The next chapter of the Prostate Story involves living with a catheter while the cutting and resectioning of the urethra heals. I think I read or heard somewhere that they used to remove the prostate gland by shaving it off around the urethra. This proved to be neither very efficient or successful, because it often didn’t remove all the tissue, and some of what was left behind might be cancerous. What they do instead is cut the urethra on either side of the prostate gland, remove that section as well as the prostate, then join together the two loose ends. According to the documentation, this means you are not able to urinate naturally, so the catheter is necessary.
I’ve never experienced one before; and if I ever have to again, it will be way too soon. Some of the documentation warns that the catheter may have to remain in place for 2 to 4 weeks; I was relieved to read that the Oxford Hospitals say 7 to 10 days. Because of Christmas and New Year holidays, it was the full 10 days before my appointment arrived.
Turning up at the hospital at 8.00 a.m. on a cold January morning, to find that the clinic doesn’t open until 8.00, and all the appointments are timed for 8.00. This amounts to a wait in anyone’s book, for which I suppose there’s a good reason (as we may see), and it was indeed 9.00 before the nurse called me in.
The appointment is called TWOC, which stands for ‘trial without catheter’: an unwelcome reminder that though you’ve come in hope and expectation that your catheter will be removed, there’s no guarantee that you will go home without one. Should you fail the trial…
The nurse begins with a series of routine questions. She is inordinately interested in bowel movements. “Are you constipated? Have you opened your bowels within the last 24 hours? Are you feeling any pain around the catheter site?” Depending on where you draw the line between pain and just discomfort, you may lie a little…
Then she attaches a small syringe to the catheter and drains the bubble in the bladder which has been holding the catheter in place. She gets ready to pull the tube out along the urethra. “This may feel a bit strange.” Yes, you could say that.
And then the ‘trial’ begins. She sends you out to sit in the waiting area – along with a mixed multitude, some of whom are undergoing the same trial, others waiting for other kinds of appointments or consultations. The instructions are to keep drinking water, and when you need to empty your bladder, go into the specially designated toilet (TWOC patients only) and fill a cardboard bottle. Then tell the nurse, who measures the amount you’ve produced and then performs an ultrasound scan to discover how much remains in the bladder. In order to pass the trial, you have to produce significantly more in the bottle than remains in the bladder, twice. And then you can go home.
Producing any urine at all after not doing so for 10 days is a bit painful. But I did it! And was allowed to leave without catheter. Huge relief all round. Now I just have to learn to pee again, and while I’m learning there is a degree of involuntary leakage before and afterwards. So we are told to resume the pelvic floor exercises to strengthen the muscles.