T2 diagnosis for husband, how to choose option?

Hi,

That is so cool that your husband's surgeon is O'Donnell! We have been pen pals since 1998 and he has helped me through the development of this website.

I'm pretty sure they aren't doing the Da Vinci robot technique ( blcwebcafe.org/roboticsurgery.asp ) for bladder removal at U of Iowa (yet), no laparoscopic, both are still very experimental though laparoscopic has more longer term data on it just coming in from trials in Europe (if anyone wants some more info there's an online article about laparscopic cystectomy that is reviewing the latest European retrospective 10 yr results on Medscape:
www.medscape.com/viewarticle/559497_1 ). The benefits of these techniques are less blood loss and shorter hospital stays but the time on the O.R. table is the same, about 7 hrs depending on surgeon's experience. (sorry to be contrary Pat, please forgive me).

What O'Donnell said about patient satisfaction post-op, weird but true, the studies done show that everyone is equally happy with their choice of diversion (though sometimes there is not a choice once the surgeon gets in there and looks around), whether it's neobladder, continent reservoir or ostomy. The assumption is that patients are well prepared on what to expect from things, thus all are equally satisfied.
All three types of diversions have their good sides and potential problems but just about all of those treatable and survivable.

Wishing you and your husband well,
Wendy

IMH......and all those other numbers i can't remember...
Why was your husband on Mandelamine? I've never had a kidney infection and i'm 4 l/2 yrs with an Indiana Pouch. Thats kind of an extreme..i've not heard of anyone prescribing something to kill bacteria in the urine these days.
Also the surgery by really experienced surgeons is down to between 5 to 7 l/2 hrs with conventional surgery.....laproscopic or DaVinci its around 4 hrs. And they also kick you out of the hospital much faster...once those bowels are moving so are you!!
Pat

Stephany,

My husband had his bladder and urethra removed in July 1995 and he was back to work (3 days a week) 6 weeks after surgery. He had an Indiana pouch. It worked very nicely and he did not have any problems with it for the 11 years he had it.

He took a medication called Mandelamine twice a day to prevent urinary tract infections.

He also worked out a whole system for carrying catheters to work (and when he was out and about) and I would be happy to share it with you when you need that sort of Practical info. Right now, it is all a lot to digest and process. You also need to find a source for his catheters (my husband's ins covered them). Again, I would be happy to share what I learned over the years.

Basically, my husband had an 11 hour surgery and was in hospital for about two weeks, 3 days in ICU. He started on ice chips then clear fluids and worked up to food. This was not a problem. He had several stents and tubes for about a week and then started to catheterize the new bladder through a stoma, a dime-sized hole on the right side of his abdomen. He had two surgeons -- one removed the bladder and one made the Indiana pouch. They worked as a team and had done this surgery many times before. After he came home, an ostomy nurse came to our house a few times and helped him irrigate the pouch and generally learn to use it. This was very helpful to have this nurse. He covered the stoma with a band-aid at all times.

It is a pretty overwhelming thing to face, but my husband was a real trooper.

I would make sure the surgeon has performed this operation before. My husband's Indiana pouch was made by a doctor who trained at Memorial Sloan Kettering.

From what I know, if it were me, I would want an Indiana pouch over an external bag.

I hope this helps.

So many great replies....I'm very grateful. And for the smiles, too. I actually have been promising myself a new haircut as soon as I lose those next five pounds.

We are going to ask the doc about the stricture and the "tummy tuck", etc. And I hope he likes email. That works so well for me.

Stephany

Dear Stephany,
    Do ask your husband's urologist about his stricture. Self catheterization has been presented to me as one of the options to keep my stricture open. Of course you can't go into a stricture with a catheter, but once it's open, regular cathetrization may be just the ticket to keep it open. Depends where it is and how long it is, and perhaps other factors that I don't know since I'm not a urologist.
    -Warren
      TaG3 CIS 12/2000

thats a male perspective.....how do you explain Queen Elizabeth and Camilla?