Bladder neck obstruction

User

Posted 19 Jul 2014 at 11:09

Hello

Just a query really or after others experience.

Following my RP in Feb 13. I was left with a bladder neck stenosis, basically my flow is weaker due to the smaller opening. They were going to do a badder neck incision but agreed the potential SE ie possible incontinence was not worth it. I go to the toilet normally ie a stand up wee, I'm never up through the night and I don't have urgency and I'm totally continent.

But I recently read urinary tract obstructions can cause kidney and bladder problems. Do you think I am right in presuming this is when men can't empty their bladder fully ie still have a sense of the need to go when they have been, up through the night etc or is it something I should raise with the medics. As I say my toilet life is pretty normal apart from it probably takes 30 seconds longer than the average man

Cheers all

Bri

User

Posted 19 Jul 2014 at 14:58

Hi Bri,

As a bloke who now has a catheter in I will answer your question before Lyn has a go........30 seconds longer than the average man.....who is this average man and who is the person going round gents toilets measuring this "average flow" secondly stop reading up on such matters....there you have been told off, you know what I'm going to say next....if you want to have a good read have a look at some of the books Mark Shands has written. What a life he led every bit an adventure, killed by a revolving door but for him and you,

Life is for living

Barry ( alias Barrington )

User

Posted 19 Jul 2014 at 15:16

Forwarned Forarmed TG, you know that. Ok maybe I should have said my flow post op is quite reduced when compared to how it was pre op. Having seen the offending bladder opening via David Attenborough's camera I can see why. They couldn't get the camera in my bladder as the opening was so small.

I'm having no other problems but do need to be aware of possible complications so I can be proactive.

Anyway you've cheered me up telling me off, you haven't done that for a while which worried me a tad

Keep kicking its axxse Barry

Bri

Edited by member 19 Jul 2014 at 15:17 | Reason: Not specified

User

Posted 22 Jul 2014 at 22:00

I had an operation to remove scar tissue from my urethra about six weeks prior to my RRP. Scar tissue in the tube, a 'stricture' was found by my surgeon when a camera was inserted to check out my bladder. Of course the camera would not go past the stricture and so the operation had to be done before the RRP so that a catheter could be inserted after that op.

The stricture op was done as a day case, in in the morning and out and home late afternoon. A bit of discomfort peeing for 24 hours but then no further problems at all. No effect on continence and after the op the flow improved a good deal. Probably on a par with having a tooth out at the dentists but of course a general aesthetic rather than local.

Steve

Edited by member 22 Jul 2014 at 22:01 | Reason: Not specified

User

Posted 24 Jul 2014 at 07:51

Hi Bri

My take on it would be if it's not getting any worse leave it alone, if you can cope with it that is. As regards Si post on lasers this link may shed some light on it, pardon the pun.

www.youtube.com/watch?v=-B_wJpGhQ5Y

All the best

Roy

Edited by member 24 Jul 2014 at 07:52 | Reason: Not specified

User

Posted 01 Aug 2014 at 20:33

Chris, I self catherise twice a day and probably will continue to do so for ever now as I do not manage to empty my bladder sufficiently retaining between 250 and 400 mls. There is a risk of UTIs from self catherising but equally it stops residue building up in the bladder which can be a place for infection too.

So what does it entail? Without giving you all the details it requires you to insert a catheter, a thin tube, up your penis, past your squinter muscle which can be slightly painful and then into your bladder. At that point the urine is removed easily. When this has stopped you simply draw out the catheter and discard. As long as you do not tense, it sounds a lot worse than it is. You have to be careful with hygiene, I wash my hands three to four times during the process as well as use the hand gels. You only use the catheter once so each catheter is sterile.

I hope that helps. I can tell you more if you need more detail. It's ok and does empty your bladder. The thought is much worse than the reality.

User

Posted 01 Aug 2014 at 22:29

I'm doing about 5ml a sec. But that's measuring it myself. I've never had a flow test

Something else.... our Yorkshire Puddings haven't tasted the same for some time now :)

Bri

User

Posted 08 Nov 2014 at 22:51

Hi Chris,

I don't have the complications you describe but ISC (intermittent self catherising) for me is much more a case of mind over matter. The thought of sticking a catheter up my penis was difficult. When I realised I would have to do it four times a day I decided I just needed to overcome the psychological resistance. It now takes me five minutes in total and most of that time is washing. My key tips are:

Stay relaxed, tensing can stop the flow of the catheter.
Wash thoroughly using both hand wash and the antibacterial gel. I wash before I start, after I have got the catheter ready and afterwards. Infection is the biggest worry.
Slide the catheter in, it should be very smooth until it meets the sphincter muscle where there is a little pain, push through it, it stops quickly.
When it goes inside the bladder, you can see the urine emerge and hold steady until it stops. It's magic!
Then simply slide out in a smooth movement.
Wash agin.
Job done.
Occasionally there is some blood on removal, this disappears in a couple of uses. If it does not report it to your uro.
Occasionally the catheter does not work, I have assumed the suction motion simple fails. I just remove, leave it for a while and if my bladder is evidently still full, repeat. I think the odd faulty catheter is inevitable. I have had two or three at most.
Do not re use any catheter.

