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  • QUESTION ABOUT PROSTATE SURGERY

    Posted by dukel on February 26, 2010 at 9:37 pm

    Question for Mike & Pat and others.
    A 66 year old friend of mine had his prostate removed at vet.
    hospital in Portland, Oregon a little less then two years ago.
    Ever since then he has had no bladder control. If he is trying
    to urinate he can start and stop his flow. But if he is doing anything else he has no control, does not even know he is
    urinating until there is wetness. The people at vet. hospital
    are telling him they may be able to do another surgery to fix this problem. I don’t know, I thought once it was done this
    poorly it couldn’t be corrected.
    I know this is a little off this sites topic, but also know how
    knowledgeable Mike and Pat and others are here.
    Does anyone think another surgery would help?
    I don’t believe he has the means to go to other Doctors.
    Would an external catheter be a better option then diapers?
    Any help would be appreciated.
    Thanks, Duke

    dukel replied 14 years, 11 months ago 3 Members · 5 Replies
  • 5 Replies
  • dukel's avatar

    dukel

    Member
    February 27, 2010 at 10:20 pm

    Pat, thanks for your help! I will pass it on.
    I know you are going through some rough times yourself and i am wishing you the very best.
    Thanks, Duke

  • 's avatar

    Guest
    February 27, 2010 at 3:57 am

    Duke..there’s a good doctor at OHSU (Oregon Health and Science)..Dr. Michael Conlin who has seen about everything. Being in Portland he might go over to the VA..i suppose its worth an inquiry.
    http://www.ohsu.edu/xd/health/services/providers/conlinm.cfm
    Pat

  • dukel's avatar

    dukel

    Member
    February 27, 2010 at 1:09 am

    Mike; can’t thank you enough. You are THE MAN. Will pass info
    along.
    Thanks, Duke

  • mmc's avatar

    mmc

    Member
    February 26, 2010 at 10:37 pm

    In the meantime (UNLESS he is supposed to do kegels and just isn’t) using a condom catheter with a leg bag would certainly be an option. The important thing when doing this is to trim the leg bag hose to the proper length. Unless he is a tall guy there may be excess tubing and that can show through the trousers in the crotch and thigh areas.

    Mike


    Age 54
    10/31/06 dx CIS (TisG3) non-invasive (at 47)
    9/19/08 TURB/TUIP dx Invasive T2G3
    10/8/08 RC neobladder(at 49)
    2/15/13 T4G3N3M1 distant metastases(at 53)
    9/2013 finished chemo -cancer free again
    1/2014 ct scan results….distant mets
    2/2014 ct result…spread to liver, kidneys, and lymph system

    My opinions are my own and do not reflect the opinion of ABLCS or anyone else. I am not a doctor nor do I play one on TV.
  • mmc's avatar

    mmc

    Member
    February 26, 2010 at 10:01 pm

    I looked at this once before for someone.

    Here is a link.

    http://www.upmccancercenters.com/cancer/prostate/incontinence.html

    As you will see in the article, going to a SPECIALIZED facility with HIGHLY EXPERIENCED surgeons is one of the key differentiators when it comes to successful outcomes. Gee, sound familiar to anyone????

    Total incontinence after prostatectomy is pretty high when done by less experienced surgeons.

    Long-term incontinence
    If incontinence persists for more than 18 months, your doctor may suggest one of the following treatments:

    •When incomplete closing of the urinary sphincter causes persistent stress incontinence, a series of collagen injections may be given to narrow the bladder neck and reduce leakage.

    •Men with overflow incontinence can help prevent too much urine from collecting by learning to insert a catheter periodically to drain their bladder. A condom catheter placed over the end of the penis drains leaking urine into a bag that is worn under the man’s clothing.

    •A stricture (narrowing) of the urethra caused by scar tissue can block the flow of urine and result in overflow incontinence. Strictures can be treated by incising the scar tissue surgically or by dilating (stretching) the urethra.

    •In severe and persistent cases of incontinence, an artificial sphincter may be implanted surgically.

    I don’t know about the success rate for artificial sphincters. I am sure that one of the key factors there is experience of the surgeon as well. I do know that excellent surgeons do surgery at vet hospitals in addition to their teaching hospital surgeries. So checking out top doctors is important.

    Pat is the master of finding the right surgeons so maybe she has some pointers for how to find them for urinary sphincter surgery.

    It sure doesn’t sound like it could get much worse so it might be worth at least getting the surgery. If it doesn’t work, then he can go to condom catheters with a leg bag.

    As you can see in the quote above from the article, what they do depends on the reason for the incontinence.

    Do you know if he did kegels after the surgery to gain continence?

    Mike


    Age 54
    10/31/06 dx CIS (TisG3) non-invasive (at 47)
    9/19/08 TURB/TUIP dx Invasive T2G3
    10/8/08 RC neobladder(at 49)
    2/15/13 T4G3N3M1 distant metastases(at 53)
    9/2013 finished chemo -cancer free again
    1/2014 ct scan results….distant mets
    2/2014 ct result…spread to liver, kidneys, and lymph system

    My opinions are my own and do not reflect the opinion of ABLCS or anyone else. I am not a doctor nor do I play one on TV.

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