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adderboy
Regular Member


Date Joined May 2011
Total Posts : 33
   Posted 6/9/2011 3:50 PM (GMT -6)   
I am just about 8 weeks post surgery and doing well other than two issues. I have a weak flow - takes much longer to empty bladder and might even be getting worse. I don't have incontinence though. The second problem is my incision is taking forever to heal. It just seems tender on the surface and it worsens as the day progresses.

I called my urologist and he thought a stitch my be protruding from the incision (I will have a closer look at that). As far as urine flow is concerned, he suspects scar tissue my be impeding flow and wants to have a look at that. Does anyone out there have an idea as to what I can expect he will do to to look at the problem and if it is scar tissue, what are my options.

Thanks
Age: 55 Ontario, Canada
PSA: 1.2
Dec 2010: Family Dr. found lump on routine physical (not there 1 year prior)
Feb. 6 2011 biopsy: 3 of 11 cores, T2a, Gleason 6 (3,3)
Urologist recommended "watchful waiting" ...back to my family doctor he recommended surgery.
Back to Urologist asked him to refer for third opinion (he did so reluctantly)
3rd opinion: Urologist recommends surgery
April 15: open radical prostatectomy
April 27: catheter removed...absolutely no ED issues and a little incontinence.
May 6 2011: Pathology report excellent, cancer confined to prostate, Gleason score remained at 6!

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 6/9/2011 4:39 PM (GMT -6)   
You may be experiencing the beginning of a stricture at the bladder neck. The uro would probably want to "scope" you and have a look, and the blockage, if you have one, may be able to be opened or widened by dialation rods in the office. This helps some men. If it is heavy scarring, it may involve a mini day surgery, where the doc can full open the stricture or blockage while you put under. I had 6 such ops for that purpose. For a small percentage of me, it can be a chronic situation, like with me, or it can be a one or two time shot, and then its fixed.

The most common place is at the bladder neck to urethra connection. Strictures can also occur within the urethra itself, which is the easier of the two locations to work with.

If you are scoped, the first time, it is scary, but they heavily numb the tip of the penis with lydacaine gel, and gently insert the probe. If you relax (hard to) and not try to watch, its not so bad. The scope even has a camera so they can see everything clearly. Often after you have been scoped or dialated in that area, you may have to spend a few days to a week with another catheter to allow healing after the correction.

I wish you luck. What you don't want, is total blockage and end up in the ER. So be sure to keep your uro informed of your condition before it gets that bad.

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 margin
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, 2/11 1.24, 4/11 3.81
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 9/10

SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 6/9/2011 5:10 PM (GMT -6)   
I went thru a couple of scopes, dilation, and then surgery to correct stricture problem.  The main thing is to get it checked before you get a total blockage and the real pain begins.  As far as the scoping, the only part I really found uncomfortable was when the doc was trying to clear the blockage with different size "dilators". There is pressure and then a "pop".  Just kind of startling, like the snap sound during the biopsy with the needle gun.  All in all, not bad, but something that has to be done to prevent blockage and trips to the ER.  If your Uro didn't already warn you, if you have to end up in the ER because of a blockage, try and have a urologist place the cath to prevent further damage.  I guess some ER docs aren't too good with caths.  Good luck.  Hope it is nothing to worry about.  Squid.

adderboy
Regular Member


Date Joined May 2011
Total Posts : 33
   Posted 6/9/2011 8:38 PM (GMT -6)   
Thank you Purgatory and SubicSquid. Sounds like a "fun" procedure but it is nice to know what I can expect during the scope.

I will update after my appointment next week.
Age: 55 Ontario, Canada
PSA: 1.2
Dec 2010: Family Dr. found lump on routine physical (not there 1 year prior)
Feb. 6 2011 biopsy: 3 of 11 cores, T2a, Gleason 6 (3,3)
Urologist recommended "watchful waiting" ...back to my family doctor he recommended surgery.
Back to Urologist asked him to refer for third opinion (he did so reluctantly)
3rd opinion: Urologist recommends surgery
April 15: open radical prostatectomy
April 27: catheter removed...absolutely no ED issues and a little incontinence.
May 6 2011: Pathology report excellent, cancer confined to prostate, Gleason score remained at 6!

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 6/9/2011 9:15 PM (GMT -6)   
In the "old days", adderboy, they use to use a rigid scope, which made it much more difficult and painful. In our time, the scopes are flexible and generally much easier for the doctor to make passage. The shorter rigid scopes are reserved for women, whose passage is much shorter and straighter.

With one of my stricture emergencies, was forced to use the local ER, they had no idea what they were doing. I insisted they reach the on-all Urologist from my doctor's office. They did, but didn't take his advice and it turned into a visit from hell. My uro was furious when he found out, and said it was a miracle that they didn't do serious damage to me. Needless to say, he had words with the ER department. Best bet, not to let it get closed up bad enough to need to go to the ER. A full bladder with no way of being relieved is a "10" on the pain scale for sure.

You should do fine, and again, don't hesitate to call your Uro, if you feel even remotely like your are backing up. See you are from Canada, gotta love you brothers from the far north.

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 margin
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, 2/11 1.24, 4/11 3.81
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 9/10

adderboy
Regular Member


Date Joined May 2011
Total Posts : 33
   Posted 6/21/2011 11:30 AM (GMT -6)   
Had my cystoscopy yesterday - not nearly as bad as I thought it would be. The scope has smaller diameter than a catheter. It was quite fascinating to the monitor while the doctor explained what I was seeing. He saw some white objects blocking part of the urethra and took them out. He wasn't sure what they were but guessed they were stones but will have them checked.

As well, there was something else looking like a stitch protruding through? The urologist (not my regular urologist) was not certain and is going to have my Urologist follow up with a second look in a couple of weeks as well as a flow test. I did notice a much better flow this morning - not quite what it was, but close.
Age: 55 Ontario, Canada
PSA: 1.2
Dec 2010: Family Dr. found lump on routine physical (not there 1 year prior)
Feb. 6 2011 biopsy: 3 of 11 cores, T2a, Gleason 6 (3,3)
Urologist recommended "watchful waiting" ...back to my family doctor he recommended surgery.
Back to Urologist asked him to refer for third opinion (he did so reluctantly)
3rd opinion: Urologist recommends surgery
April 15: open radical prostatectomy
April 27: catheter removed...absolutely no ED issues and a little incontinence.
May 6 2011: Pathology report excellent, cancer confined to prostate, Gleason score remained at 6!
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