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Supra-Pubic Catheter

WHW's picture
WHW
Posts: 189
Joined: Jul 2009

Since of many of you do not participate in other forums, I thought I would start a new discussion here that I started today on another site. This is the first post I made to begin the discussion. I will post a second that answers questions arising from the original discussion.

As always I am looking forward to an open, honest and constructive dialog that may be of help to me and others that come here looking for answers.

My surgery is scheduled for the 17th and I glean every bit of information and experience I can from all of your posts in preparation.

So here is the new subject: Supra-Pubic Catheter

My Dr. uses the Foley for the day of surgery and the one night hospital stay only. The following day before being released it is replaced with a Supra-Pubic which is removed 1 week from the surgery date. They made this change about four years ago after hundreds of follow-ups with patients who described the Foley as one of the worst parts of the surgery process.

From the posts I have seen here and other forums, the Foley seems to be a constant source of irritation and aggravation (pun intended).

Has anyone personally experienced the Supra-Pubic? I have researched it and found discussions from others that are using it for situations where they must wear one for extended (months-years) periods and they all extol it's virtues. They talk about wearing it under their jeans and suits and so on, with no issues.

If it avoids the aggravation so well I just can't figure why more surgeons aren't using it for Prostate Surgery.

Chime in and let's discuss it. Maybe for a few minutes we can forget about PC and think about something else.

Sonny

60 years old
PSA November 2007 3.0
PSA May 2009 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
<5%, 90%, 40%
Gleason Score (3+4) 7 in all positive cores
CT Organ Scan - negative
Nuclear Bone Scan - Negative

Surgery set for September 17th, 2009 with Dr. Mani Menon at the Henry Ford Medical Center in Detroit.

WHW's picture
WHW
Posts: 189
Joined: Jul 2009

Here is the second post that addressed questions about the Supra-Pubic Catheter.

All of you guys have a lot more experience dealing with this issue than I do, no doubt. Each of you have raised some very good points. So in the interest of being complete with my input, I called Dr. Menon's office and asked the questions.

They started doing the Supra about 2 years ago, not 4 as I thought.

Initially their goal was to relieve the source of aggravation that their patients had expressed in having to deal with the Foley. To these patients the discomfort was real and the feedback seemed to be at the top of the list when conducting the follow-ups they do for the next 5-10 years.

The Foley and the Supra are both put in at the time of surgery. Thank God this is done while my butt is knocked unconscious.

They found that removing the Foley before you leave the hospital got rid of the aggravation. Additionally, the surgical techniques they have developed for reconnecting to the bladder neck (their effort to reduce the incontinence issue) showed evidence of a better and more complete healing, in a shorter period of time.

Lastly, they told me I would actually have three tubes when I woke from surgery.

The third tube is also their effort to reduce discomfort. It is connected to a pain pump device that administers pain medication during the week following surgery before the cath is removed and you are cleared to go home. The device is called the On Q. I have personal experience with this device. My baseball playing, college senior son, had arthroscopies on both knees this summer and the device was installed for the week following to allow him to heal without pain. I have had 5 of this type of surgery over the years and I have to tell you he was moving around and rehabbing much quicker than I ever did.

What a bunch of nice guys, don't ya think? They take the tube out of the penis to make you comfortable and then pump you with pain medication so you really don't care about the rest of it anyway.

Seems to me that their reputation of dealing with the removal, cure or whatever you want to call it, of Prostate Cancer would be enough. They sure do seem to go the extra mile to help the patient recover with as little difficulty as possible.

I am not a commercial for these folks yet. Let's wait and see how they actually do. But, I just haven't seen this kind of patient first effort on many others posts on PC forums.

I am sure that if I have all of this wrong, some of you guys will let me know. Feel free. As I see it all of our discussions are about open and honest dialog in our efforts to be supportive to the members of this "Sorry You Have to Be Here Club", anyway.

Sonny

60 years old
PSA November 2007 3.0
PSA May 2009 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
<5%, 90%, 40%
Gleason Score (3+4) 7 in all positive cores
CT Organ Scan - negative
Nuclear Bone Scan - Negative

Surgery set for September 17th, 2009 with Dr. Mani Menon at the Henry Ford Medical Center in Detroit.

novaguy
Posts: 76
Joined: Jul 2009

Sonny
Since you're having surgery by Dr Menon, I'm sure he knows what's best, and he must have good techniques and reasons for using this Supra catherer, as you indicated. I don't know anything about it, other than what I've read. I know those guys who choose HIFU use it, so you might ask those who have had that procedure.

