his post-op visit to remove the staples and catheter. Both were a complete nonevent for him. He brought pads with him and had a few squirts on the way home but nothing major. Overall, he was very happy after that visit!
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009 - 0.1, September 0.3, October back to 0.0, December 0.0, March 2010 0.0. Next PSA in 6 months. Thank you God!


Timm
Regular Member


Date Joined Feb 2010
Total Posts : 83
   Posted 7/16/2010 8:27 AM (GMT -6)   
Be prepared for the youngest best looking nurse in training to be there.  Congrats- Tim

58 yrs.
PSA 6.94  12/10
Bio. 8 of 12 cores pos. 2/1
Gleason   3+4=7
Da Vinci    4/14
Tumor volume  9%
Extraprostatic extension- within margins
Margins    clear
T2c NO Mx
PSA. 6wks. post surgery .01


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6894
   Posted 7/16/2010 8:32 AM (GMT -6)   
Timm,
That was a real downer for me - hot nurse, no signs of respect from woody.

STW
Regular Member


Date Joined Jun 2009
Total Posts : 292
   Posted 7/16/2010 2:34 PM (GMT -6)   
No tips prepared me for my experience - the cath got hung up on a stitch and would not come out. The PA deflated the balloon and gave a tug - nothing. I could feel the pulling internally and could tell this wasn't right. The doc was called in - same result or lack of result. They told me to go home and if I couldn't get it out my Monday (this was Friday) to give them a call. I gave it a shot again on Saturday night, felt a pop as the stitch broke, and out it came.
Diagnosed at 54
PSA 8.7 Biopsy 1/7/09
4 of 6 cores positive, one at 90%
Gleason 3+4=7 Neg bone scan 1/15/09
One shot Lupron Depot 1/27/09 Tax Season
RP 4/29/09
Neg lymph nodes, postive seminal vesicle, 1 positive margin
Gleason 3+4=7 with tertiary 5 T3b
Catheter out at 2 weeks no nighttime incontinence Pad free week 5
PSA 6/6/09 <0.1; 9/10/09 <0.1; 3/11/10 <0.1


freinds
Regular Member


Date Joined Jun 2010
Total Posts : 76
   Posted 7/16/2010 3:29 PM (GMT -6)   

Sorry to hear of that experience. That had to be a really stressful weekend. It looks like things have gone well since then for you, hope I'm right.


pre-op PSA 3.7
Gleason 6
post op. surgical margins clear
 


Timm
Regular Member


Date Joined Feb 2010
Total Posts : 83
   Posted 7/16/2010 4:47 PM (GMT -6)   
Yea 142
 
 It was a case of showing up at a gun fight, with a very dull knife.  Sorry freinds, I remember thinking it felt a little bit like bumping your crazy bone but it's over so fast and your so happy to done with the whole thing.   Best of luck Tim

Jstars
Regular Member


Date Joined Oct 2005
Total Posts : 489
   Posted 7/16/2010 9:32 PM (GMT -6)   
Friends...

Too late to mention this now I suppose, but for the Next Guy to have his catheter removed:

They like to see that you can hold in everything at the moment the cath is removed (they load up the bladder with saline for you before they remove the cath). Then they want you to let it out and stop it in a controlled way as you void all the saline+urine.

So, remember to concentrate on those things and you will get Good-Boy! from your nurse (mine was a male nurse -- oh well).
Age 59, 57 at DX, PSA Aug2008 7 4 ... June2007 4.7 (BPH + LUTS)
11/2008 Biopsy: 1 of 12 cores 5%, Gleason 3+3 - Sona showed size 140+ cc (110 grams post op).
02/03/09 open RRP surgery ,Nerve sparing, 1 day in hospital.
02/18/09 Cath out -- passed 1 cm oblong bladder stone (not kidney!).
Pathology Report: All margins clear - No Invasive spread - no change in Gleason score.
04/09, 07/09, 10/09, 01/15/10 PSA <0.1
03/2009 Levitra@20mg / Viagra@100mg/Cialis@20mg -- (nocturnal stirrings started 02-03/2010).
08/09-09/09,02-03/10 MUSE@1000mcg 80-90% (with some ache )
10/09-11/09 TrimixGel@(500/300/100mcg): 60,70,80%,
02/10-03/10 TrimixGel@1000/300/100mcg - 80-90% - just @ usefulness.
Gel + MUSE 500mcg -- 100% for 30-60 mins and 80-90% for hours after that).


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 7/16/2010 10:12 PM (GMT -6)   
Mine came out very easily. Just a strange tingling feeling when it came out. I was a leaker from day one. My cath never did completely seal off. There were times that it would seal. But other times I would get leaking around the bulb inside the bladder and urine would drip from around the outside of the tube. Anyway, I knew I would most likely need pads when it came out. In the end I had to have a AUS to finally stop the leaking!
Hope your journey is much easier and DRIER than mine.
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
     Dec. 2006 – Oct. 2008 Cystoscope, Two Collagen injections,Second Opinion   
    Consultation for Incontinance at OU Medical Center, Bio-Feedback       
    training, Chiropractic, Accupuncture , AdVance Male Sling, Two More Collagen 
    injections, AUS Installed and Activated (Dr. Morey at UT Southwestern Dallas TX)
    All to try to resolve incontinence (using 6-8 Depends Guards a day)

    To Date All PSA's 0.00.

   http://www.healingwell.com/community/default.aspx?f=35&m=721171

    http://www.healingwell.com/community/default.aspx?f=35&m=978691

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