Suprapubic Catheter

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Hello,

I am doing some research to help my dad who is 87 years old.  Despite having a stroke induced by anesthesia which left him unable to speak and with right arm paralysis, he’s done well for the past 12 years.

Now because of an enlarged prostate, the urologist insisted to do a Cystoscopy then left him with a Foley catheter inserted. It’s been over 2 weeks and he is now in the hospital with a bad infection and very weak, where just recently he was very active.

The urologist wants to do Greenlight laser on him put since he is high risk with the anesthesia and bleeding: heart we don’t want to do it.

Someone in another forum suggested suprapubic catheter and I would like to know if anyone has any advice.

Thank you

Was the procedure very painful? Can it be done with minimal anesthesia? Is it very painful afterward?

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  • Posted

    I assume he was having difficulty voiding, and that's the reason for the cystoscopy?    Can I assume that he did not have a UTI before the cystoscopy?   Can you reword your third paragraph.  Does he have heart problems making him a poor surgical risk?

    I would ask a lot of questions before going the GreenLight route.  Has the doctor done a lot of GreenLight procedures?   Apparently some people have good results from GL for BPH.  I had GL at age 76, and was released the same day to go home. Unfortunately, I had a bad outcome from the surgery, leading to more surgeries.  I think my doctor was not adequately trained and experience, so maybe there are a lot of men with a good result from GL.

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    • Posted

      Hi,

      Thanks for your reply.  I literally just came from the hospital and sad to see him in so much pain. The dr. said thank God we brought him when we did. No he never had a UTI before it was wearing the Foley for almost 3 weeks that did it.  He's high risk because he's on blood thinners, has bad reaction to anesthesia and has had stroke/heart issues.

      Yes the cystoscopy was because he is having retention. He needs a break from that Foley and they can't take it out because of the infection and also he may not be able to pee if they take it out because of all the inflammation.

      The doctor says we need to make a decision soon.  Because he can't speak/read from the stroke they look to me for guidance and none of these things sound good to me for a high risk older man.  I really wish he could self cath till he gains his strength but with one arm (his non dominant) one I don't see that happening.  The suprapubic sounds safer but I think he may get demoralized and at risk for another infection.

      I'm sorry the GL did not work for you and hope you have found a more suitable solution.  Any thoughts/advice you can give me would be appreciated.

      Thanks [smile]

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  • Posted

    Hi,

    Thanks for your reply.  I literally just came from the hospital and sad to see him in so much pain. The dr. said thank God we brought him when we did. No he never had a UTI before it was wearing the Foley for almost 3 weeks that did it.  He's high risk because he's on blood thinners, has bad reaction to anesthesia and has had stroke/heart issues.

    Yes the cystoscopy was because he is having retention. He needs a break from that Foley and they can't take it out because of the infection and also he may not be able to pee if they take it out because of all the inflammation.

    The doctor says we need to make a decision soon.  Because he can't speak/read from the stroke they look to me for guidance and none of these things sound good to me for a high risk older man.  I really wish he could self cath till he gains his strength but with one arm (his non dominant) one I don't see that happening.  The suprapubic sounds safer but I think he may get demoralized and at risk for another infection.

    I'm sorry the GL did not work for you and hope you have found a more suitable solution.  Any thoughts/advice you can give me would be appreciated.

    Thankssmile

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  • Posted

    Laura,

    I'm sorry that your dad has been put into such a bad situation.   Did he receive a prophylactic antibiotic at the time of his cystoscopy?  (It's always possible that the technique was poor and resulted in contamination if someone was careless.)

    Given his situation and bleeding tendency, GL may be a reasonable option, IF you feel comfortable with this doctor.  However, it seems clear that he is not a good surgical risk given his age and health.

      Again, ask how many GL procedures he/she has done, and how many in the last few months.   If possible, I would seek a second opinion from another urologist.  If his current urologist is older (55 or older), I would try to talk to a younger urologist who would most likely know about newer procedures, such as urolift.

    Both  Foley and supra-pubic catheters are subject to infections, and require good cleaning and care to prevent infections..   I know from experience that a Foley is very uncomfortable for a man, so I expect a supra-pubic catheter would be more comfortable.   (I have had only Foley catheters, and never had a UTI, as a week was the longest time I had one in place, and I was very careful about cleaning around the exit tube.  I think i've had at least 6 Foley catheters over the last two years. (I went to a second urologist who finally got me to a good situation.)

    If your father has a GP doctor you could talk to, that person may help you with your decision.  I'm sorry that you and your father are dealing with this.

    Best of luck,

    Glenn

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  • Posted

    I am so sorry to hear this about your dad! Some people on this forum said that suprapubic catheter is a good solution, better under many aspects than other forms of voiding. Personally, I haven't tried this, but I had Green Light with poor results, i.e. no complications, but didn't solve the problem. I was doing self-cathing for a year. Now, as I have prostate cancer, I am taking Zytiga and surprisingly I pee much better, but this is an anti-cancer drug with many side-effects...Take care, you are such a good daughter!

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