Having said that, and since you asked for comments, my initial reaction is that the Foley catherer was a nuisance, but in no way was it enough of a nuisance for me to choose another tube coming out through an extra incision, and an extra hole put into the bladder where there wasn't one before. Furthermore, I'm not sure the nuisance issues with the Foley go away with this Supra. One of the nuisances was having to check the bag and take it to the bathroom to empty it, but you will have to do the same thing. It's worse with the Foley leg bag, because it's small and the velcro doesn't hold tight, so I had to use medical tape to wrap it around my leg. But doesn't that supra catherer also have a bag? And if it's small, you have the same issue. One thing you may not have is the strange feeling of the tube tugging every now and then at the penis, but that wasn't very painful, it was more of a strange sensation especially if urine and air backed up a little bit. I'm not sure if the Supra has that same sensation or not but, again, it wasn't bad enough for me to choose another hole in my body.

Not trying to talk you out of anything, as I said, Dr Menon is one of the best out there. Just a little surprised that he's using this other technique but I suppose he knows best. Maybe others here will have a different opinion and different experiences with their Foley.

lewvino's picture
lewvino
Posts: 1010
Joined: May 2009

Sonny,
As I've mentioned to you I had the cath for 12 days. It was not as bad as I thought it would be but of course was happy to be rid of it. I'm not in the medical field but the one advantage I can think of for a foley cath is that it is keeping the opening from the bladder to the penis open to allow time for those incisions to heal and keeping the stiches dry.
I'm curious with the subra pubic cath if you will have urine coming out both ways or if the subra pubic cath will drain it all.

Larry

NM
Posts: 214
Joined: Jul 2009

I have no knowledge of this type of catheter but will add 1 thing, if you trust your doctor I say trust him all the way. I have only heard good about your doctor of choice. Sonny your support here has helped many myself included so I am praying for you both presurgery(anxiety) and will be doing the same post. Again if you trust your doctor put it in his hands and worry about what you can .....wishing you a successful surgery and recovery ...Nick

novaguy
Posts: 76
Joined: Jul 2009

Nick, I have to agree with you. Sonny, I may have been too negative in my comments, and was thinking about my situation more so than yours. The fact is that you have, arguably, the best prostate surgeon in the country. Everything else, including the type of catherer, is secondary, and I'm sure Menon is on top of the latest in everything involving RRP.

Before I had my surgery I entertained some doubts about my choices of surgeon, hospital, technique, etc etc, but then decided that I had made a choice and was going to live with the choices I had made. After the surgery I was glad that I had made those choices, even if the way my doctor did things were a little different than others.

If I had Dr Menon I would just follow his instructions, put everything else out of my mind, and watch James Bond movies. Best of luck, and my prayers are with you for a successful surgery.

dopplerjockey's picture
dopplerjockey
Posts: 39
Joined: Jul 2009

Sonny,
I was aware of Dr. Menon's history and experience with robotic PC surgery, as I had tried to do my homework pre-operatively. I mentioned to the urologist in Idaho that did my surgery about the Supra-pubic catheter that Dr. Menon touts. My surgeon was at a conference where Dr. Menon had presented some data on his surgery results, and asked Dr. Menon personally about the results of the supra-pubic catheter. According to my Idaho surgeon, Dr. Menon did not feel that it made a significant difference in outcomes. But, interesting enough, the Idaho surgeon later told me that he might look into it further to see whether his surgical outcomes might be different utilizing the technique. Not sure all of this helps you much, but gives you another perspective.
Good Luck Sonny,
Dallas

WHW's picture
WHW
Posts: 189
Joined: Jul 2009

Thanks guys for all of the positive support, prayers and blessings. Surgery is officially one week from today and I feel as ready as I will ever be. Dang, I am so tired out from the countless Kegels throughout the day, everyday, in preparation.

I am not really giving much thought to it right now. I am way to busy trying to finish all the "honey do's" and "Job Jars" before I leave. I sure don't want my wife to be worrying about anything while I am gone. As you know from my previous posts, the Dr. won't allow her to go with me because of the airplane bugs. Her system just can't take another hit right now or ever for that matter.

Reading through the posts, you guys have to know that all I ever look for is open and honest dialog. Nothing is ever viewed as negative by me. Like my own posts, they are always only someone's opinion, research and experiences. We all have to remember that like I and all of you, we came to be members of the "Crappy Club - You Don't Want to Be A Member Of", through no fault of our own. We came to this site in search of answers, questions, knowledge and support.

As I see it something is to be learned in one way or another from every post I read or write. No one size fits all in this arena.

So keep the posts a flyin. Somebody will read something along the way and use it or pass it along and we will never know whose life we touched, made better or saved because of something we wrote.

Thanks guys,
Sonny

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