Bladder ureteral obstruction/stricture

Posted by jimb1950 @jimb1950, Jul 29, 2020

Anyone else have bladder/urethra constrictor problems? Been dealing with this past 7 mo, now have Supra pubic cath in for past 6 weeks, see specialist next week for game plan. I am completely scarred over. Just wondering what sort of procedures others have had to rectify this problem?

Interested in more discussions like this? Go to the Kidney & Bladder Support Group.

@jackpine

Had the BNC surgery on Sept. 18 2020 and have been majorly incontinent ever since. So, am currently using condom catheters, which are irritating the underside of my penis. The other drawback is the requirement to always be wearing a leg bag. Thus, am looking into alternatives, especially the Suprapubic Catheter. Are there any downsides to this procedure? Once it is installed, can it be removed? I gather that the catheter needs to be changed every ~6 weeks. Can it be changed by any doctor, in the event that I'm traveling? Is the suprapubic catheter the best solution? I am 70, had prostatectomy in 2016 and radiation in 2019; the urethra blockage started to occur in Nov. 2019. Thanks for any help.

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Have you looked into an artificial-urinary-sphincter? I had one installed via Rochester Mayo Clinic. I'm very happy with it. https://www.bostonscientific.com/en-US/products/artificial-urinary-sphincter/ams-800-urinary-control-system.html

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@seamayofan

Have you looked into an artificial-urinary-sphincter? I had one installed via Rochester Mayo Clinic. I'm very happy with it. https://www.bostonscientific.com/en-US/products/artificial-urinary-sphincter/ams-800-urinary-control-system.html

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Many thanks for this info. My Uro told me that this might not be the best solution, as I am self-catheterizing which can damage them. That said, I've not been catheterizing very often.

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I had same problem prostrate removed 1-20-20 & had nothing but problems. Ended up at Mayo Clinic Rochester had surgery in Aug by wonderful Dr & all has been excellent since. Prior to surgery I had caths, did self cathing Supra pubic all that good stuff. Now able to urinate stream like a race horse!

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@jimb1950

I had same problem prostrate removed 1-20-20 & had nothing but problems. Ended up at Mayo Clinic Rochester had surgery in Aug by wonderful Dr & all has been excellent since. Prior to surgery I had caths, did self cathing Supra pubic all that good stuff. Now able to urinate stream like a race horse!

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What surgery did you have in Aug? You had a suprapubic catheter and now you don't?

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@jackpine

What surgery did you have in Aug? You had a suprapubic catheter and now you don't?

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Urethra constricture surgery, I was scarred & completely shut off, finally put a Supra pubic cath in June kept in post surgery just as a safety valve for couple weeks then I removed it myself at home & have been going ever since. The surgeon I had was absolutely the best.

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@jackpine

Had the BNC surgery on Sept. 18 2020 and have been majorly incontinent ever since. So, am currently using condom catheters, which are irritating the underside of my penis. The other drawback is the requirement to always be wearing a leg bag. Thus, am looking into alternatives, especially the Suprapubic Catheter. Are there any downsides to this procedure? Once it is installed, can it be removed? I gather that the catheter needs to be changed every ~6 weeks. Can it be changed by any doctor, in the event that I'm traveling? Is the suprapubic catheter the best solution? I am 70, had prostatectomy in 2016 and radiation in 2019; the urethra blockage started to occur in Nov. 2019. Thanks for any help.

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@jackpine Welcome to Mayo Clinic Connect. You have surgery in September and have been incontinent ever since. You are wanting to connect with members to get ideas about your options moving forward. Members @kellanns @tom1984 @jakedduck18 have experience discussing this topic and may be able to help with suggestions.

Below I have linked a previous discussion related to suprapubic catheter specifically. You may want to scroll through the posts to see previously offered suggestions and information.

- Stricture of the urethra: Have you had a suprapubic catheter? Other https://connect.mayoclinic.org/discussion/stricture-of-the-urethra-what-treatment-options-have-you-tried/

May I ask when you go back to see your provider for a check in and what options your provider has presented you?