Hope this helps. It's part of my daily routine now, usually three times a day.

Happy days!

User

Posted 22 Aug 2015 at 21:15

Sorry to hear it's still not sorted Chris.

As you know I declined on the operating table. I've had two years so far and it doesn't seem to have got worse so fingers crossed.

I hope they can resolve it for you once and for all

Bri

User

Posted 22 Aug 2015 at 21:39

Sorry to hear you are having such trouble Chris, hope it gets sorted soon!

User

Posted 23 Aug 2015 at 09:26

Chris

I am really sorry to hear about this latest setback. I hope you recover quicky and find that despite the rather traumatic sounding experience, things have actually been improved.

My best to you and to D as well

User

Posted 23 Aug 2015 at 09:55

Wishing you a speedy recovery from the trauma of the op at least Chris and here's hoping the camera shows what's happening down there
All the best
Sandra

We can't control the winds - but we can adjust our sails

User

Posted 23 Aug 2015 at 21:40

Hi Chris,

Just wanted to wish you all the best and hope things improve for you soon.

Good Luck for a speedy solution.

Steve

User

Posted 26 Aug 2015 at 14:56

Really sorry to hear of your problems Chris .hope it gets better very soon . Andy

User

Posted 26 Aug 2015 at 15:22

Chris
I missed this post somehow . Crikes it sounds awful friend and very painful indeed . I just hope you get great attention and get it sorted asap
Chris

If life gives you lemons , then make lemonade

User

Posted 26 Aug 2015 at 16:25

Hope you've had your urgent appointment Chris and that the problem has been resolved.

You're really going through it my friend.

Hope life improves for you shortly

Sandra

We can't control the winds - but we can adjust our sails

Show Most Thanked Posts

User

Posted 19 Jul 2014 at 14:58

Hi Bri,

Life is for living

Barry ( alias Barrington )

User

Posted 19 Jul 2014 at 15:16

I'm having no other problems but do need to be aware of possible complications so I can be proactive.

Anyway you've cheered me up telling me off, you haven't done that for a while which worried me a tad

Keep kicking its axxse Barry

Bri

Edited by member 19 Jul 2014 at 15:17 | Reason: Not specified

User

Posted 19 Jul 2014 at 18:24

Hi Bri

Forgive me if I am wrong, but isn't it an offence to stand in a public convenience timing people with a stop watch.

Keep Smiling

Roy

User

Posted 20 Jul 2014 at 07:07

it's one of my SE's. Just seeking advice

Edited by member 20 Jul 2014 at 19:06 | Reason: Not specified

User

Posted 20 Jul 2014 at 18:45

Originally Posted by: Online Community Member

Hi Bri

Forgive me if I am wrong, but isn't it an offence to stand in a public convenience timing people with a stop watch.

Keep Smiling

Roy

Now you tell me! I guess I'll just have to find another hobby!

Lawrence

Edited by member 20 Jul 2014 at 18:46 | Reason: Not specified

"I am not young enough to know everything."

Oscar Wilde

User

Posted 22 Jul 2014 at 17:20

Brian

Just had the camera in the penis this afternoon had had the same experience as you ,could not get the camera into the bladder. I recalled your post and asked if surgery to remove scar tissue was going to cause incontinense as I am at present dry, the registrar said as it was scar tissue it "should not " have an effect on continence as it did not work like muscle and sphincter. He said he would discuss with my surgeon/consultant but suggested if nothing was done it could stop me urinating altogether . My op was 28th April 2014 had a couple of bladder scans and the bladder empties fully, had one possible water infection and one definite infection three lots of antibiotics. Flow varies,fire hose discomfort and flow slows or full flow or slow flow or sprays like a garden sprinkler. Does anyone else have any experience of scar tissue removal and it's effect.

Thanks Chris

User

Posted 22 Jul 2014 at 18:10

Chris I haven't had any infections and mine now,whilst not as strong as pre op, is usually a steady slower stream. I did google possible side effects of the bladder neck incision and they did kind of confirm what the consultant said.

Can't see he'd say it if it wasn't possible. But there is a chance without a doubt that the procedure may not effect continence. To be honest if I was having pain and UTI's I would probably opt for the procedure

Bri

User

Posted 22 Jul 2014 at 18:23

Hi Bri,

Father in law has bladder cancer and they stick the camera down his thingy every 3 months then a week later they stick a laser down there to zap them.

