Posts Tagged ‘urethra’

URO TODAY: Implantation of a peri-urethral constrictor – a device that injects saline – appears to be a safe and effective treatment for post-prostate surgery urinary incontinence. READ MORE>

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URO TODAY: A technique for restoring the position of the urethra during radical prostatectomy – using a suture with a figure-of-eight knot – restores continence more quickly. READ MORE>

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PART 12 of My PC Adventure (read full story HERE)

Love him or not, Mr Catheter becomes a dominant part of your life after a radical prostatectomy.

I didn’t ever love mine, of course. And I see now that the guys who told me I would were just jiving, trying – prior to me having the operation – to make light of something that, as urology nurse Bob Hale wisely warned, is a very uncomfortable experience.

But, my God, having Mr C certainly gives you insight into the workings of your inner plumbing.

I will forever respect my bladder (although not to the extent of giving up Heineken). What an amazing organ. It’s working full time, day and night, judging by the flow I watched going into my temporary “outer bladder”.

As they say, you watch pinot noir gradually become rose and then chardonnay and finally lime juice.

When you’re lying abed, which I did for most of my first few days at home, the paraphernalia of a catheter is easy to manage during the day.

catheter2The bag is strapped to my upper right calf by a couple of adjustable elastic straps. It has a clear plastic tube running up through another strap around the thigh to a three-way junction, one of whose tubes – made of opaque grey plastic – enters the penis, and presumably heads up to the bladder.

Your first thought is – what the hell’s stopping it falling out. Aha. A little bit of Googling tells me there’s an inflatable balloon on the bladder end.

Ulp! How do they get it back out again? No, no, no – put that thought aside. That’s next week’s worry. None of my catheter-hardened friends have talked about that bit, although a female neighbour accidentally (I hope) recounts how much it stung to pee after she had hers removed.

Why do I have this thing, anyway? So far as I recall, nobody actually explained that prior to the op. “Of course, you have a catheter,” was all that was said.

The why is explained in some literature I read: the operation to remove the prostate requires the surgeon to cut the urethra (pee tube) off the bottom of the bladder and then reattach it afterwards. The catheter is needed for a week or more to drain the bladder while the wound heals.

All right. So lying still in bed is easy enough. You can check the bag every now and again and see when it’s getting full, which requires a shuffle down to the loo, where you hold the bag over the pan and open the valve. Just like peeing, but second hand, sort of.

The whole thing is a closed system to prevent infection, so the mechanics of it are intriguing.

What about other functions, like walking and showering, and what happens at night when you’re not awake to monitor the flow?

Walking is okay, so long as you get the bag straps right to ensure the full bag doesn’t pull downwards. and the thigh strap has the tube held at the right angle: AT ALL COSTS, YOU DO NOT WANT ANY PULL ON THE WILLY.

At first it feels a bit sensitive (rather than painful), and after a while you don’t notice the ingoing tube much.

Showering is easy enough – you just leave the whole thing in place. Only trouble is trying to get it dry afterwards. I invariably get a wet patch in the bed because the bag and straps are still damp.

catheter3Night-time presents the biggest problems at first. A second, larger bag is hung from the sheets by safety pin (carefully) so it dangles just above the floor. It is connected by tube to the tap-valve on the bottom of the leg bag, the idea being it will take the overflow and ensure the leg bag never gets completely full.

Unfortunately, we have a problem with the connection between the two bags. It doesn’t seem to work, and the lower bed is soaked. That means a bed change about midnight. Then it happens again, which means another change of bedding.

We haven’t thought to buy a rubber under-sheet, but luckily the pee doesn’t soak as far as the mattress. The washing machine runs red hot next day while sets of bedding (sheets, underlays, duvet covers) have to be washed.

We have another disaster the next night when I thrash around in my sleep and rip the connecting tube out of the lower bag, spraying urine across the bottom of the bed.

Poor Lin. I assure her we’ll look back and laugh one day, but I’m not sure she’s convinced. I’m not, either.

We change to the spare bags and tubes provided by Bob, install a rubberised sheet, test everything out, and hope for the best on night three. It’s all fine. No more spillages.

Aside from the catheter, there are other adjustments to make because of the fragile state of my lower abdomen. I compile an inverted bucket list of things not to do:

  • Sneeze.
  • Laugh.
  • Cough. Even throat-clearing has to be gradual.
  • Get out of bed at anything other than glacial speed.
  • Get back into bed at anything other than glacial speed.
  • Sit in a chair.
  • Walk at anything other than glacial speed.
  • Strain on the loo.
  • Reach for anything.
  • Try to put on socks.
  • Sleep on my side.
  • Fold my arms on my chest (too much weight).
  • Look at the scar (difficult, fortunately, because of a swollen belly).
  • Allow anything to confine, bump, handle or in any way interfere with the boys.
  • Wear anything other than XXXXOS underpants.

But enough whingeing. The recovery goes well, mostly thanks to Lin’s tender care.

I’m preoccupied for days sending text messages to well-wishers and calling people to let them know I’m okay.

I watch the third cricket test between India and NZ and try not to get depressed.

I eat ravenously, and since I’ve lost a few kilos, ignore my usual cholesterol-inducing food no-goes. I drink endless quantities of lime juice to keep the system flushed, and a lot of liquorice to loosen the other function.

I read books kindly sent by friends, and plough through a series of legal who-dunnits by John Grisham, my favourite writer.

scar1I suffer no pain. There’s Panadol and a standby prescription of codeine (not needed) to keep me comfortable.

After the first weekend home, we get a visit from the district health nurse, a cheerful and competent woman, who has a student in tow. They look at the wound and she thinks it’s fine. After a chat, she’s away.

I settle in for some serious bed rest and the first real break from work in years. Heaven!

NEXT: Goodbye Mr C and hello Mr Pee, big-time

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