Optilume Balloon Treatment for Prostatic Strictures

Hi Bob,
The area where all my strictures form is just below the bladder neck where the urethra was sutured back together. My Urologist told me that incontinence after the Optilume procedure was a good indication that the ureathra is still open. I have had absolutely no bladder control for the last 2 1/2 years so I know what it's like. The supra pubic catheter that was put in during the Optilume procedure is still in, changed out every four weeks and will stay in for at least another three months. My wife changes it here at home now. I connect it to a night bag before going to bed, at least I can sleep and if we are going somewhere, I use a leg bag. The rest of the time I'm either using a clamp or Depends and absorbent pads. Good luck and always hope for the best.
Dave

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Hi Dave,
So you had your prostate removed? The reason for your sutures? My problem is in the same area as you, at the Bladder neck. They say my issues are do to radiation damage to the urethra. Scarring and stricture buildup. Just in the past week my incontinence has taken a turn for the worse. Up to a few days ago I was still doing well during the day. Minor leakage. Now that it is not minor I have found some underwear that is more comfortable than the depends called Protech Dry. Can be found on Amazon. $26 a pair. I am a 34/30 pant and bought a large but it was too small. Returned for XL which fit well. Just bought 2 more pair. I just started using these yesterday during the day and depends at night. I still have some control but the leaking is my problem and it is consistent. I do best laying down and worst in the sitting position. Did your incontinence get bad fast? I can't believe I went from doing well during the day (wearing regular boxers) to can't do that anymore overnight. So the Supra Pubic catheter does not eliminate the incontinence? That is a bummer. Does your doctor expect you will regain control of your bladder and is there a fix for urinary incontinence? I had 20 botox shots in my bladder as part of my Optilume procedure. Suppose reduce the urgency issues. That has worked but now incontinence. Ugh! Hang in there Dave.
Bob

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Yes, I had a Prostatectomy in May of 2021 based on the recommendation of two Urologist, they both suggested to go with the surgery as it was early enough that there was a very good chance of getting all the cancer and go with the radiation as a backup plan. The first stricture formed two months after surgery. I had the first dilation in July, followed by another one in September, October and November, then the first laser surgery in December. In January my PSA was higher than it should have been and my Urologist referred me to a Radiation Oncologist. Over the next six months my PSA steadily rose, in July of 2022, the Oncologist started me on Hormone Therapy (ADT) followed by radiation to start two months later. On the morning of September 27th, (my 70th birthday) I suffered a stroke believed to have been cause by the drug used for the ADT. I was airlifted to the ICU in Thunder Bay and fully recovered, radiation started the end of the following week, I had 33 treatments. Incontinence started immediately after the catheter was removed after the prostatectomy. I faithfully did Kegel exercises, at least four hundred a day but they didn't help much. The plan is to install an AUS (cuff) if the Optilume is successful. When I don't have the supra pubic catheter connected to a drain bag, it's plugged off and all urine flows through the urethra, even when it's connected to a drain bag, there is still a slight bit of leakage. The supra pubic catheter was put in only to use if a stricture formed and blockage occurred due to my poor history of having them develop so quicky but I'm using it and my Urologist is okay with that.
Dave

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Hi Dave,
Update. Saturday night I went into urinary retention again and went to the ED at Mayo Clinic Phoenix. I decided to go with the SupraPubic Catheter instead of more risky surgery and increased incontinence which has gotten worse. Good news is my incontinence has ended ... bad news is I have a more permanent catheter. Apparently I will have to have the current suprapubic I rec'd replaced with a larger catheter in the next month.
The reason for this message is to ask you what supra pubic supplies have worked best for you. I am talking about the leg bag and overnight bag. The leg bag I rec'd from the hospital has straps which are a not that comfortable. I have seen on Amazon some sleeves that you can pull up your leg and then place the leg bag into it. Looks better fitting to me and the reviews are encouraging. I wondered what you found worked best for you mostly in the leg bag area. Thanks for your insights.
Bob

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Hi Bob,
During the Optilume surgery the Urologist put a 14 mm catheter in which he replaced 4 weeks later with a 16 mm catheter. My wife changed the one for October here at home and will also be doing changes for December and January, the hospital supplied us with all necessary supplies to do this. The leg bags I use have velcro straps which can be cut to the appropriate length, I wear the bag just below my knee. I don't find it uncomfortable but I guess I've gotten used to wearing it. My wife did make me a couple of fabric covers for leg bags, they fit inside but use the same straps, she also made a matching cover for the drain tube, I only have worn them when wearing shorts during the summer. I also wear a velcro strap just above the knee to help hold the drain tube close to my leg. The drain tube can be shortened to fit better. I typically use the same bag for two weeks sanitizing it every night with a vinegar and water solution, same for my night bags. Keeping everything clean is essential. Don't forget to stay hydrated. My wife was a registered nurse for more than 30 years, her knowledge and experience has been put to very good use. If the Optilume doesn't work for me, I will stick with the supra pubic catheter, I have already spent too much time recovering from surgeries and other procedures. Good luck, hope it all goes well for you.

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Thanks Dave,
I have only had the supra pubic catheter for one day and even though getting used to it will take some time I feel a sense of freedom already. No running to a bathroom or getting up 5 times plus at night. Wearing depends etc. Sounds like your wife was pretty handy working on solutions that make things easier for you. That's great. Do you replace your bag after two weeks and get new ones? Night and leg bag? I hope the Optilume works out for you. Certainly it's success rate seems good. Thanks for our detailed response.
Bob

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Thanks Dave,
I have only had the supra pubic catheter for one day and even though getting used to it will take some time I feel a sense of freedom already. No running to a bathroom or getting up 5 times plus at night. Wearing depends etc. Sounds like your wife was pretty handy working on solutions that make things easier for you. That's great. Do you replace your bag after two weeks and get new ones? Night and leg bag? I hope the Optilume works out for you. Certainly it's success rate seems good. Thanks for our detailed response.
Bob

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