Posted 2/6/2011 1:12 PM (GMT -6)
Fair question. After my open surgery, I had constant stricture problems right at the bladder neck. Altogether I had 6 day surgeries to attempt to correct it, but had severe scarring issues each time. At one point, the bladder neck scarred 100% closed within 30 days of a correction.
Going into the SRT, it was a known risk that there is a lot more chance of having strictures, even if you didn't have them before. So the URO, my radiation oncologist, and I, mutually agreed to have the suprapubic cath installed, so that I wouldn't have to chance having any painful and potentially dangerous situations with a closure in the middle of the the SRT treatments.
The original intent was to remove the cath a month after the radiation ended, but there was already too much bladder and bladder damage from the radiation at that time to do it. So each month, with a fresh cath tube in place, we would hope for some kind of natural healing to take place. It never did. So after 11 months of increasing pain, the decision was made to bypass the bladder altogether. It was a tough decision, and a life changing one at that.
Advanced re-constructive bladder neck surgery was considered and then ruled out by the expert at Duke, because of the extent of the radiation damage.
That left me with the tried and true, old school ileal conduit surgery which was done in September.
There is no doubt in my mind, that without the suprapubic cath in place, I would have ended up in a serious emerency situation.
We tested my ability to urinate naturally a few times during that 11 months of waiting, and they were pain level 10 attempts each and every time because of the damage.
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 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10