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or "how close did you cut?"  Show this Post

 
as stated, the reason for the follow-up visit with the urologist/surgeon was two-fold – to have my catheter removed and to learn how successful the surgery was in eradicating all trace of prostate cancer from my body!
 
I don't recall the order, but let's cover the "extraction" first. In order to remove the catheter, that water-filled balloon anchoring the tubing in place first had to be deflated, by allowing the water to flow back out to the external reservoir. Then came the matter of carefully and cautiously pulling the tubing that had been in place for the past 16 days out of my urethra – remembering that during this rather extended period and given that the urethra had been resected… the outer wall of the tubing had become very attached to the inner wall of the urethra and wasn't likely to "want" to be removed very easily.
 
Forget that nonsense about "carefully and cautiously"! What the urologist did was ask me to take a deep breath and that on the count of 3 he would pull it out. Instead he ripped the catheter from my body on the count of 1 – and how my entire urethra didn't come out with it, I will never understand. I do know it "felt" like having 20 feet of duct tape torn off the most sensitive parts of your anatomy – except from the inside out. Given the amount of grunge that was adhering to the outside of the tubing, that sure looked an awful lot like bits of flesh, I am also amazed that the result was not an incredible amount of bleeding and infection in the days that followed. Instead, other than a very minor amount of blood in my urine over the next 24 hours – everything was fine!
 
Note that this is not always the case, as catheterization in general has a high incidence of infection associated with it, especially over longer periods. Basically, more than 15% of all infections reported in hospitals are UTIs (urinary tract infections) and virtually all health-care related UTIs are as a result of catheterization. Advancements are always being made to try and reduce these numbers including innovations in product design – with things like antimicrobial silicone and silver-alloy coatings to minimize biofilm formation (that's the gunk that builds up/grows on the outside of the tubing) that can cause infections. Also greater care in the insertion procedures to ensure completely closed systems can eliminate sources of contamination.
 
However, enough about catheters – let's move on to the "results" of the surgery. Here's where the news was not so great. Without getting too technical… the surrounding lymph nodes were clear, there was no spread beyond the shell of the prostate itself, there was no spread to the seminal vesicles, but the tumour did extend right up to the wall of the bladder (ie. biopsy of the removed organ showed that the margin with the bladder was not clean – meaning that cancer cells remained in my system – at least in the bladder tissue.) This basically guaranteed that follow up treatment would be necessary down the road.
 
Additionally, the surgery was considered to be nerve-sparing, although one side was lost, being fully involved, the other nerve bundle was "supposedly" saved. This ability to save one or preferably both of the nerve bundles in radical prostate surgery is critical to the possibility of maintaining any hope of unassisted (ie. natural) erections, but in no way guarantees it – which once again, makes a great topic for another post…