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Catheter removed

Charlie5168
Posts: 17
Joined: Mar 2013

I had robotics surgery for PC 2 weeks ago with catheter removed yesterday. I can urinate but encountered some sore/pain on my penis (when urinate). I would really appreciate if anyone can tell me whether it is normal (due to weaker muscle?) and when it will be back to normal?

Thanks

VascodaGama's picture
VascodaGama
Posts: 1531
Joined: Nov 2010

Charlie

Pain is expected to occur but not persistent. In some cases, scars may be caused at the bladder sphincter or urethra when removing the catheter, particularly in those that kept the catheter inserted for long periods. In any case, the causing effect can be treated with anti-iinflamatory pills and it should be short till one starts feeling good. In worse cases, damage to the sphintcter occur and one may experience incontinence, however, the pain has nothing to do with it.

Just give time a chance for complete healing. I hope that after that you can report here the success of the surgery.

Best wishes for successful recovery.

VG

Charlie5168
Posts: 17
Joined: Mar 2013

Thanks VG for your valuable inputs. They are very helpful. Not sure whether energy level will drop after RP as I am more tired than before. I thought RP itself with small cuts and minimum blood loss shall have minimum affect to my body but not sure whether it could be caused by losing my prostate,

In addition, I have more pressure to urinate (cannot hold as much urine). for instance, before surgery, I don't need to urinate after sleep. Now I'll need to get up a couple times. Not sure it will improve over time after urethra muscle gets enhanced.

Thanks again for any advice

Charlie

janei1
Posts: 18
Joined: Dec 2008

My hubby s 4 weeks post opt and doing great. Had davinci and catheter removed afterb7 days. Urine was all over the place in the beginning but now he has really good control and only using 2 pads a day. Be patient as it is early days and it will get better. Good luck 

Charlie5168
Posts: 17
Joined: Mar 2013

Thanks Jane for your encouragement. Glad to hear that your husband is getting a lot better now. Is it OK for your husband to drive now? I am thinking to wait for a week and decide whether I should start driving. In addition, do you know what is the average recovery time before going back to work?

Charlie

janei1
Posts: 18
Joined: Dec 2008

Not the best idea but he is a man and he is stubborn lol. He drove to his follow up on day 7 and it was a 70 mile round trip and he did well. I don't know the recovery time form work because we are retired but I think my hubby would be back to work at about 3 weeks if we were not .  You will be amazed at how quick this will turn around. My hubby was like his old self really quick.  I know it is hard to be patient , I had two knee replacement 2 years ago and boy droid I need patience. Just keenypur r spirits up, try to walk. Good luck. 

Charlie5168
Posts: 17
Joined: Mar 2013

Thanks a lot Jane for all info. It really helps.

randazzo
Posts: 6
Joined: Mar 2013

New to this forum; so just jumping in.  I had Robotic Surgery at the University of Michigan on 2/18/13. Surgery went well according to my Surgeon.  Pathology came back good; cancer was confined to the prostate, negative margins and the lymph nodes showed no cancer.  There was a significant amount of cancer, as indicated by the biopsy where 6 or the 12 biopsy cores came back positive.  So now on the mend, Monday will be 5 weeks.  The worst for me initially was the catheter, that was very uncomfortable, I was very glad to get that out.  Urinary control is getting better, I leak a little, and have small surges if I move a certain way, stand up, sit down; I normally use 1 pad a day, sometimes 2.  My Surgeon said the nerves were not damaged at all, he said I have a head start toward a complete recovery (Urinary Continence and Sexual Function).  One issue I have is when I urinate, I feel a quick stabbing pain about where the prostate was; not sure what this is and if it gets better; but its annoying.  The surgical site is still somewhat tender.   I'm taking 50mg of Viagara every other day as that is suppose to increase blood flow and support faster healing; they have me using a "Prelude" and an Erection Pump..( for 6 months)..all to promote blood flow and support the healing process.. so far, no natural erections happening.  I'm 56 years old, with no other health issues, so I'm hoping for some speedy results.. At least for me, this hasn't been an easy recovery since the surgery, I'm scheduled to return to work in another week; this will put me at 6 weeks.  I would welcome any comments.. good to have people to talk to who have been here or are here.  Thanks.

VascodaGama's picture
VascodaGama
Posts: 1531
Joined: Nov 2010

 

Randazzo

Welcome to the board. Your post serves as a guide to solve the biggest scare with surgeries; Incontinence and ED. You lay it well with the complete specifics such as phases, methods, techniques and tools. Behind that it will be an experienced surgeon and team.

