Bladder ureteral obstruction/stricture

I am in my 5th week of proton therapy and have severe restriction particularly at night. I had some issues before the cancer diagnosis and took uroxatrol which helped. Immediately after my biopsy my urination problems worsened, couldn’t play a round of golf without running to the bathroom after 5 holes. One week after I started proton therapy the restriction began to get severe. So far the recommended treatment is to take 400 milligrams of ibuprofen once a day. It doesn’t help much. I hope to avoid a catheter and considering only doing 4 treatments a week instead of 5.

@wrig1jam, allow me to bring into this discussion a few members who have had proton beam treatment for prostate cancer like @dandl48 @jim20403 @waynen @daveywavey. They may be able to share experiences with ureteral stricture or obstruction.

Jim, are you doing 20 radiation treatments?

44 at 180 cGy per treatment. I had the 6 month hormone, but no SpaceOAR gel. I opted for the longer treatments because I hoped it would be less intrusive to other parts of my body. No one mentioned the risk of urination blockage when they described the program.

Thx for responding and sharing with others. Jim

Jim @wrig1jam Jim, I had the 5 treatments over 10 days SBRT at Mayo Rochester in September. I'll be back later this month to check in with my Radiation Oncologist. After the 5 treatments I did develop some problems with urination but 2 weeks of Flomax cured that and remains good. May I ask why you chose not to have the SpaceOAR gel injected? Best of luck to you!
Dave

I intended to have the SpaceOAR gel and was scheduled to have it done in early February this year, but Mayo Phoenix stopped all elective surgical treatments due to Covid. I had my 6 month hormone shot in mid November and began to get concerned about waiting to long to start treatment. Talking to my oncologist about it he said they would have to do the planning all over again and sometimes the gel wasn’t placed properly or migrated. So I decided to move ahead with treatments. So far no bowel issues.

The answer is No .Instead of a leg bag I use a belly bag (Rusch) and I find it very helpfull and convenient
. It is not obtrusive nor is it uncomfortable . It has a nozzle attached to the bag, When you feel the bag (externally),and find the bag almost full, you can go to the washroom, open your fly, reach the nozzle and drain it. Close the nozzle (must remember to do so to prevent an "accident") and Bob's your Uncle.. I have used these bags for over 18 months now and feel good about myself. Hope this helps.
Victor A.

@jackpine
My Dad was a Quadriplegic and used indwelling catheters for quite awhile but later switched to condom type.
He developed bladder cancer believed to be a result of chronic irritation from both catheter use and infections.
If I were in your situation I’d avoid long-term use of indwelling catheters considering your age.
Has your urologist addressed the possibility of irritation from catheters and infection. Not that my opinion matters but I don’t believe it’s a question of if but when.
Take care,
Jake

If I may respond to @jackpine again, my father's experience with an indwelling catheter seems to mirror some of his concerns. My dad's prostate surgery led to scar tissue that blocked urine at the top of the urethra, and his only recourse was a "suprapubic catheter" thru a hole cut in the wall of his lower abdomen, just above the pubic bone. Dad was almost 80 when the catheter was emplaced, and he lived another 15 years with that fixture which was endorsed by a series of urologists as his only solution. He had several infections every year around the catheter where it passed through his body wall and dealt with them with treatments the urologists recommended, assisted by nurses at the long-term care facility where he lived more than five years. His passing came as something of relief for the family; he had descended into dementia in his last years and could not relate to us at all. Martin

I had severe restrictions and was put on Flomax, 400 mg ibuprofen twice a day and AZO uninary tract health maximum strength, which is an over the counter drug. Now no longer have blockage but need to urinate every 1 to 1 1/2 hours. And there is an urgency when I have to urinate so need to be close to a bathroom at all times.

Hi, Jim @wrig1jam. I have just entered diagnosis of similar urinary problems, and as soon as I get my situation clarified, I'll be back with you and share what I can. In the past, Flomax was a prescription in connection with benigh prostatic hyperplasia (BPH), which I took far too long awaiting a decision to undergo TURP to cut down the size of my prostate. That was 12 years ago. I'll be visiting with my Urologist next month to see how my bladder, prostate, and urethra are doing now, particularly because of frequent urination in less than total amounts. Hope we can share good news for both of us soon. Martin