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recurrent bladder neck contracture/scar tissue
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recurrent bladder neck contracture/scar tissue

My question is are there other treatments??
My husband had a prosectomy in Oct. of 08. He has had ongoing problems with scar tissue in the uretha and urination issues. He has had 3 tur of his bladder neck since that time and still has issues.  The last 2 days he has had to dialate everytime he needs to urinate.  His doctor says the only alternative is to put in permanent catheter. Are there other procedures or things that can be done to help this situation.  Is  ultrasound or laser surgery a possiblity.  Please help we are at our wits end................. what is out there??????
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Avatar_m_tn
I am a patient with a situation similar to your husband's. I have had two resections to remove the scar tissue that formed after TURP laser surgery.

The only solution my urologist, who is a department head at a major medical center, recommends is self-catheterization. I do the procedure at least twice a week. It's not painful, just one heckuva inconvenience.

Let me know if your husband finds a better solution.
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Avatar_m_tn
I dont know if this will help you now, but it might help others so I am going to post anyway.

I was talking to a friend of mine who has had this same issue.

He said instead of the permanent catheter his doctor prescribed a new gizmo called a spanner stent. It is not a foley or it is a new foley? Anyway, it doesnt have a bag. From my own experience the foley was a nightmare. And now he can pee normally. It isnt inconvenient because it stays in for a couple of months.

6 months on and he has not had another stricture and he is back down the golf course. Which is good for me.

Hope this helps.
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Avatar_m_tn
Go for the Spanner.  I had MAJOR problems with bladder neck stricture for several years as a result of having to treat PC twice. After way too many trips to Emergency Room for a Foley catheter, I had laser surgery and then cold knife surgery.  Surgery alone almost never fixes a stricture permanently. What finally worked is a second cold knife surgery followed by 6 months with a temporary stent (Spanner).  I took the Spanner out March 30 this year and have had NO retention problems since that date and my flow rate is above normal for my age (77) and has remained unchanged since the Spanner was removed.  Spanner is a new device, many urologists haven't heard of it, but it's approved for Medicare and is very easy for a urologist to install in fifteen minutes or so with only a topical anesthesia.  It can be removed in less than a minute.  Avoid a permanent stent; they can result in very serious complications that may be harder to treat than the original stricture.
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Avatar_m_tn
Ask your urologist about doing a Y-V Plasty. The proceedure involves sewing vasculated bladder tissue into the bladder neck area to keep scar tissue from forming. It is a reconstructive type of surgery so not every urologist can do it and your entire urinary system has to be in good working order with good bladder pressure.
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Avatar_m_tn
I am curious how are you doing now? My husband is facing a third TURP for bladder contracture, want to know if you think the spanner stent was helpful long term.
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