Bladder Constriction

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*Optimist*
Regular Member


Date Joined Jun 2009
Total Posts : 35
   Posted 11/17/2010 10:08 AM (GMT -6)   
I got good news yesterday on my surgery results - G7 - clean margins - organ confined disease - waiting for confirming PSA test at the end of December.
 
I live in Canada but travel often to the US on business - mostly 1 or 2 days at a time. I asked my Uro about travel and he cautioned me that there is a small percentage of men that have a bladder condition develop in the first few weeks after surgery that blocks the urine flow and could possibly require surgery. Has anyone had this happen? If so is it a sudden event? Reason for the question is that I would not be covered by my medical insurance out of Canada as it would stem from a pre exisiting condition. If the condition is slow developing I could hopefully get back home for treatment. Any info would be appreciated.
On active surveillance for 18 months then had first follow up biopsy
Sept 1/10 - biopsy - 3 cores positive 2 @ G6 (20% & 50%) & 1 @ G7 (70%)
RP surgery booked for Nov 3/10.
Pathology - G7 - clean margins - organ confined disease

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 11/17/2010 11:15 AM (GMT -6)   
Optimist:
 
My guess is that there are plenty of complications that could arise after surgery. They all have very low probabilities of happening. I had some problems and I think they were infections (urine samples showed blood cells and white cells but cultures revealed nothing). For me the problems eventually cleared up.
 
I would suggest that you don't make any special adjustments for what MIGHT happen, unless your doctor is ascribing a very high probability of this happening (which would surprise me).
 
Mel
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .
Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64
Surgery: Dr. Menon @Ford Hospital, 1/26/10.
Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- in progress. First post-op PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. 9/21/10--0.06

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7078
   Posted 11/17/2010 11:26 AM (GMT -6)   
I would think that he is talking about a stricture at the point where the urethra has been stitched back together after the prostate is removed. That would restrict or block the urethra with scar tissue. There have been posts from those who had to either go back on a catheter temporarily or have the stricture removed (cleared out).
 
I have no idea how common that is, and so far (fortunately) have not had a similar problem.

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 11/17/2010 11:43 AM (GMT -6)   
Optimist,  I developed a bladder neck stricture after my surgery.  It was very slow to develop and took about six months for it to become a problem.  In my case the stricture was dilated using "dilating sounds" in my uro's office.  Some sounds are flexible and some look like these:  http://www.bcmamedicalmuseum.org/object/993.226.1.   Some extreme cases do require surgery.
 
Carlos

Diagnosed 2/2008 at age 71, PSA 9.1, Gleason score 5+3, stage T1c.
Robotic surgery 5/2008, LFPF at 6 wks.,nerves spared, stg. pT2c, N0, MX, R0, Gleason 5+3
PSA .12 at 2.5 years. All prior tests <0.1.

Post Edited (Carlos) : 11/17/2010 9:53:18 AM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/17/2010 12:04 PM (GMT -6)   
Felt I needed to come in and answer this one. Optimist, after prostate surgery, there's a small group of men, 2-4%, that have stricture problems. For most, its often a once or twice event, usually from difficulties of the urethra to bladder neck connection in surgery. Some surgeons know in advance that there might be a problem. Usually, for the simple stricture problems, the dr can go up with a scope, look around, and find the problem. Often they reopen things with either a soft or hard dialation, or the can open it up with a small snip here and there.m

For others, like me, the stricture problem is chronic. In the 2 years since my open surgery, I have had 6 out patient surgeries to re-open
my bladder neck, plus 2 emergency dialations at the dr office. All of this kept me on a total of 21 catheters, about 1/2 year on foley catheters and a year on a suprapubic catheters. So yes, strictures can be a big issue.
 
Some strictures can take months to block things, however, I have been opened up surgically, with a laser yet, and had the bladder neck scar 100% closed shut in 30 days, which amazed even my surgeon.

When I had my Salvage Radiation, it made matters worse, often radiation alone can cause stricture issues, even if you didnt have them to start.

Now that my bladder has been shut down and bypassed, I will never have to deal with strictures, catheters, bladder spasms, or any of that the rest of my life. But this relief came with a big price, now that I have an ostomy and will for the rest of my life.

If you need any more info or help on the subject, feel free to email.

Hopefully, you wont have to deal with it.

david, now back to my disapearing act

SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 11/17/2010 12:10 PM (GMT -6)   
My stricture problem developed slowly.  The stream diminished until I could barely pee.  The first correction was in the uro's office with dilation (not a fun process) and a catheter for four days.  A month or so later the problem developed again and I had same day surgery to correct the problem.  That was in March.  So far, so good.  You will know when the problem is developing because it will become harder and harder to empty the bladder.  When that happens your uro should be contacted before you get plugged up all together.  Then it is serious.  Squid.

airborne72
New Member


Date Joined Oct 2010
Total Posts : 11
   Posted 11/20/2010 5:26 PM (GMT -6)   
My stricture was slow to develop.  Robotic surgery in mid June; developed urinary tract infection in mid July; one week later passed a plastic laproscopic clip through my urethra; noticed increased urination frequency and associated pain until November; then my Uro attempted a bladder scope but encountered scar tissue 4 inches upstream-next came the attempted dialation to no avail; underwent bladder neck constricture repair a few days later.
 
I had two problems - scar tissue from the laprascopic clip and a bladder neck constricture.  Don't know if they were related.
 
No problems since then, but the Uro said it might return in two months or two years or never again.  To date I have total continence, along with total ED.  If I had to choose between the two, this would be my selection; however, I am not content.
 
Good luck and think happy thoughts.

Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 11/21/2010 8:21 AM (GMT -6)   
*Optimist* said...
I got good news yesterday on my surgery results - G7 - clean margins - organ confined disease - waiting for confirming PSA test at the end of December.
 
 
Hi Optimist!
 
I have no response to offer on your bladder condition (other than I hear it's not uncommon, and shouldn't last long)...but I simply wanted to let you know that it's good to hear from you, and I'm glad to hear your surgery otherwise went well and as expected.
 
Continued best wishes...

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1152
   Posted 12/15/2010 4:09 AM (GMT -6)   
Hi Optimist,

I missed this post and just found it. I am so pleased about your pathology results, I am sure there was celebration!

An
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg (margins, seminal vesicles, extraprostatic extension). Multifocal, with main involvement in the fibro-muscular zone.
Post RP PSA,
Lab 1: Sep10 – 0.02|Nov10 – 0.03
Lab 2: Nov 10 - 0.01
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