Scar Tissue

teacuplady

My husband had prostate cancer about 12 years ago. Shortly after his treatment, he was unable to urinate. His urologist did a procedure which moved some scar tissue and he was able to urinate fine until about two years ago. It happened again, and his doctor tried again to move the scar tissue. This time it didn't work so my husband has to self cath. After a year and a half, he was able to urinate himself fine for six months. In May he had a UTI and now he is having problems urinating again. Has anyone else had this problem? Is there any procedure that can fix the problem? Any words of wisdom will be appreciated. We never had a very good understanding of this condition.

Old-timer

I'm not sure I have any words of wisdom, but I will talk anyway. What treatment did your husband have about 12 years ago? What is a UTI? Are you certain he had prostate cancer, or was it an enlarged prostate? Based on what you say and what I understand from what you say, I think the latter may be the case. The reason I ask is that men who have prostate cancer and have the prostate removed more commonly have trouble controling urination. In other words, many of us must deal with incontinence. I don't remember hearing anybody say they were unable to urinate after having the prostate removed.

You mention that the doctor "moved" the scar tissue. My understanding--which may be wrong--is that the doctor "cuts" the scar tissue out (or off). I am facing the scar tissue problem now for the first time. I had RP surgery 20 years ago and radiation 7 years ago. The scar tissue issue has just now surfaced. A few days ago, my doctor says we need to do something to take care of it. I don't yet understand what that something is.

Hope this info is useful to you and your husband.

Swingshiftworker

Radiation & TURP
Correct me if I'm wrong, but I'm assuming that your husband had some form of external beam radiation treatment 12 yrs ago which damaged part of the urethra passing thru the prostate resulting in his difficulty urinating and was treated w/a TURP ("transurethral resection of the prostate" which is commonly referred to as a "roto-rooter" procedure) designed to clear the urethra of scar & other tissue blockage.

TURP is obviously not indicated for post surgical PCa patients since their prostate has been removed and since they most often experience problems of incontinence related to the loss of the external urinary sphincter muscle located below the prostate (which is removed w/the prostate) and/or damage to the interior urinary sphincter muscle located at the bottom of the bladder and start of the urethra above the prostate. If all control of urinary function following surgery is lost, the implantation of an AUS (artificial urinary sphincter) is the common -- albeit extreme -- solution.

Damage to the urethra, rectum & bladder was a common side effect of earlier radiation treatments which could not be controlled well enough to avoid such damage. Current radiation treatments -- most notably CyberKnife (a form of SBRT) and/or proton beam therapy -- are much more precise and have almost entirely eliminated such damage.

Your husband may be suffering a recurrance of his earlier problem (the regrowth of scar tissue blocking his urethra) & might need another TURP. Your husband's urologist would be the best person to consult about this.

Best wishes & good luck!

teacuplady

Scar Tissue
Sorry if I was unclear about my husband's problems. Yes, he did have prostate cancer 12 years ago. The treatment was high dose radiation with needles in the prostate once and then 30 out patient radiation treatments. His prostate was not removed. He had difficulty urinating and had to have a catheter put in for a week. Then his doctor did a procedure where he either pushed back or removed some scar tissue. I believe he told us that he didn't want to remove it all as he didn't want an incontinence problem. Everything was fine for 10 years. Then 2 years ago, he couldn't urinate and I had to take him to the emergency room. The doctor again did the same procedure but it didn't work. The doctor gave him 3 choices: wear a catheter (one that fits on his leg), have a tube in his stomach, or to self catherize, which he chose. After about a year and half he was able to urinate by himself again fine. Then several weeks ago he had a UTI (urinary tract infection) and couldn't urinate again. Hope this clarifies the problem.

