Posted 1/9/2020 6:57 AM (GMT -7)
Sorry, guys...this is just a whiney, complaining post. The last time I posted about this, Randy was is the hospital with a UTI, blood in his urine and bloodclots. Monday, Randy will be admitted, placed under general anesthesia, and, most likely, the AUS will be removed.
Since the last post, we have been through 3 more ER visits and multiple appointments. The Supra-pubic catheter tube that was installed on December 1 is very small (10 French). Originally, it was intended for a very short-term use and was not intended to handle blood and clots. It has repeatedly clogged, and finally, could not be flushed clear. At that point, (New Years Day) a foley catheter was inserted. The foley is also small, since it had to pass through the AUS cuff, and is therefore not handling the blood and clots well, and constantly has to be flushed. As of right now, Randy has both a SP catheter AND a foley catheter, yet is battling constantly to keep his bladder from getting overfull. The blood and clots are not as bad as they were, but are still there intermittently.
The docs suspect that Randy has an erosion and the site of the cuff, which is not allowing urine to flow out. Erosion is much more common with men who have undergone both RP and radiation. When Randy attempts to go on his own, his scrotum swells. CT shows a fluid collection there, which they believe is where the urine is going. When his bladder gets too full, the pressure causes continued leaking through the erosion site.
The plan for Monday is for the docs to replace the SP catheter with a larger one to accommodate the blood and bloodclots. They will also do a cystoscopy to determine for sure if what he's dealing with is an erosion. If it is, all components of the AUS will be removed. There will be a foley placed, not for urine removal, but to act as a stint to hold the urethra in place while it heals. Best case scenario at this point is that he is not more incontinent after all this than he was before. Worst case is that all this makes the incontinence worse. I'm not sure what the plan will be if it's not, in fact, an erosion. We didn't think to ask. It's all a little overwhelming.