The issue regarding the feel of stabbing pain when urinating may be the tinny muscles of the bladder sphincter at work. I would be more careful and not use so frequently the pump. This is the tool used to get the penis length back to normal size but it causes some “pulling” at the re-attached “V-neck shaped” of the sphincter . Do not be in a hurry to get it "sized" so fast. Let the sphincter heal properly first.

I wonder about your diagnoses before surgery. What were the Gleason score and the PSA chronology?

How far low is  the PSA set now?

Best wishes for complete recovery and treatment success.

VGama  Laughing

randazzo
Posts: 6
Joined: Mar 2013

Thanks for the welcome, and your comments.  Just to clarify the treatments post operative: (they call it Penile Therapy; even have a department to monitor this process).  The Prelude is a rubber cylinder that uses suction to attach to the flacid penis, they want this to hang on you for approx. 8 minutes per day; this is to prevent (or reduce) penile shrinkage.  The Pump is used to achieve an erection; this is done 3-4 times per week; and both are done for 6 months.  It was explained to me that the term ( use it or lose it) is applicable in the case of erections.  Evidently erections occur several times while we are sleeping in addition to sexual activiy; so our body is use to this.. this therapy with the pump tricks our body and is a substitute for these erections occuring naturally; supposedly this will promote natural occurance of erections.  As for the other question (below) regarding the reason for using viagra.  Viagra does not cause instant erections; its  in 09/ purpose is blood flow to the pelvic area; with ED, this increase of blood flow will cause an erection when stimulation occurs.  In the case of recovery; the purpose is to get  in blood to that area of the body as that will promote healing (the surgical site, the pelvic floor, the nerve bundles etc.  My PSA was 1.1 in 08 / 1.8 in 09 / 2.0 in 10 / in 12 it was 2.6 in February, so my Doctor and I agreed to recheck in 6 months, recheck it was 3.1.  6 of 12 samples were positive and it was 3.4=7 Gleason Score.  Thanks so much for your well wishes

 

Randazzo

Charlie5168
Posts: 17
Joined: Mar 2013

"By taking 50mg of Viagara every other day to increase blood flow and support faster healing", do it mean speed up erection faster or also help to heal incontinence?

My doctor gave me 3 kinds of medications (including viagra) to try out and determine which one has no side effect. However, I am thinking not to take them unless it will also help to heal incontinence faster.

Does anyone know which adult pads/diper work out the best (should different kind be used between day and night?)? I am OK during day time as dripping is not much. However, when I sleep, it could have more after the bladder gets more full. With regular pads (like the one for women's period that I currently use), it will leak to my underwear.

I would appreciate if anyone can provide some recomendations.

Thanks

Charlie

randazzo
Posts: 6
Joined: Mar 2013

Hi Charlie; wanted to say it sounds like you're doing really good if you have minimum dripping during the day.. I'm almost at 6 weeks post op and I'm dry at night (when sleeping); I'm getting up maybe 2 times durning the night, but if I rememeber to be good and stop any liquids around 6PM; I get up maybe once.  I'm still leaking during the day, some days are better than others.  I started "Pelvic Floor Therapy"  Learning quite alot about strengthening the Pelvic Floor, and I'm doing alot of different exercises that they've given me to do, including some abdominal toning as there is actually an abdominal muscle that wraps and attaches to each side of the pelvic bone and supports the floor.. interesting stuff. It tooki about 3 weeks for that stinging at the tip of my penis to subside ( I think that was one of your questions).. that catheter really aggravates from entry on.. the catheter was the worse thing for me.. I took all the pain meds mainly because of that catheter.. healing will be gradual, but consistent.. I feel much better today than I did even 1 week ago... so be patient and rest, let your body heal.  As for pads, Depends (with wings) for Men works good.. nothing gets through, absorbs it all.. they come in a 52 pack for about $15.  Hang in there Charlie.

Charlie5168
Posts: 17
Joined: Mar 2013

Thanks a lot Randazzo for all info. They are very helpful to know.

Do you know whether drinking a lot water would still be helpful for healing or it is not necessary? As you stated, if I drink less water during day time or stop drinking earlier at night, I'll not need to get up as often after sleep which would give me better sleep.

It looks like you also had some pain on the tip of the penis and it is helpful to knww the cause (by Catheter?). I had 2 weeks on Catheter (instead 1 week for most people). Around 11 days, I started getting some pain on the tip of the penis and I tried open a little bit and saw some redness. I then applied Neosporin cream (antibiotic/pain reliever) and the pain/redness went away the next day. Have you had Catheter only for a week or longer?

