Stricture of the urethra: Have you had a suprapubic catheter? Other?
I have a severe ureteral stricture due to a traumatic catherization. As a result, I have a very thin
stream when I pee and do so very frequently and it takes a long while each time… This leads to
retention of urine when I void causing me to have constant UTI’s. I have had 3 Internal
urethrotomies (VIU’s) with no success. My doctor is recommending having an indwelling
Suprapubic catheter. Do any of you know of any other options that are available to me?
Also, what are the Pro’s and Con’s of having a Suprapubic catheter installed?
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Your doctor shouldn’t be obsessed about your chronological age. Risk is assessed (or should be) based on health conditions and your medical history. Anesthesiologists evaluate patients based on a 1-5 score and is not affected by your chronological age. It is based on your health. Request that your surgeon refer you to an Anesthesiologist to be evaluated for surgery. Sadly many doctors think if your over 65 your a bad surgical risk. Do you have high blood, diabetes or other health issues that might put you at a higher risk? A lady (95) fell and broke her hip and used a chair to walk to the door to let the ambulance people in. Sadly older people just aren’t given the respect and credit they deserve.
I know a man who was nearly 100 (believe he was 98 at the time) when he fell on an irrigation pipe and pulled himself off the pipe (In his abdomen) and drove home for help. Doctors said his chances we’re slim but they had no choice but to operate, he came through it like a teenager. Later he had a leg problem and they refused to operate based solely on his age. He developed gangrene and the choice was amputation or death. They amputated and he came through like the champ he was. He was fitted with a prosthetic leg and went back to doing every aspect of farming and lived to almost 105. Active up to a few days before he died He never took medication of any kind. They say kids are resilient but so are many elderly folks.
The problem with urethroplasty is there are different procedures with different statistics. Basically they range from a 60-99% success rate. Depending on type of stricture, location, size and procedure. Anastomoses may have the best success rates provided the stricture is small. What reasons did your doctor give for not wanting to operate? I hope there were other reasons besides age.
Good luck on whatever you decide.
Victor (@victor1930), sorry to say I just heard about this bypass directly down from the still-whole section of the upper urethra, so I can't provide any useful information. I can say I'd be interested in learning more about it, and I suspect your urologist has access to the information you're seeking. I'll keep my ear to the ground, and if I run across meaningful information, I'll bring it to your attention here. Having just read about your "uro-surgeon" (?) being indisposed to do the new bypass, I'll express the hope that he's more forthcoming about his reasons. A major one could be that the straight-down surgery (depending on where the upper and healthy section of your urethra is located) may pose nerve and blood vessel avoidance problems, compared with a horizontal straight-out catheter through your body wall. That's the kind of question you deserve to have an answer to. Martin
My doctor has recommended having a suprapubic catheter due to constant UTI's caused by severe urine retention.. Is anybody who is using a suprapubic catheter; has used one; or knows someone who has used one; have answers to my concerns:
. Will I have to be "put under": or have localised anasthesia?
My uretheral stricture has a small aperture at the present time. Will i have leakage (due to gravity) from the water tube despite the SP catheter?
Are there any other concerns that I should be aware of ?
Although my first choice would probably be a Urethoplasty, a Superpubic has urethral catheters beat in my opinion. I’d ask your doctor about studies that seem to indicate an increase in bladder cancer. As long as you have regular cystoscopy and catch any cancer in its earliest stage it my not be an issue. Also about the possibility of leakage through the urethra as well as the Superpubic, both of which can occur.
Also I’d ask about the potential of increased bladder stones. Infections are lower with Superpubic vs Urethral. Tell you doctor you want to know ALL the risks as well as the benefits.
I wish you luck,
I just wanted to mention I have known many paraplegic and quadriplegic people and I don’t remember any who preferred a urethral catheter. Some especially younger guys had the Superpubic primarily to improve their sex life.
I'd like to revive the option raised first above by Leonard (@jakedduck1) for purposes of discussion. I'm referring to the "external condom type catheter" that avoids all insertions into the bladder or urethra and merely uses a condom that is manufactured with an external tube extension from the end of the penis. My experience is borrowed from my brother-in-law — a quadriplegic who lived nearly 40 years after his accident in 1977, most of that time living alone in a three-room apartment where he spent time for only a few meals every month and a good night's sleep most nights (except when we took him out on a camping and canoeing excursion or when he rode his arm-driven 3-wheel bicycle across Iowa). He was an amazing man ("was" because he died 3 years ago due to other causes unrelated to his urinary tract).
Through those 40 years, he used the external condom catheter that he fitted onto his penis every day (with some difficulty due to his inability to achieve an erection). But it served him well, and his experience with UTIs was not much different from mine — about once a year. Victor, I hope you can consider this option, which could take you past your century mark in the future. Martin
I posted some weeks ago about my being unable to pee at night; your advice was to get a second opinion which takes place 30th September. Meanwhile however, things became worse and I had to have a supra catheter inserted on 3rd September. I was expecting some discomfort but this is impossible to live with – my bladder feels as thought it’s always full and according to Google, this is normal! How can one live like that? I’ve been put on Vesicare and Betmiga together but they aren’t working as a result of which I’m tearing my hair out. Has anyone else out there experiences the same problem?
@alderton How terrible! I’ve never heard of this before. Please keep us posted. I’m curious to see if there are others that have to deal with this as well. Sending loving thoughts your way.
I’ve had Supra pubic in for couple months now & really haven’t had much problem you may be experiencing a spastic bladder which I’ve dealt with they gave me oxybutynin which helps. I had bladder neck constrictive surgery month ago & been dealing with 2 caths which are suppose to come out Friday. Good luck hope things get better
I have not, however it appears your kidneys may be the culprit. You may want to see a nephrologist