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?

@joelp

I am a 41 yr old Male.

I am supposed to have surgery this week for a tight bladder neck. I have had the issue for 7 years and my bladder is getting weaker.
I am very scared and not sure if it is the right decision. I have been on flowmax and it helps some. I am on two pills totaling .80.
I am 41 years old and had a qmax score of 6 without any meds and 12 with meds. The meds cause some side effects like eczema and some dizzyness, maybe even some back and side pain.

If anyone has an experience with having a BNI at 5 and 7 could you please share with me your experience>?
My BIGGEST fear is incontinence. I am 41 have two kids and a beautiful wife.

Did you get and form of Incontinence?
Did you get the dreaded Retro?
How long was your recovery time?
Would you share with me your outcome and if any complications?
Did you get the results you were looking for?
Would you do it again knowing what you know now?

Am I jumping the gun having this surgery or am I scared of things that are very unlikely?

I see some people have good flow after the surgery but then find out a few weeks later their slow flow comes back. Thank you for anything you can share.

Thank you,
Joel P

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Joel, sorry I didn't see this in time. Have had terrible incontinence since the BNC surgery. Am still trying to solve the problem and have made an appointment in Apr. with Dr. Viers. As of now I am using an indwelling catheter. For several months, I tried to make condom catheters work, but finally threw in the towel as there were too many problems – leaks, skin issues etc. Good luck, please let us know how it went.

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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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That could be my problem,ever since I had a camera inserted into my penis by a urologist some 15 yrs ago I have had some difficulties urinating.Latley I am experiencing pain at the start of urinating the pain is in the shaft or my penis.I only have to get up once at night.

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@tessa2004

That could be my problem,ever since I had a camera inserted into my penis by a urologist some 15 yrs ago I have had some difficulties urinating.Latley I am experiencing pain at the start of urinating the pain is in the shaft or my penis.I only have to get up once at night.

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@tessa2004, if the pain at the start of urinating is a new symptom, you may wish to consult your doctor. It could be a urinary tract infection or other problem that needs medical attention. Is it a new symptom? Have you talked to your doctor about it?

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@jimb1950

I had same problem started post prostate surgery removal. Eventually it was completely scarred over had the Supra pubic cath & finally had corrective surgery at Mayo Rochester. Dr Viers was best thing that happened to me in past year.

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Did you have the AUS put in? I'm looking at going that route.

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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.

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@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.

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@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?

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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

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@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

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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

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@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

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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.

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@colleenyoung

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

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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.

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@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.

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@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

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@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

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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

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