He has now been told that the laser struggles to get down and may need a op to make it easier, now i am not sure how big these lasers are but it makes my eyes waterhttp://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-surprised.gif

of course he get lots of sympathy from me http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-surprised.gif

Hope that helps, what was the question, no that doesn't help bugger

See you soon si

Don't deny the diagnosis; try to defy the verdict

User

Posted 22 Jul 2014 at 18:57

Cheers Si will forget the laser

Chris I'm aware that it may dwindle to nothing which does make me think. But im now 18 months post op and so far so good. Be interested to hear what your consultant says.

The other thing I didn't fancy was self cathing for so long, but was prepared to accept it

Go with their advice mate. I will speak to the urol at the next appt but think he will prob say same

Bri

User

Posted 22 Jul 2014 at 19:09

Hi Chris,

Over the years I have had 2 TURPS to remove scar tissue and they have never affected continence issues, why would they when the aim is to overcome that type of problem,. However on both occasions I had a urine infection which took some clearing. It is possibly only a coincidence but following both TURPS my PSA rose. This is of course most likely to be the effects of the infection. As a mere layman with no medical background, for me personally I would delay things as long as possible but I must emphasise that's only my take on things,

Best of luck,

Life is for living

Barry (alias Barrington )

User

Posted 22 Jul 2014 at 19:28

Bri

Got slightly confused with Feb 13 in your first post then read it again and realised you meant op was Feb 2013. We are all different but if you have been okay for 18 months makes me lean towards leaving it alone? Not sure how long the inside of the penis takes too heal but the catheter removal was painful as it got stuck. Provided I do not keep getting UTIs I can put up with the erratic flow and it is only discomfort not pain.

Si my father in law and my nieces father in law had the TB treatment for bladder cancer my father in law has been clear for over twenty years.

Thanks to you both. Chris

User

Posted 22 Jul 2014 at 20:16

Barry

Think the turps scar tissue and bladder neck scar tissue are different things. Please correct if I am wrong but, I guess your scar tissue is within the prostate were as Brian and myself no longer have a prostate and the scar tissue is were the bladder is joined back to the urether.

Thanks Chris

User

Posted 22 Jul 2014 at 21:09

That's right Chris. The TURP and bladder neck incision are two different procedures.

I would be guided by the consultant as he knows your situation. When mine said the risk of side effects outweighed what he would achieve you couldn't get me out of there fast enough.

Bri

User

Posted 22 Jul 2014 at 22:00

Steve

Edited by member 22 Jul 2014 at 22:01 | Reason: Not specified

User

Posted 23 Jul 2014 at 06:33

Chris and I have a bladder neck stenosis as a result of our ops. It's a build up of 'scar tissue ' where the urethra joins the bladder. This means the bladder neck opening is reduced in size. The procedure is different to a stricture in the urethra

I believe the risk of Incontince is increased due to the location ie near the sphincter etc

Bri

User

Posted 23 Jul 2014 at 19:26

Bri

Quite strange today the flow has been much better and longer between visits to the loo,wonder if the camera moved some thing. Today was continuos flow then stop, no squirts no slow dribble. Seeing nurse led clinic next week 12 weeks post op and phone consultation with Incontinence nurse in couple of weeks. I suppose one slight concern is, do they make smaller cameras if we need to look inside the bladder. Will keep you informed.

Thanks Chris

User

Posted 23 Jul 2014 at 22:33

I think if they needed to look in the bladder they would have to do the procedure Chris. That along with if I ever needed a cathetar is something that has crossed my mind, fingers crossed I/we never will

Bri

User

Posted 24 Jul 2014 at 07:51

Hi Bri

My take on it would be if it's not getting any worse leave it alone, if you can cope with it that is. As regards Si post on lasers this link may shed some light on it, pardon the pun.

www.youtube.com/watch?v=-B_wJpGhQ5Y

All the best

Roy

Edited by member 24 Jul 2014 at 07:52 | Reason: Not specified

User

Posted 01 Aug 2014 at 20:24

Had my 3 month post op review on Wednesday PSA undetectable, also did a flow rate test 3.7 ml/ s for main flow, average including squirts to finish 2.5ml / sec. Nurse rang today, surgeon is proposing dilation followed by self catheter for a period , when I queried if the period could be six months she said possibly. Also possibly it could restart the incontinence

Brian have you had the measuring jug and stop watch out to know what your flow is ? Good old google suggests a flow rate of 10ml/sec On the advice of previous posts I have avoided timing men in toilets.

Bladder scan showed 33 ml left in bladder, but I have had no recurrence of infections so far. Looked at the link to green light laser treatment , sounds like an option.

What does self catheter actually involve ?

Thanks Chris

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