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Thread: So much for the idea of getting a Sphinctor operation.

  1. #1

    So much for the idea of getting a Sphinctor operation.

    The Doc I saw yesterday told me I have a stricture (scarring) from years of cathing and that in or order to do another Sphinterotomy I'd have to first have to have a fairly major operation done to repair the stricture, no thanks. I dont want to go though all he was talking about only to become more incontinent. I think I'm going to try Bob Clarks idea of cathing using Hydrogen peroxide and see if I can avoid getting UTI's that way.
    "Life is about how you
    respond to not only the
    challenges you're dealt but
    the challenges you seek...If
    you have no goals, no
    mountains to climb, your
    soul dies".~Liz Fordred

  2. #2
    Quote Originally Posted by Curt Leatherbee View Post
    The Doc I saw yesterday told me I have a stricture (scarring) from years of cathing and that in or order to do another Sphinterotomy I'd have to first have to have a fairly major operation done to repair the stricture, no thanks. I dont want to go though all he was talking about only to become more incontinent. I think I'm going to try Bob Clarks idea of cathing using Hydrogen peroxide and see if I can avoid getting UTI's that way.
    Curt, I am sorry to hear this. Wise.

  3. #3
    Moderator jody's Avatar
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    I dont know about people, but in vet practice, Hydrogen peroxide used frequently causes further damage or erosion to injured tissue. especially if it is undiluted. Is it common to use hp for cathing?
    I have been using a pink cleanser by betadine mixed with filtered water. its supposed to kill 99.9% microbes, and I think it works, because when I ran out and went back to sterilube, I got a uti. sorry about your troubles. have you gotten a second opinion?

  4. #4
    Hi,

    Sorry, this path did not work.
    I am not a believer of using hydrogen peroxide due to the destruction of the tissue, though I know Bob has had success with this. I will keep thinking on other ideas.
    Reviewing the 2 sticky notes at the beginning- the Bladder Managment for Adults document and also the posting of ideas to prevent UTI's may provide some help.
    Keep us posted.

    AAD

  5. #5
    I never used h/p before, so thats not the reason I got a stricture, I guess it just goes with the terratory of Cathing 5 times a day over a period of years according to the doctor, something I probabley should have been told more about when my original doc put me on the I/C program.

    I really think I might just try a S/P tube and avoid all these operations? Does that seem like a good idea? If I leak just I can just wear an external cath in conjunction with the S/P tube, at least I would not be changing the external cath 5 times a day like I am now. I know there is increased risk of bladder cancer, but at least when you go with bladder cancer it is fairly fast and it really looks like my future is not very bright anyhow so it might be a blessing.
    "Life is about how you
    respond to not only the
    challenges you're dealt but
    the challenges you seek...If
    you have no goals, no
    mountains to climb, your
    soul dies".~Liz Fordred

  6. #6
    Sorry about your latest problems Curt.

    We need an inexpensive antiseptic that kills bacteria but is harmless to mucosal tissue. I don't like the idea of using hydrogen peroxide in my urethra either.

    I wish Dr. Young would comment.

    Bob.
    "Be kind, for everyone you meet is fighting a great battle." - Philo of Alexandria

  7. #7
    Quote Originally Posted by Curt Leatherbee View Post
    I never used h/p before, so thats not the reason I got a stricture, I guess it just goes with the terratory of Cathing 5 times a day over a period of years according to the doctor, something I probabley should have been told more about when my original doc put me on the I/C program.

    I really think I might just try a S/P tube and avoid all these operations? Does that seem like a good idea? If I leak just I can just wear an external cath in conjunction with the S/P tube, at least I would not be changing the external cath 5 times a day like I am now. I know there is increased risk of bladder cancer, but at least when you go with bladder cancer it is fairly fast and it really looks like my future is not very bright anyhow so it might be a blessing.

    Hi Curt,

    Being constantly bacterially colonized and having dozens or hundreds of UTIs over the past 30 years while you catheterized sure didn't help prevent the formation of your stricture(s). And whatever other damage you have in your urinary tract.

