AUS ISSUES - or WHY CAN'T RG PEE

[COG1]

11/19 - Husband had AUS surgery - by all accounts it went well

11/20 - Catheter removed, went home. All was well. He felt good (Maybe too good?)

11/29 - Husband 'overdid it'. He climbed a small ladder to take a broken spring off of a garage door, among other less than smart activities.

12/1 - at 3:45 am, Husband woke me up to tell me that he could not pee....at all. He had been having issues since about 4:00 the previous afternoon. It was very painful to try. I called the surgeon's emergency line. The on-call doc told us to go to the ER at the hospital where the surgery was performed (about 2 hours away from home). ER doc inserted a catheter and sent us home, with instructions to see the surgeon on Monday morning.

12/2 - Went to see surgeon. They assured us that even though they had no idea why this was happening, it was not a result of his overdoing it, unless he was 'moving funiture'. He wasn't. They forced fluid into his bladder, pulled the catheter and asked him to try to void what was put in. He did...just fine. No pain, no problem. We went home. Just after arriving home, he tried to go with no luck. He only dribbled and it was painful. I called the surgeon's office. The directed us to go to the local ER and have another catheter inserted. Next appointment on Wednesday.

12/4 - Went back to surgeon's office. Same routine as Monday. Fill the bladder, remove the catheter, try to void. He did, but there was no 'stream'. It wasn't pretty. We waited a couple of hours in Atlanta to see if he could go on his own before we made the trip back. Sure enough, he couldn't go, and it was painful to try. Went back to docs office. PA called the surgeon (out of the office) who ordered a supra-pubic catheter (through his lower abdomen). We ended up spending the night in a hotel.

12/5 - Procedure to insert SP catheter, the back home. (We were released at 5:30 pm. How do folks who live in Atlanta deal with the traffic every. single. day?)

12/11 - Back to doc to see if he could pee now. He can't. They inserted a valve so he can turn it off and try to pee about every other day. We're now to call them when he can.

The docs are saying the issues are being caused by swelling. They are also insisting that his activity level shouldn't be the cause, although they don't know what the cause might be. The inserted the SP catheter because the in and out of the foley was causing more inflammation/swelling. And they didn't want him to have the foley for any length of time because it can cause erosion and the site of the cuff. From day 1until day 11 everything went fine. From day 11 forward, it's been a nightmare. The docs are expecting this to eventually resolve on its own, but we're getting worried.

That's the story, now here are the questions: 1) Did anybody else experience this with their AUS? 2) When/how was it resolved?

Thanks, guys!

Donna.

[Tall_Allen]

What a nightmare! Is the problem swelling or is it scar tissue? A guy I know had excess scar tissue (after SRT) removed with injections of Xiaflex into the anastomosis. It's usually given to dissolve scar tissue for Peyronie's. Alternatively, perhaps injected cortisone can be used to dissolve excess tissue at the anastomosis and reduce inflammation. Worth discussing with his urologist.

[COG1 in reply to Tall_Allen]

Hey, Allen, no one has mentioned scar tissue as a possible cause. That's something to ask about. The doc at the first ER visit suggested the AUS might have become accidentally activated. The surgeon nixed that idea, since they were able to insert a foley catheter. I wonder if a catheter could be inserted past scar tissue?

[Tall_Allen in reply to COG1]

Yes, it can be forced past. But, as they said, everytime one is inserted causes more irritation with cocommitant inflammation and possibly scar tissue. They should be able to see it on a cystoscopy or an MRI.

[COG1 in reply to Tall_Allen]

My understanding is that if he hasn't started going on his own within the next week or so, that an MRI will be the next thing. The only imaging he's had so far was ultrasound and a CT after the placement of the SP catheter to be sure it was placed correctly.

[gleason9guy]

During the last round of work on my urinary system, I was told the catheter needed to be in at least three days in order to ensure any swelling had gone down. I'm not a doctor, but it seems to me the catheter wasn't in nearly long enough. It's no fun, but they're put in for a reason.

[COG1 in reply to gleason9guy]

Hey, gleason9guy, everyone we've talked to who had this particular procedure only had the catheter in overnight. It was 10 days after the catheter was removed before there was any issue. As of now, he still has the SP catheter (it's been a week yesterday), but still can't go on his own.

[Istomin]

This is awful! Hope it's resolved soon, and please let us know what happens.

[COG1 in reply to Istomin]

Will do.

[Hidden]

Having had HIFU surgery I am well familiar with dealing with a supra-pubic catheter and doing those trial voids to know when it is OK to remove it. I had my SPC in for a solid 4 weeks but was a different situation than AUS complications. Hoping for a quick resolution for your husband. Urinary retention is a nightmare that no one who hasn't gone through it can appreciate. Been there and done that multiple times. It is indeed panic worthy.

[Garbonzeaux]

For those (like me) not familiar with this surgery:

AUS = Artificial Urinary Sphincter

I think

[COG1 in reply to Garbonzeaux]

That's correct. Sorry. After 5 years of lurking around prostate cancer message boards, I forget that not everybody knows our secret alphabet.