As a result of PC treatment and a TURP (after radiation, not advised) to correct a brutal catheterization I now have extreme difficulty urinating and at this time can not even get a catheter into my bladder. I have straight caths arriving later today and hope to be able to get one of them to work since the coude tip variety definitely can not get through my bladder neck. The cath just bunches up and folds over itself. I also have a guide wire to try in a variety of ways.
My local urologist is suggesting another TURP but since it took over two years to heal badly from the last one I am not excited about this option. I really hope that the caths that arrive today can be made to work and that I can put off making a decision for a while longer. I also have to deal with the treatment of the recurred PC at some point although my oncologist is monitoring my PSA and scans and is putting off ADT for as long as possible.
So here is the question of the day. What about a urethral stent possibly combined with an artificial sphincter? If you look up urethral stent online Google will show mainly uretral stents which go between the bladder and kidneys. This is not what I am proposing. There is a stent that goes in the bladder neck.
Also how much of urinary control is done by the bladder sphincter and how much by the external sphincter? If the bladder neck is stented (of course there are complications and maintenance and then a catheter will be totally useless) would I still have control without an artificial sphincter?
One other consideration is that in determining suitability of a urethral stent it seems that you need to be within 2 hours of a center that can deal with it. I am not but I am within 2 hours of a hospital where they should be able to do an emergency SP cath if the stent is blocked.
I really want to stay living in my remote mountain home for as long as possible but having intermittent inability to urinate combined with the current inability to insert a cath in an emergency is making this scary. The local hospital does not have a urologist oncall. The closest is 4 hours away. However my primary care doctor who is also an emergency specialist said that an SP cath is no big deal and that she or any decent ER doctor could do it. If she were in the ER I have complete confidence that she could and would do the right thing. Not so with the Dr. nurse team that rammed a cath into my prostate 3 years ago. But now I know what to watch for and will never let that happen again. I can always demand to be transported to the bigger hospital with a full time oncall urologist if it looks like things are not goinf well at the local hospital. Other than this one horrible experience, everything else has been great at the local hospital.
