Passing Gas hrough penis after having surgery

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Jack Hammer
New Member


Date Joined Aug 2010
Total Posts : 1
   Posted 8/26/2010 4:37 PM (GMT -6)   

On March 17th 2010 I had robotic surgery to remove my prostate. After 5 days in the hospital I returned home. Upon arriving home while sitting on the toilet I started to pass; what I believe was gas through the head of my penis while the catheter was as still in me.lem  The catheter came out a few days later and the problem was still there.  After several days I contacted the surgeon who told me to keep an eye on it. After having several medical procedures to try and diagnose the reason for this problem, I am left with the problem still. The procedures included a CAT scan, a test that involved me taking charcoal, and a scope exam. The results came back negative. The Dr. said I should monitor it and if the problem persists that they may have to go back in and operate.

No one has given me any information as to what this could be.
 
Can any one help me to understand what I am going through???
 
Thank you in advance!

seconder
Veteran Member


Date Joined Jun 2008
Total Posts : 610
   Posted 8/26/2010 5:22 PM (GMT -6)   
Excuse me for jumping in here; I usually post on the UC board.
 
I once had a doc obsessed with this potential problem of UC.  It sounds like a fistula.  In IBD, a fistula is  connection between the bowel and another anatomical structure such as the bladder.  It should show up on a CT scan, but then again it might not, especially if the person looking for it doesn't know to look for it.
 
You might try the Crohns board since they have quite a bit of accumulated knowledge about fistulas and finding them.

Radical
Veteran Member


Date Joined Mar 2009
Total Posts : 739
   Posted 8/26/2010 5:30 PM (GMT -6)   
Hi Jack,
I have seen this topic, being discussed here just recently in the last couple of months.  Hopefully those involved in the discussion will chyme in soon.  We have another member here with the same problem, and from memory, I think he got to the bottom of it.
Sorry cant remember who it was, but hopefully they will see your post.  Good Luck !
.............Kev

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 8/26/2010 6:06 PM (GMT -6)   
Hello Jack,

Can't remember the other posters name either, but he had a very similar problem, and it ended up being some kind of fistula. Appearently, its easy to damage the wall between the rectum and the prostate when its being removed. Not sure how this fellow was corrected for it either. Perhaps someone else will remember.

Good luck

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 8/26/2010 6:54 PM (GMT -6)   
Jack,
 
A friend of mine had an experience similar to yours this past February.   His surgeon accidentally damaged the colorectal tissue during the prostatectomy and caused the formation of a fistula.   He was faced with two more surgeries.  The first to perform a colostomy to allow the tissue to heal and a second to reconnect the colorectal tissue.  The bad news is that the first attempt failed.  As soon as he heals from his last surgery,  they will try again.  He has changed surgeons to a very experienced colorectal surgeon.   You might want to consider getting an opinion from a good colorectal surgeon.
 
Carlos
 
 

Diagnosed 2/2008 at age 71, Gleason score 5+3, stage T1c, PSA 9.1.
Robotic surgery 5/2008, nerves spared, stg. pT2c, N0, MX, R0, Gleason 5+3
PSA <0.1 at 26 months and at all tests since surgery.

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3743
   Posted 8/27/2010 4:06 AM (GMT -6)   
I think this might be the thread you are looking for:
Gas in urine ??? http://www.healingwell.com/community/default.aspx?f=17&m=1796526

I had passed gas about 2 weeks after surgery. Never since then.
Jeff

brainsurgeon
Regular Member


Date Joined Jul 2009
Total Posts : 137
   Posted 8/27/2010 6:17 AM (GMT -6)   
At this point in time after a March surgery, you must have a vesico-colonic fistula (an abnormal connection between the colon and bladder) or some other bowel-bladder abnormal connection. Don't be surprised if you pass fecal matter also. A urine culture should show colon bacteria also, but that would not be a definite clue. A cystogram will likely show a fistula unless there is a ball valve connection there. A spontaneous closure is unlikely.
70 years old (1939) USA citizen
Prostatic carcinoma dxed June 2009 by PSA (7.0) and then Bx
PSAs yearly since 2001 ranged 1.52 to 7.0. Doubled from 3.5 to 7.0 in one year.
Neg. CT and Bone Scan
4 of 8 biopsies positive (all right side) Gleason Score 3+4=7
Robotic assisted total prostatectomy and node excision July 2009 in Luzern, Switzerland by Dr. A. Mattei in the Kantonsspital. New Gleason was 4+4=8
pT2c G3 pN0 (0/14 nodes +, Margins, etc. clear
Catheter out in 5 days (home in 3 days). No incontinence
Positional neurpraxia in hip and knee resolved 90+% in 5 months.
Potency: beginning tumescence??? at 3 weeks post-op. Still happens at 3 months PO. Nearly usable one month later. At 5 mo. with 100 mg Vitamin V, pretty good. Now beginning 5 mg Cialis daily. 11 months post-op had first usable erection.
3month PSA less than 0.01, 6 month PSA less than 0.01, 11 month PSA remains less than 0.01

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 8/27/2010 11:43 AM (GMT -6)   
Also known as a vesiculorectal fistula. An abnormal passageway between the bladder and the rectum. Normal procedure is to have another operation to close the hole.
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


CharlieTuneA
Regular Member


Date Joined Aug 2009
Total Posts : 37
   Posted 8/27/2010 12:35 PM (GMT -6)   
Hello Jack,
 
I had the fistula last year. Mine was a bit more severe - I was actually getting some feces through the penis right after my RRP. The doc kept me catheterized for two months, but after having the catheter removed, I began to get gas (penis farts) .  
 
The catheter went back in for another month, and I was placed on a "low residue" diet. That meant no roughage at all, no nuts, no whole grains, a very bland diet. Consequently I ended up gaining weight because I could eat ice cream, so feeling sorry for myself, I did that a lot.
 
After the catheter was finally removed, I had one more episode of gas, but convinced the doc not to re-catheterize me. He had told me that if it wouldn't heal on its own, then I would have to have another surgery. He had done hundreds of DaVinci's, and had seen this only once before. On a recent office visit, he told me that he had another one. He said that it was caused by a suture not holding.
 
Anyway, it's all healed now. But after all the catheterization, I had some muscle atrophy, and have had a "hard time" (excuse the pun) with both continence and erectile function.
 
Hope it all goes well for you.
 
-Charlie
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