    I understand you wanting to knock out one of the SCI voiding steps. Either IC or the wearing of an external catheter, tubing and legbag. Having to do/use both is a PITA.

    If you could keep your urinary tract free of bacteria you may be able to get your bladder in shape to reliably hold 400ccs. To have enough trust in it so you wouldn't need to wear the external catheter, etc. Maybe with a high enough dose of an anticholinergic so you don't leak but a low enough dose so your mouth and eyes don't dry out. I imagine that's quite a balancing act.

    Or get a SP. The downside to getting a SP is your bladder is going to shrink. I've heard down to the size of a damn walnut. Ouch. Although a SP is easily reversible I don't know how easy it is to get your bladder back to its normal size without augmentation surgery. Major augmentation surgery. And once it shrinks the Foley balloon can rub against the wall of your bladder causing irritation and perhaps more dreaded spasms. Why is everything so damn difficult!?

    Just an idea. Perhaps first try a urethral Foley for a month. See how you "like" it. If you're vigilant you can clamp it on and off at 400ccs to keep your bladder toned. Just make sure you're not spasming and refluxing into your kidneys. Perhaps have a C&S (Culture & Sensitivity test) done first and get on antibiotics (usually 10 days) until all the bacteria is out of your urinary tract. Then maybe stay on a prophylactic dose for the remaining 20 days. This might give your urethra a chance to heal and also clean up anything that may be hanging around in your urinary tract. Then start cathing intermittently... but now do whatever it takes to keep the bacteria out of your urethra and urinary tract. Hopefully you'll end up being able to reliably hold 400ccs and not need to wear an external catheter, tubing and legbag.

    Maybe I'm just wacky and have wacky ideas but I don't like surgery of any kind. And the idea of my bladder shrinking to the size of a walnut is scary. Actually it's unacceptable. And surgery puts us at risk for things like MRSA. I'm not sure but doesn't a SP leave raw open muscle and other stuff exposed to the air? To bacteria? I saw a picture of one and I didn't like the looks of it!

    Hopefully those who have a SP will comment.

    I hope you figure something out that makes taking a simple wiz not such a dreaded affair. SCI sux.

    Bob.
    "Be kind, for everyone you meet is fighting a great battle." - Philo of Alexandria

  8. #8
    Senior Member rdf's Avatar
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    Quote Originally Posted by Curt Leatherbee View Post
    The Doc I saw yesterday told me I have a stricture (scarring) from years of cathing and that in or order to do another Sphinterotomy I'd have to first have to have a fairly major operation done to repair the stricture, no thanks. I dont want to go though all he was talking about only to become more incontinent. I think I'm going to try Bob Clarks idea of cathing using Hydrogen peroxide and see if I can avoid getting UTI's that way.
    Curt, sorry to hear this. I've had two strictures removed, and everything is working fine with inserting the catheter. I'll probably get another one or three or four, but to remove the strictures was actually a pretty simple procedure. The first one (probaby 12 years ago) they just "bored" out right in the doctors office before I even knew what the hell was going on (but it worked), and the second one (2006) they incised via cystoscopy because the stricture was very close to my bladder sphincter. The urologist who did the surgery said I would probably never get another stricture in that area again after the cystoscopy.

    The cystoscopy is done under general anathesea, but it's an outpatient surgery. In both cases, I wore a foley for a couple of days and took one 500mg Cipro as I left. There was minimal bleeding for a day or so after I took the foley out, but that was it.

    Is a cystoscopy the fairly major operation was your doc referring to? It's not that big of a deal if that's what he was talking about, at least it wasn't to me or the urologist who performed it. Get another opinion on what's involved removing your stricture.
    Good luck Curt.

    There was a small possibility because the stricture was so close to my bladder sphincter of bladder leakage, but very small...my urologist was very good, and truth be told, I used to leak a little if I bent forward for longer than a few minutes. That has disappeared since the surgery, so it worked out well. Talk it over with another doc.

    eta: cystoscopy might not be the name of the actual procedure where my stricture was incised. But it's close. It's the procedure where the stricture was found and identified, but the actual removal has another name, I believe.
    Last edited by rdf; 12-14-2008 at 06:53 PM.
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  9. #9
    Quote Originally Posted by bob clark View Post
    Hi Curt,

    Being constantly bacterially colonized and having dozens or hundreds of UTIs over the past 30 years while you catheterized sure didn't help prevent the formation of your stricture(s). And whatever other damage you have in your urinary tract.