Do you know whether it would be helpful to apply again now (reduce stinging on the tip of the penis)? I tried to open a little bit but didn't see any redness this time therefore I thought it should not have any infection therefore not sure why there is pain when/after urinating.

Thanks on "Depend", I just bought some and will try to use them.

Charlie

randazzo
Posts: 6
Joined: Mar 2013

Hi Charlie;

its good to drink fluids; water being the best choice.  Cranberry Juice is a good choice while you're healing up, because it will prevent a UTI; good to just sip 3-4 hours before going to bed to reduce your need to get up during the night.  i mentioned that I started Pelvic Floor Therapy; the Therapist has given me a list of things to avoid that irritate the bladder (citris drinks, soda, caffiene, spicy foods, etc); to my surprise, she was right.. When I stay away from those, my bladder calms down and I don't feel the urge to go all the time.. Today, I primarily drank water and I've had a really good day with my control, leaking etc.  Yeah, that catheter was horible for me, the tip of my Penis hurt all the time; and after the catheter was removed, it was a few weeks before the stinging went away.  Ask your Doctor to give you a Prescription for Lidocane ointment..  I would put that on before putting the antibiotic ointment on.. Lidocane numbs it.. It worked really good when the catheter was in.. I would think you could use it now until the pain subsides..  My catheter was in for 9 days.  Keep me posted Charlie.. remember, you're very early in the recovery process.. hang in there.. I can't believe how much better I'm feeling even from a week ago... Let me know how those pads work for you..

 

Randazzo

Charlie5168
Posts: 17
Joined: Mar 2013

Hi Randazzo,

Nice to hear you are getting better with some diet adjustment. Hope it will improve further after time goes on.

Glad to get your advices. They are all good.I normally don't drink coffee, soda and eat spicy food therefore it is OK there but nice to know it is not good for healing. Depend pads work out better. Since my underware is lose therefore it could still have leak (only when I take a nap in the afternoon with excessive urine in the bladder as it could get to underware instead of the pads). Sleep overnight is OK as I don't drink much after 7~8 PM. Dripping is not a problem either with the pads on.

As far as penis pain, it gets much better now. Though I am not sure it was due to the cream that I applied once or it is the time for healing. Thanks again for your advice,

Do you know what is the reasonable time (on conservative side) for recovery before going back to work (I had plan to be back 6 weeks after Catheter removed) . My boss is nice and he wanted me to get fully recovery before going back. As a result, I'll need to provide him my return plan by mid of April.

Can you see anything negative to start driving now (it's been 9 days after Catheter removed)? I think it shall be OK for short distance (10 ~ 20 miles?) but would like your opinion.

Thanks & Have a nice day

Charlie

randazzo
Posts: 6
Joined: Mar 2013

Hi Charlie;

I'm going back Monday, and that will be 6 weeks exactly from my Surgery date.  Of course, it all depends on what you do for a living for the Doctor to let you go back to work.. I sit at a desk all day and thought about going back last week; but decided to take another week to heal up more.. I would take as much time as you can; rest and let your body heal... Driving should be no problem for you now; they just don't want you to drive while taking the pain meds.. Glad the pads are working better for you..If you don't mind; I was wondering some of the specifics about you; specifically your age and the cancer specifics, also, how was your final pathology?  Hope you are having a good day Charlie.

 

Randazzo

Charlie5168
Posts: 17
Joined: Mar 2013

Hi Randazzo,

I am 60 years old. My PSA was 4 2 years ago, it went to 5.4 i year later and 6.4 before RP. Biopsys done in Jan with gleason grade 7 (3+4) but cancer only appeared on left side,

Final Pathologic report shows gleason grade 7 (3+4) which is the same as Biopsys but right side also showed cancer with gleason grade 6 (3+3). Lymph nodes were not involved. Cancer stage is T2C.

Doctor told me that survival rate should be high. Since I am not familiar with the calculation therefore hope he is right. I was thinking to do radiation first (as I heard susrvival rate is similar as RP with newer technology). However, I was concerned the possible side effect (which could happen a few years later), In addition, also heard after RP, radiation can be done but not vice versa.

I am always wondering the following:

- If I don't do either, could the cancer affect me (heard prostate cancer is slow growing but not sure on my case whether it can get me to 80 ~ 90 years old without causing any problem)?

