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.

@wrig1jam

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.

Jump to this post

@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?

REPLY

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

REPLY
@wrig1jam

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

Jump to this post

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

REPLY
@dandl48

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

Jump to this post

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.

REPLY
@colleenyoung

@alderton, good question. @victor1930, do you find the catheter uncomfortable?

Jump to this post

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.

REPLY
@jackpine

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.

Jump to this post

@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

REPLY
@jakedduck1

@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

Jump to this post

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

REPLY

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.

REPLY
@wrig1jam

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.

Jump to this post

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

REPLY
@jakedduck1

@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

Jump to this post

Leonard, thanks for sharing this story about your dad. I'm with you re: indwelling catheters. The uro who likes them is less than useless; after the staff at this particular hospital failed three times to get me fitted properly with a catheter that didn't leak, I could see it was a losing proposition. I'm back on pads and condoms. Actually am also trying Pelvic Floor Therapy, in a last ditch effort to avoid an AUS.

REPLY
Please sign in or register to post a reply.