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Erika, many thanks for the information which I have just read. Must research urethroplasties, of which I know nothing. I had a prostatectomy in 2016, after which I was mildly incontinent i.e. using a pad or two or three per day. Cancer was found in one lymph node. PSA rose in 2018. Had radiation March-April 2019. Starting Nov 2019 began having bladder neck blockage due to scar tissue. Had the BNC surgery Sept 2020. Massive leakage (6-7 "pull-ups" per day) ever since. Uro who performed this surgery fixed me up with condom catheters. I am looking for alternatives. I have a remote appointment on January 7 with a new uro. He has mentioned the possibility of an indwelling catheter or superpubic cath. From my experience with catheters (following the two surgeries), seems like the former would be mighty uncomfortable. He advised against artificial sphincter because I am self-catheterizing intermittently. That said, I'm not certain that intermittent catheterizing needs to continue. And one other thing - am on my last injection of hormone therapy, which began in Dec, 2018.

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@alderton

I'm 70 years of age and had a TURP operation 15 months ago to reduce the size of my prostate. In short, the operation didn't work properly. Urinating during the day is normal but night time is a problem - up every 2 hours and then the sphincter muscles refuse to open resulting in my having to massage my penis to stimulate a flow of urine. My urologist has prescribed Valium to relax the sphincter but this isn't working either. No-one seems able to explain why this occurs at night time and why the sphincter muscles don't work as they should. I'm told the next step is a supra pubic catheter which I am trying to avoid. Has anybody out there had a similar experience?

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alderton, Vitamin B1 is involved with the vagus nerve function and a deficiency of B1 (thiamine) may be the cause of your problem. Thiamine requires magnesium to become bioactive but excess carbohydrates or alcohol will turn thiamine off. Research the vagus nerve as it applies to the bladder sphincter muscle and the rest of the body. Then investigate thiamine deficieny and it's impact. Also research benfotiamine a fat soluble form of thiamine that passes through the blood/brain barrier more efficiently yjan water soluble forms.
https://www.objectivenutrients.com/insights/thiamine-ttfd-bladder-emptying-disorders-of-retention-and-incontinence-stones-interstitial-cystitis
https://nootropicsexpert.com/vitamin-b1-thiamine/
https://www.krispin.com/magnes.html

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@jackpine

Erika, many thanks for the information which I have just read. Must research urethroplasties, of which I know nothing. I had a prostatectomy in 2016, after which I was mildly incontinent i.e. using a pad or two or three per day. Cancer was found in one lymph node. PSA rose in 2018. Had radiation March-April 2019. Starting Nov 2019 began having bladder neck blockage due to scar tissue. Had the BNC surgery Sept 2020. Massive leakage (6-7 "pull-ups" per day) ever since. Uro who performed this surgery fixed me up with condom catheters. I am looking for alternatives. I have a remote appointment on January 7 with a new uro. He has mentioned the possibility of an indwelling catheter or superpubic cath. From my experience with catheters (following the two surgeries), seems like the former would be mighty uncomfortable. He advised against artificial sphincter because I am self-catheterizing intermittently. That said, I'm not certain that intermittent catheterizing needs to continue. And one other thing - am on my last injection of hormone therapy, which began in Dec, 2018.

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@jackpine, any new insights from your remote appointment with the new uro today?

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@alderton

Thank you. Do you find the catheter uncomfortable in any way?

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Alderton, I have used the catheter for ten years, as of coming October. I have a plugged urethral valve from Gelsolin which invades, swells, leatherizes, and disables all the valves in the system. I started with ol' red floppies, but have now been on stiff tubes about 8 years. The only discomfort I really have is when I have to work a while, several minutes, to get the cath through the frozen valve. This nearly always raises pain and considerable blood, so my discomfort also comes when I have to clean up the spilled blood around the toilet. This happens every 5-7 days now, and lasts a day or so. I also leak a lot of blood into my shorts.

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