Anyone dealing with Prostatic Strictures after Radiation therapy?

Hi,

My husband had a prostatectomy in 2013. Cancer returned in 2015 and he received salvage radiotherapy which left him with strictures in 2018. Frankly, there was a discussion of a supra-pubic catheter as a "last resort", however, my husband chose to go the route of self catheterization which he has been doing weekly for 5 years. Outside of this, we have no knowledge of any other alternatives. In fact, he just met with the Mayo Urologists and they haven't made any progress in the past 5 years which is kind of shocking and certainly disappointing. Overall, he said that while it is definitely not something any man wants to do, it's better than the alternative! Best of luck to you and God Bless!

~Carla

Hi Carla,
Thanks for your response. Much appreciated. Not that catheterization is any fun but it seems to be doing the job for your husband. I have a post surgical meeting with my Mayo Doctor coming up and I believe there may be one other procedure other than supra-pubic I need to learn about called urinary diversion. I have been catheterizing every other day to keep things open but I still develop these strictures. I have had 3 surgeries in the last year and my body is starting to have difficulty recovering from anesthesia. Like your husband I really want to avoid the supra-pubic process as it would likely permanently end my ability to urinate naturally if left in for an extended period of time.
Bob

If your stricture is in your urethra they can do a urethroplasty. But suprapubic catheter is needed for the surgery to heal. Both have problems. Catheter needs to be in for a while and changed every 4 weeks. Mine will be in for a year in December. Better than an ostomy. Kinda get used to a leg bag and overnight bag. Good luck.

Hi budisnothome,
Like your name and thanks for your response. So you have chosen to do the supra-pubic catheter vs Urethroplasty or have you done both? Good to hear you get used to the bags but wonder how much that has affected your lifestyle. I have had two strictures in the last year that have been treated with Urethoplasty and or TUIP. (Transurethral Incision of the Prostate) to help relax the area of the stricture and allow for clearing calcifications and stones. In both cases I have had a foley catheter in for about a week after surgery followed by self catheterization which I do continuously but only every other day to keep the urethra open. That does not bother me but I still am able to make new strictures. I am told that the Urethroplasty lasts on average only 4 months to a year. So continuous surgeries with anesthesia are not a good long term solution either. I wonder if there are other options.
Bob

Hi Bob. Very long journey. Had pc robotic October 2019. gene testing 5% chance of reoccurring in 10 years. !6 months later 35 radiation treatments to lower tummy lymph nodes. Lots of bleeding, 40 hyperbaric oxygen chamber sessions to try to stop bleeding. Nope. Total incontinence. I had the AUS 800 installed August 2021. Failed. Fix surgery December 2021 nope. Emergency surgery Feb 2022 after cysto showed stricture in urethra. AUS 800 cuff had eroded into my urethra causing many UTI's. Found urologist in St Paul that specializes in radiation caused strictures. I have radiation cystitis and radiation proctitis. Suprapubic catheter installed Christmas 2022, giving my urethra time to heal before urethroplasty. That was done April 2023. Had both foley and suprapubic catheter for 5 weeks. Now only suprapubic. It gets changed every 4 weeks. Cytso in August to make sure urethra is healing. If it is, suprapubic until maybe December or January , another cysto and if healed we are going to try the AUS800 again. He is hoping for a 50% success rate this time. The only other choice for me is to take out the bladder or make a direct tube to tummy, Ostomy bag forever. Will hope 50% success rate is better choice for now. I always were shorts, I have for years. My leg is exposed all the time. People get used to it. I tell some people I have a leg bag, you have ..... whatever they are using. Cane, crutches, glasses, you name it. This is mine for a while. Night bag at night, Medicare pays for the bags and supplies. The Mayo store has the good stuff. Other places bags don't work as well. I hope my long story helped you. If I can answer anymore questions please let me know, I am very experienced with the catheters, including self catheterizing, many times per day. It becomes you and this is how you live. Nothing too it, Good luck. I am in Rochester.

I am so sorry to hear about those with strictures. I am 3 months post RP and I’m getting tested for a possible stricture caused by the surgery in two weeks. My stream is weak and is broke into two streams when I urinate. I have to sit when I pee to completely evacuate. Not to mention I have a burning sensation most of the time. No UTI’s. I’m fearful of next steps, but I also can’t go on like this. Has anyone had similar symptoms after RP and what course of action worked best.

Hi Myersja,
I was not aware that RP could cause such problems. I think the test you are talking about would be a cystoscopy where they can see what is happening in your urethra. Are you healed up from the RP at this point? I would think when they get this addressed you should be good to go. (no pun intended). Wish you the best as you go through this added complication to your surgery.
Bob

Hi Bud,
Wow you have been through and hell and back. The side effects or clean up activities after PC treatment were not really discussed much with me before hand. You? It is like a whole new world of problems I did not imagine but with Gleasons 7's and 8 not much choice. Surgery or Radiation. I had to look up the AUS800 to learn it is about sphincter repair. So you have had lots of surgeries? I have never had an anesthesia issues until this last surgery just a month ago for stricture removal. Nightmare like dreams for 3 or 4 days after. Wake up dreaming about getting a glass and my hand is up in the air like I am trying to reach one. What is that? I also went through the hyperbaric 02 treatments hoping it would help healing but not much if any effect. It did accelerate the development of cataracts and had them removed in March. I did not know that the 2x atmospheric pressure in the chamber could mess with your vision. You have a good attitude Bud and I am sure that helps you cope with issues most people will never know about. Thanks for sharing your experience. I am learning more. Wishing you the best as your journey with PC continues. BTW I am in Phoenix.
Bob

Yes. I forgot about the eyed. New glasses about every 6 months and my cataracts are speeding up. Maybe another year. Only 77 here and sunny. I don't know if I could stand your heat. I suppose you get used to it like our 30 below in January. Have a fun weekend.

I grew up in Buffalo NY. I like the heat better than the cold. Summers here are like your winters. We head north in the summer while you head south in the winters. This year has been record breaking hot. 110+ for 22 days in a row and no rain in over 120 days. Flagstaff is only an hour and 1/2 from my home and is 7000 ft elevation. Much cooler but even there it has been in the 90's recently but better than 119.