- If I chose radiation, will my right side also be treated (not showing any cancer through Biopsys but did show on the final pathlogic)? If it doesn't, then I'll need to deal with later. If it does, any other exam will be able to identify the right side also had cancer?

Did your family doctor allow your go back to work or surgeon who did RP for you? Just wondering when time comes, whom that I should be consulted with (my family doctor did disability request for me).

Wish you are well after returning to work.

Charlie

randazzo
Posts: 6
Joined: Mar 2013

Hi Charlie;

Thanks for sharing your info. As far as survival rates; I was told if the cancer is isolated to the prostate; and pathology confirms by showing (negative margins), then the removing of the prostate removes the cancer; they take samples of the lymph nodes to confirm no traces of cancer has spread outside; if the lymph nodes are clear, it should be gone.  My Surgeon told me that I'm as cured of PC as anyone could be.  Having said that, the regular PSA tests after surgery should confirm by showing NonDetectable levels of PSA in the blood, as long as they are non-detectable, should be good.. If a test shows detectable PSA, I guess it means either cancer has returned to that area, or microscopic cancer cells are still there.. in either case they can Radiate.  My Father had a Prostectomy 20 years ago (the old fashion way, cut across the abdomen).. his PSA tests have been non-detectable ever since; he's now 82 and was told he doesn't even have to have checkups anymore regarding the cancer. Here's my take on your questions:

1. They told me PC is slow growing too. How they treat depends on the aggressivness of the cancer and the patients age.  Someone my age is still considered young, and could have a 30 year life expectancy, the cancer will grow and spread well before that; so they want you to get the cancer out' also, the younger you are, the better the likelyhood of return of natural sexual function and recovery from the incontinence side effects.  Older Men, say if I was 70, they would probably tell me to either radiate, or watch it and deal with it later.  I was told because of my age (56), I should get it out.  They considered your age and the aggressiveness (7 Gleason is Moderate Growth; good choice to get the prostate out of you); and you're only 60, sounds like you are very similar to me in this Journey.  My Doctor said if I did nothing, I probably wouldn't die in 5 years.. however, within 10 I would have a problem, he didn't need to say anything more to me.

2. When they radiate, it was explained to me that they put Markers in the Prostate where the Cancer is at, then they radiate directly to that spot.. My guess is that if the cancer was not being detected on the right side, they would have not treated it because they didn't know it was there..  I'm glad you didn't choose this option for your treatment.

3. I got Clearance through my Surgeon to return to work.  He's the one who put me out on short term disability.  In your case, you probably have to go through the Primary

On a personal level, I'll say this: I'm a Believer in Christ, I saw Gods Hands in my care from the beginning and some of the things that occured are nothing short of the miraculous, from the choice of Surgeon all the way through the surgery itself.  I'm happy to share this info if you would like me to... I give Him the credit for my outcome and my current recovery... and He used some outstanding Medical People.  Being diagnosed with Cancer hit me hard, it really shook me up.. I had so many people praying for me; and for this I am so very grateful.  Tomorrow is Easter Sunday, a very special day. Charlie I wish you and your Family a Blessed Easter.  Talk to you you soon.

 

Randazzo 

Charlie5168
Posts: 17
Joined: Mar 2013

Thanks a lot Randazzo for all the valuable information. It is much more than what I am looking for. Now I have a very good understanding of the PC with its treatment options based on different factors. I am very glad to have made the decision best for me.

I didn't do too much study after being told with PC as I was scared. the Urologist did Biopsys for me cannot do RP therefore I went to different one. Since Biopsys film was not saved, I had to do Ultrasound one more time. I heard the doctor did hundreds of RP in the past and is very good therefore I chose him without further research. I didn't do bone scan and MRI. May be it is not necessary based on Gleason grade.

I did a little bit more research recently and found out University of Michgan Hospital is top ranked on Urology which may indicate why you are so satisfied with your doctor along with the treatment. I also noticed UCSF is very good too. I didn't go for that route as I didn't know it before. Fortunately my surgery also went well but I think I should have done more study before selecting my RP Surgeon.

Thanks for sharing your dad's treatment on PC and i am glad to hear that he is doing well 20 years after his treatment. I am also very glad to hear that you are a Believer in Chris with so many people prayed for you. My wife and my daughter with church's brothers and sisters did it for me too.

Do you know when PSA check should be done? 3 months from Surgery? My doctor ask me to see him 6 weeks after Catheter removed and I think he also said 3 months for PSA test but not sure 3 months after RP or after Catheter removed.

Wish you and your family have a Blessed Easter too.

Charlie

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