    I understand you wanting to knock out one of the SCI voiding steps. Either IC or the wearing of an external catheter, tubing and legbag. Having to do/use both is a PITA.

    If you could keep your urinary tract free of bacteria you may be able to get your bladder in shape to reliably hold 400ccs. To have enough trust in it so you wouldn't need to wear the external catheter, etc. Maybe with a high enough dose of an anticholinergic so you don't leak but a low enough dose so your mouth and eyes don't dry out. I imagine that's quite a balancing act.

    Or get a SP. The downside to getting a SP is your bladder is going to shrink. I've heard down to the size of a damn walnut. Ouch. Although a SP is easily reversible I don't know how easy it is to get your bladder back to its normal size without augmentation surgery. Major augmentation surgery. And once it shrinks the Foley balloon can rub against the wall of your bladder causing irritation and perhaps more dreaded spasms. Why is everything so damn difficult!?

    Just an idea. Perhaps first try a urethral Foley for a month. See how you "like" it. If you're vigilant you can clamp it on and off at 400ccs to keep your bladder toned. Just make sure you're not spasming and refluxing into your kidneys. Perhaps have a C&S (Culture & Sensitivity test) done first and get on antibiotics (usually 10 days) until all the bacteria is out of your urinary tract. Then maybe stay on a prophylactic dose for the remaining 20 days. This might give your urethra a chance to heal and also clean up anything that may be hanging around in your urinary tract. Then start cathing intermittently... but now do whatever it takes to keep the bacteria out of your urethra and urinary tract. Hopefully you'll end up being able to reliably hold 400ccs and not need to wear an external catheter, tubing and legbag.

    Maybe I'm just wacky and have wacky ideas but I don't like surgery of any kind. And the idea of my bladder shrinking to the size of a walnut is scary. Actually it's unacceptable. And surgery puts us at risk for things like MRSA. I'm not sure but doesn't a SP leave raw open muscle and other stuff exposed to the air? To bacteria? I saw a picture of one and I didn't like the looks of it!

    Hopefully those who have a SP will comment.

    I hope you figure something out that makes taking a simple wiz not such a dreaded affair. SCI sux.

    Bob.
    Bob, I like the idea you have about maybe trying out a urethral Foley for just a month and maybe that would give the stricture time to heal, I don't know. But at least it would give me a feeling of what a S/P tube would be like to have and deal with. I understand the procedure of putting in a S/P tube is fairly simple though and it can be reversed fairly easily too. The shrinkage factor you mention is a little scary and like you said might even take an augmentation to reverse that once it happens. Like you said, any operation that is not 100 percent necessary I want to try and avoid. I'll talk about what the Doctor told me he needs to do to operate on the Stricture in my next post to RDF. It really kinda surprised me, I wish mine were as simple as RDF's.
    "Life is about how you
    respond to not only the
    challenges you're dealt but
    the challenges you seek...If
    you have no goals, no
    mountains to climb, your
    soul dies".~Liz Fordred

  10. #10
    Senior Member 6string's Avatar
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    I know there is increased risk of bladder cancer, but at least when you go with bladder cancer it is fairly fast and it really looks like my future is not very bright anyhow so it might be a blessing.[/quote]


    Curt, you've never been fatalistic since I've known you. I think you are just in a winter funk! When spring comes, and you can climb into that boat of yours, you'll be OK. Or the hand cycle. Just hang tight. Better times are coming!

    When spring comes, beers on my deck. OK!
    "Music will always find its way to us, with or without business, politics, religion, or any other bullshit attached. Music survives everything, and like God it is always present. It needs no help, and suffers no hindrance. It has always found me, and with God's blessing and permission, it always will." Eric Clapton

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