Second post-surgery office visit. No more "baggage" (except for one small overnight bag).

Two weeks (plus) since discharge from hospital and we're taking a huge step back towards "normal". 

• Remove Foley catheter (penis). 
• Remove Ostomy bag and barrier that has been used to collect from the stints and the suprapubic catheter.
• Leave SupraPubic catheter in place. 
• Instruct on use and care of neo-bladder and remaining equipment. 

 This is the office visit I've been anticipating for two reasons: 

1. Since last Friday my Foley catheter has been leaking. 
2. The bags will no longer be needed (for the most part) & I hate those bags. 
3. (3?) Let's get on with this - I'm curious how it will all work. 

Restructuring the plumbing (closer to final configuration): 
The Foley catheter came out first (the one up my penis). This is painless once they deflate the balloon that holds it in place. It's kind of like "whoops, there it is".  Whew! From now on all the urine that is collecting in my neo-bladder will come out through my penis - hopefully under some kind of control by me.  The first thing I get introduced to is a male maxi-pad. There WILL be leakage. 

suprapubic catheter in urostomy bag

Next to go is the Urostomy pouch and the sticky disk that held it on (barrier disk) to my belly. That sticky pad really sticks (when you don't want it to). 

The catheter (suprapubic catheter) remains but it is fitted with a plug. So now I have a tube coming out of my belly. I'll get to the reason for keeping this later. I am given a dressing patch that is form fit to cover the hole and protect my clothes from seepage (a weeks worth of these patches).

My assignment for the week is to get used to the muscles and techniques needed to empty this neo-bladder. It doesn't have any muscles in the walls - like the old bladder - to squeeze the urine out of the 'balloon'. I will now have to use abdominal muscles, hand pressure to my lower abdomen, and relaxation techniques to force the urine out of this new bladder. We'll see how that goes....

Also missing is the constricting muscles that were in the prostate (also removed) which effectively shut down any leakage. Both these muscle systems were involuntary (to the extent that I didn't have to consciously contract or release either). I will now have to exercise the muscles in the floor of my abdomen through - which the urethra passes - to build up the muscle tone that will pinch off the urethra and stop leakage. This exercise is called a kegel. [ What are kegel's? ]

Suprapubic catheter (SPC):  [what's a suprapubic catheter?]

SPC  after removal of ostomy bag

What I have here isn't exactly an SPC as defined in the above link. Before the surgery I was measured for an ostomy and the location marked on my stomach where an ostomy would be located if, during surgery, it was determined that they couldn't give me a neo-bladder (for whatever reason).  During the first week after the surgery they needed an external reservoir to collect urine from the stints coming from the kidneys - before the neo-bladder was sufficiently healed and ready to function. For this I needed an Ostomy pouch which was installed in the ostomy location (logically enough). Since they already had a hole, they may as well use it for the SPC (dual purpose). When after two weeks, the ostomy pouch was no longer needed it was removed leaving the SPC. 

For the next week I will be using the SPC for two things: 

1. After doing my best empty my new bladder I unplug the SPC and measure how much runs out. This tests how well I am doing at peeing.  If it's less than 100cc I am doing good. 
2. Night relief: at night I can unplug the SPC and connect it to a bag (overnight bag). This allows me to sleep thorough the night without having to get up every hour or so to pee.

So armed with all this information; psyched by our enthusiastic doctor; stripped of tubes and bags we ride off into the midday (stopping at our favorite restaurant for a late breakfast) to try out all these new ideas. 

Stay tuned....