Old-timer

teacuplady said:

Scar Tissue
Sorry if I was unclear about my husband's problems. Yes, he did have prostate cancer 12 years ago. The treatment was high dose radiation with needles in the prostate once and then 30 out patient radiation treatments. His prostate was not removed. He had difficulty urinating and had to have a catheter put in for a week. Then his doctor did a procedure where he either pushed back or removed some scar tissue. I believe he told us that he didn't want to remove it all as he didn't want an incontinence problem. Everything was fine for 10 years. Then 2 years ago, he couldn't urinate and I had to take him to the emergency room. The doctor again did the same procedure but it didn't work. The doctor gave him 3 choices: wear a catheter (one that fits on his leg), have a tube in his stomach, or to self catherize, which he chose. After about a year and half he was able to urinate by himself again fine. Then several weeks ago he had a UTI (urinary tract infection) and couldn't urinate again. Hope this clarifies the problem.

I now understand
After reading your new message and the one from swingshiftworker, I have a better understanding about your husband's situation. It is very different from what I have experienced during my 20 year history of dealing with prostate cancer. Consequently, I feel that I have no knowledge that would be useful to you.

I extend best wishes to you and your husband. Keep your hopes high and continue to search for answers.

scarred_urethra

Swingshiftworker said:

Radiation & TURP
Correct me if I'm wrong, but I'm assuming that your husband had some form of external beam radiation treatment 12 yrs ago which damaged part of the urethra passing thru the prostate resulting in his difficulty urinating and was treated w/a TURP ("transurethral resection of the prostate" which is commonly referred to as a "roto-rooter" procedure) designed to clear the urethra of scar & other tissue blockage.

TURP is obviously not indicated for post surgical PCa patients since their prostate has been removed and since they most often experience problems of incontinence related to the loss of the external urinary sphincter muscle located below the prostate (which is removed w/the prostate) and/or damage to the interior urinary sphincter muscle located at the bottom of the bladder and start of the urethra above the prostate. If all control of urinary function following surgery is lost, the implantation of an AUS (artificial urinary sphincter) is the common -- albeit extreme -- solution.

Damage to the urethra, rectum & bladder was a common side effect of earlier radiation treatments which could not be controlled well enough to avoid such damage. Current radiation treatments -- most notably CyberKnife (a form of SBRT) and/or proton beam therapy -- are much more precise and have almost entirely eliminated such damage.

Your husband may be suffering a recurrance of his earlier problem (the regrowth of scar tissue blocking his urethra) & might need another TURP. Your husband's urologist would be the best person to consult about this.

Best wishes & good luck!

Scar Tissue in urethra from radiation cancer treatment
Patient:
My father (80+ yr old male)

Problem:
'Re-occurring' Scar Tissue in urethra
from radiation treatments (~10 yrs ago) of prostate cancer...
both 'External Beam Radiation' treatment &
and 'Prostate Brachytherapy'/(‘radioactive seed implantation’).
[These treatments were being 'pushed' by Urologists in North East TN.]

The scarring constricting his urine flow &
he started having significant difficulty urinating
(emptying his bladder completely)
and in Jan 2010, was treated w/a TURP
("transurethral resection of the prostate" a.k.a "roto-rooter" procedure)
designed to clear the urethra of scar & other tissue blockage.

A 20-22 French Foley Catheter w/ a 5-10cc balloon was then inserted &
indwelled for ~ only 2 wks.
After this catheter was removed; enough scar tissue grew back
which warranted another TURP procedure in less than 6 months.
A 22 French Foley Catheter w/ a 5 cc balloon was then again inserted &
indwelled for over 4 wks.
It is changed-out every ~2-4 wks for hygiene reseasons only.
otherwise it stays indwelling,
which causes frequent discomfort, leakage, & reoccurring UTI's.

Because of the Scar tissue keeps growing back & constricting his urine flow;
he supposedly was not a potential candidate for
the 'Self-Cath' option (vs. the indwelling 'Foley Cath').

Question:
Are there any surgical (or other?) treatments to...
A) Remove Scar Tissue from urethra?
Prevent it from growing back?

I heard there might be special surgical instruments/methods/drugs used
to inhibit scar regrowth...
I also heard that Urologists in Greenville, SC might be performing these procedured.

