Bladder ureteral obstruction/stricture

Posted by jimb1950 @jimb1950, Jul 29 11:01am

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?

Liked by Leonard

Hi @jimb1950, I know that @kellanns, @tom1984 and @jakedduck1 have had some experience with the topic of obstruction. Perhaps they can speak to their experience and if they had any scarring. I know that there is a minimally invasive procedure using a laser. What symptoms are you currently experiencing?

Liked by Leonard

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@amandaburnett

Hi @jimb1950, I know that @kellanns, @tom1984 and @jakedduck1 have had some experience with the topic of obstruction. Perhaps they can speak to their experience and if they had any scarring. I know that there is a minimally invasive procedure using a laser. What symptoms are you currently experiencing?

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I’m completely plugged up can’t go at all hence the catheter.

Liked by Leonard

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@jimb1950
My problems were different than yours. I only had to use a catheter for several days. I haven’t had the scarring issue that you are having. Do you know what the scarring is from. How often do you change your catheter? My dad’s doctor wanted to do a super pubic on him but I put a stop to it but after 40 or so years I don’t remember why. Of course my father’s condition was different as well he was paralyzed from the neck down so he had to have some type of catheter.
Since UTIs are more frequent with catheter usage of course water is probably the best thing to drink but lemon lemonade and orange are helpful as well. Basically anything acidic I don’t drink them or eat them while you have an infection.
Wish I could’ve been more helpful.
Best of luck to you,
Jake

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@jimb1950

I’m completely plugged up can’t go at all hence the catheter.

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Hi jimb1950. I too became completely blocked in January 2019 due to BPH. Had catheter for several months and then Bipolar Turp. About 2 months after the surgery was having issues again and doctor diagnosed bladder neck constriction from scar tissue formation and also a small urethral stricture. Had surgery again in July (Bladder neck incisions) to relieve the scar formation and at the same time they dilated the urethral stricture (since the urethral stricture was small, Dr felt that was worth a try over urethroplasty which is better for larger strictures he said). Surgery went well and been good since then – a little over a year has passed now. Recovery was smooth with little to no discomfort. Back to work in about 1 week. Keep us posted on what the Dr. recommends.

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Thanks hope mine goes as well as yours👍

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One other thing I forgot to mention is that before the surgery and since, the doctor recommended increasing my vitamin c intake and to eat extra protein post surgery to try and reduce the scarring from recurring. He said there is only limited data on this having an impact but he said it wouldn’t hurt to try and push the odds more in favor of reduced scarring since it looked like I had a propensity for that. It did help me mentally too since it was something I could do proactively and feel a little more in control of things. I went to 2000 mg per day of vitamin c and also increased my protein intake with a protein bar, extra nuts and things for the first several months post surgery. Might be something to discuss with the specialist to make sure it would be ok in your case. Good luck!

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Good input, though I question the remedial effects of Vitamin C in this example. That said, good nutrition is important. Mayo Clinic has a nutritionist on staff who was very helpful to me in recommending a diet strategy for cancer recovery and prevention. Mayo also has a book that can help guide cancers patients on nutritional dos and don'ts both hard copy and online.

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@tom1984

One other thing I forgot to mention is that before the surgery and since, the doctor recommended increasing my vitamin c intake and to eat extra protein post surgery to try and reduce the scarring from recurring. He said there is only limited data on this having an impact but he said it wouldn’t hurt to try and push the odds more in favor of reduced scarring since it looked like I had a propensity for that. It did help me mentally too since it was something I could do proactively and feel a little more in control of things. I went to 2000 mg per day of vitamin c and also increased my protein intake with a protein bar, extra nuts and things for the first several months post surgery. Might be something to discuss with the specialist to make sure it would be ok in your case. Good luck!

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Thank you

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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?

Liked by Leonard

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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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Hi @alderton and welcome to Mayo Clinic Connect. You'll notice that I moved your message to this existing discussion where @jimb1950 @jakedduck1 and @tom1984 are talking about similar issues with bladder and urether obstruction issues. I'd also like to bring @amgracing1 @palevsky and @predictable into this conversation regarding their experiences with the supra pubic catheter and problematic urine flow.

See more in this related discussion:
– Prostate and Bladder Issues https://connect.mayoclinic.org/discussion/i-am-a-68-nearly-69-year-old-man-that-has-had/

Alderton, it's interesting that the issue is problematic at night, while urinating during the day is normal. That would seem to indicate that movement helps and inactivity doesn't, but you need to sleep. Have you considered getting a second opinion?

