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17 mons cathing after brachytherapy

jwag63
Posts: 5
Joined: Jul 2011

I have been unable to void my bladder and had 12 UTI's in the past 17 mons. My doc now suggests a turp . I haven't seen one success story of a turp after brachythearpy. Also the ams option has its controversy as the next step if incontinence comes to stay. Does anyone have a comment or advice . Hoping for a viable solution!

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Jwag,

The urinary distress you describe associated with brachytherapy is fairly rare (it only occurs in about 5% of cases) but when it happens to you it's certainly 100%. Because of the seed placement inside your prostate there is sometimes difficulty in performing a TURP but an experienced urological surgeon ought to be able to perform it without difficulty.

I would seek additional opinions from different doctors on your condition and try to figure out exactly what is causing your inability to void properly. If I were in your shoes, I wouldn't let them do anything until they can adequately explain what is causing the problem. Was it a misplaced or wandering seed that ended up burning the urethra or one of the sphincters at either end of the prostate or is it an enlarged prostate pressing against the urethra or something entirely different. A TURP would help if there was a very enlarged prostate that was pressing against the urethra but would likely only complicate things if the condition was caused by a radiation burn.

Good luck to you. I hope you find relief soon.

K

rch
Posts: 79
Joined: Nov 2011

Jwag
Sorry to hear about your urinary distress s/p Brachy.It's extremely rare, but does happen. It would help if you would give us a bit more history. Have you had multiple catheterizations over the past 17 months? Sometimes it's hard to discern whether the urinary symptoms are the cause or the result of the UTIs. I'm sure the urine has been cultured and appropriate antimicrobials have been prescribed. By now it's perhaps resistant to all oral antibiotics, and may be sensitive only to IV antibiotics. At this point I would suggest your Urologist get an Infectious Disease Consult to weigh in on this. I suspect there is a resistant strain harboring the irradiated prostate or in the viscinity feeding into the urinary tract. That would need to to be ruled out before contemplating on any invasive work up.

guards
Posts: 72
Joined: Aug 2010

Been there done that. IMHO if you can avoid the turp do so it is almost sure route to incontinance for a brachy survivor. Have you tried self cath? Don't sound like fun but was much better than the incontinance that followed after turp. I now have an Aus 800 that is in failure so I don't know whats next yet. I wish I had been put on self cath sooner ,but it sounded terrible and really wasn't that bad. It was much preferred to the results I have gotten since. according to my latest uro turp n brachy are not a good combo. Good luck and hope you have better results than I have had.

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