We would appreciate any useful feedback.

Thanx.

scarred_urethra

teacuplady said:

Scar Tissue
Sorry if I was unclear about my husband's problems. Yes, he did have prostate cancer 12 years ago. The treatment was high dose radiation with needles in the prostate once and then 30 out patient radiation treatments. His prostate was not removed. He had difficulty urinating and had to have a catheter put in for a week. Then his doctor did a procedure where he either pushed back or removed some scar tissue. I believe he told us that he didn't want to remove it all as he didn't want an incontinence problem. Everything was fine for 10 years. Then 2 years ago, he couldn't urinate and I had to take him to the emergency room. The doctor again did the same procedure but it didn't work. The doctor gave him 3 choices: wear a catheter (one that fits on his leg), have a tube in his stomach, or to self catherize, which he chose. After about a year and half he was able to urinate by himself again fine. Then several weeks ago he had a UTI (urinary tract infection) and couldn't urinate again. Hope this clarifies the problem.

Scar Tissue in urethra from radiation cancer treatment
Dear 'teacuplady':

Was your husband 'irradiated' by any doctors in North-Eastern Tennessee?

We are now finding-out that MANY prostate cancer patients in our area
who were treated here w/ 'External Beam Radiation' treatment &/or
and 'Prostate Brachytherapy'/(‘radioactive seed implantation’);
have had similar (if not exactly the same) problems/side-effects.

[These treatments were being 'pushed' by Urologists in North East TN ~ 10 yrs ago.]

Your response would be appreciated.

Thanx.

nowrest

Foley
I had Bracky in 2005 and got all the symptoms your husband experienced. Finally wound up with a Foley catheted in-dwelling through a stomah that connects to the bladder. I wear a leg bag. Not the best solution in the world but no more UTI.s from self cath.

e023813

teacuplady said:

Scar Tissue
Sorry if I was unclear about my husband's problems. Yes, he did have prostate cancer 12 years ago. The treatment was high dose radiation with needles in the prostate once and then 30 out patient radiation treatments. His prostate was not removed. He had difficulty urinating and had to have a catheter put in for a week. Then his doctor did a procedure where he either pushed back or removed some scar tissue. I believe he told us that he didn't want to remove it all as he didn't want an incontinence problem. Everything was fine for 10 years. Then 2 years ago, he couldn't urinate and I had to take him to the emergency room. The doctor again did the same procedure but it didn't work. The doctor gave him 3 choices: wear a catheter (one that fits on his leg), have a tube in his stomach, or to self catherize, which he chose. After about a year and half he was able to urinate by himself again fine. Then several weeks ago he had a UTI (urinary tract infection) and couldn't urinate again. Hope this clarifies the problem.

scar tissue
I had my prostate removed Feb/11/2009. I have recurring scar tissue growth. I had 3 bladder
neck incision operations to relieve the problem. After the last operation, my urologist
suggested self catheterization. I am currently using the catheter at least once a week to combat the scar tissue build up. I have found if I don't use the catheter within 8 to 10 days, scar tissue builds and I am unable to function properly. I have asked my urologist how long this will last, but I still have not received a definite answer. If there are more
people with this condition I would love to hear their story.

teacuplady

scarred_urethra said:

Scar Tissue in urethra from radiation cancer treatment
Dear 'teacuplady':

Was your husband 'irradiated' by any doctors in North-Eastern Tennessee?

We are now finding-out that MANY prostate cancer patients in our area
who were treated here w/ 'External Beam Radiation' treatment &/or
and 'Prostate Brachytherapy'/(‘radioactive seed implantation’);
have had similar (if not exactly the same) problems/side-effects.

[These treatments were being 'pushed' by Urologists in North East TN ~ 10 yrs ago.]

Your response would be appreciated.

Thanx.

Scar Tissue
My husband had his treatment in New Jersey. It sounds as if that was the preferred treatment here too.