Bladder neck contracture: I have a... - Prostate Cancer A...

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Bladder neck contracture

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I have a bladder neck contracture that makes urinating difficult I was able to insert catheters with difficulty so I was not terribly concerned about being very far from competent medical care. It is a 4 hour drive to a hospital with a urologist on call and my local very good primary care doctor told me to go right there and not consider the local hospital.

For about 2 months I have not been able to insert a catheter at all and I had become quite good at it and used a wire to stiffen the cath but this no longer works.

I have urgency and frequency so it is unlikely that I will suddenly have a huge amount of urine in my bladder without knowing it. I also have a bladder scanner so I can check to see how critical the situation if. My primary said that until i have over a liter of urine there is not likely to be kidney damage. So if i can't pee i can check volume and head for the hospital when i get to around 600 ml. Also because of the extreme difficulty peeing for years my bladder wall is very thick and my bladder volume is probably less than normal so maybe 600 ml is too late?

My urologist wants to perform surgery but having had extensive radiation I heal very slowly and recovering from the emergency TURP necessitated by a false passage of a cath by a brutal bitch of a doctor took over two years and i am still not really recovered so I am really hesitant to have surgery. My primary doctor thinks I should get a supra pubic cath but the risk of infection and maintenance don't sound great. I am already driving to appointments for hormone treatment and other fun stuff and really do not want to have a whole bunch of other reason to be dealing with health care. It seems that a supra cath is pretty much final that going back is not likely.

Any ideas? Is there a really stiff cath that i might not have tried yet? I thought about trying to self dilate but the sounds i can find are not long enough to get to the bladder neck. I have a machine shop and can make all sorts of things out of metal. I could make my own longer sound but what size and how flexible does it need to be etc etc? I can also make one of a variety of industrial plastics. For a while i was injecting castor oil because it is supposed to break down scar tissue very well and i think it might have helped at one point but I have not tried it recently. Should i try this again?

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