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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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Hi @alderton, glad to have a chance to share my experiences with you in hopes that they will relieve some of your anxieties about how to deal with urine flow problems. My personal experience is similar to yours — TURP a few years ago when I was about 75 years old and night time urination every 2 hours. Soon after the operation, my urologist started periodic cystoscopy to check my urethra and the sphincter just below my bladder. He's now scoping me out once a year, and I'm due for my 2020 appointment later this month.

One thing I'm preparing to discuss with him is my reluctant urine flow. My first "output" starts as expected, but doesn't remove enough urine, leaving a half-cup or a little more backed up in my kidneys and/or my ureter from the kidneys to the bladder. After a short walk around the house, I can finish the job. At night, this is a little inconvenient, but not enough to pressure me into more surgery or other medical interventions. I'm glad to report that the reluctant urine is not the result of a damaged or faulty sphincter, which the cystoscope passes through with only a little discomfort. I'd also emphasize that the night time inconvenience is not a big deal — I get up every 2 or 3 hours during the night, then go back to sleep without much delay.

A suprapubic catheter was my dad's problem. His TURP back in the 1980s essentially immobilized the urine flow through his bladder sphincter and in other points along his urethra. For a few months, he was able to self-catheterize through his urethra, but that caused a little internal damage from time to time, and his urologist recommended the permanent catheter connected to an external bag. That worked for him for several years at home, then his care takers at his assisted living facility helped him with it for several more years. During that time, he was able to dance with some of the ladies without feeling inferior about his special arrangement.

One last comment for now: Colleen as usual was on spot asking whether you have considered getting a second opinion. Both I and my dad had the good fortune of building a team of urologists and other medical personnel to deal with our needs. I hope you'll be able to do that as well. Let us know how we can help and what more information we can provide. Martin

Liked by fiesty76

REPLY
@colleenyoung

Hi @alderton and welcome to Mayo Clinic Connect. You'll notice that I moved your message to this existing discussion where @jimb1950 @jakedduck1 and @tom1984 are talking about similar issues with bladder and urether obstruction issues. I'd also like to bring @amgracing1 @palevsky and @predictable into this conversation regarding their experiences with the supra pubic catheter and problematic urine flow.

See more in this related discussion:
– Prostate and Bladder Issues https://connect.mayoclinic.org/discussion/i-am-a-68-nearly-69-year-old-man-that-has-had/

Alderton, it's interesting that the issue is problematic at night, while urinating during the day is normal. That would seem to indicate that movement helps and inactivity doesn't, but you need to sleep. Have you considered getting a second opinion?

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Funnily enough I'm seeing the second opinion urologist end next month. I'm just hoping I won't need a catheter in the interim.

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@predictable

Hi @alderton, glad to have a chance to share my experiences with you in hopes that they will relieve some of your anxieties about how to deal with urine flow problems. My personal experience is similar to yours — TURP a few years ago when I was about 75 years old and night time urination every 2 hours. Soon after the operation, my urologist started periodic cystoscopy to check my urethra and the sphincter just below my bladder. He's now scoping me out once a year, and I'm due for my 2020 appointment later this month.

One thing I'm preparing to discuss with him is my reluctant urine flow. My first "output" starts as expected, but doesn't remove enough urine, leaving a half-cup or a little more backed up in my kidneys and/or my ureter from the kidneys to the bladder. After a short walk around the house, I can finish the job. At night, this is a little inconvenient, but not enough to pressure me into more surgery or other medical interventions. I'm glad to report that the reluctant urine is not the result of a damaged or faulty sphincter, which the cystoscope passes through with only a little discomfort. I'd also emphasize that the night time inconvenience is not a big deal — I get up every 2 or 3 hours during the night, then go back to sleep without much delay.

A suprapubic catheter was my dad's problem. His TURP back in the 1980s essentially immobilized the urine flow through his bladder sphincter and in other points along his urethra. For a few months, he was able to self-catheterize through his urethra, but that caused a little internal damage from time to time, and his urologist recommended the permanent catheter connected to an external bag. That worked for him for several years at home, then his care takers at his assisted living facility helped him with it for several more years. During that time, he was able to dance with some of the ladies without feeling inferior about his special arrangement.

One last comment for now: Colleen as usual was on spot asking whether you have considered getting a second opinion. Both I and my dad had the good fortune of building a team of urologists and other medical personnel to deal with our needs. I hope you'll be able to do that as well. Let us know how we can help and what more information we can provide. Martin

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Thank you.

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Hi, I too had a uretheral obsructruction where I had to rush to the toilet every half hour to pass small amounts of urine.Eventually i had a suprapubic catheter put in and can now go and drain the bag whenever the bag is is about half to 3/4th full. I have accepted this situaion and find it a much better alternative. My anxiety is reduced and i can go out of the house without worrying.. I have my catheter changed every 4 to 6 weeks. Hope this helps. Victor

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

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