Bladder ureteral obstruction/stricture

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

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.

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!

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

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.

@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?

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.

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

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.

Colleen, thanks for asking. The Uro said that I'm not a good candidate for AUS because my BNC surgery (had a TUR in Sept 2020) suggests that scar tissue will continue to need self-catheterizing, which could tear the device, requiring emergency surgery. I told him I hadn't catheterized in weeks, but he thinks scar tissue will likely obstruct bladder neck down the road, in absence of catheterization. He favors the indwelling catheter solution and has several patients that are happy and active wearing them. I've had to endure them three times in the last four years and don't care for them at all; plus, I came across this quote from Dr. Viers: "...chronic indwelling catheter drainage... is associated with extremely poor quality of life." Plus I believe there are other long-term downsides. The last option is the Supra-Pubic Catheter. What worries me here is the potential for squamous cell bladder cancer. About 10 years ago, I had squamous cell skin cancer removed from my ear. No problem, but does this mean I am prone to this? Can this be nipped in the bud by aggressive bladder cancer screening? // As of now I've made my peace with condom catheters, though not infrequently the adhesive will cause unpleasant chafing that requires me to take a break from them for a couple days, and wear pull-ups, which rather aggravate the situation. It's a Catch-22. I'm waiting for a product to arrive, a "barrier foam", made by the same company that makes the condoms, that may help prevent this. I certainly hope so, because the condom caths seem to me to be the most benign solution. I really appreciate your checking back with me; and sorry for the long answer. I need to get a second opinion from one of the Mayo uros.