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My husband (83) recently had prostate surgery to allow better urine flow.  Urologist said his main problem was his bladder had been distended for long periods and muscles were bad.  During surgery they put in a supra pubic catheter.  Everything was going well, went to urologist's office to have it changed out for the first time and they could not get one back in.  He sent him home to see how well he does on his own.  We go back Thursday and they will see if he is emptying his bladder completely.  If not, options being offered are back to surgery for supra pubic again, catherize himself (done in the past but resulted in many infections and family Dr. had him stop)or a Foley catheter.  I would like some advice on best method.  I would also like to ask if not getting the supra pubic to go back in is a common problem?  Asking this because we were told it would be done in Urologist's office first and maybe second time and then a nurse would be coming to the house to do it.  Any suggestions would be most appreciated.  Maggie

Intermittent cathing is best but sterility is a major factor. Being 83 his immune system is not great to fight off infections so technique is key. No re-using or boiling catheters and he needs to wash his hands with hibiclens (chlorhexidine gluconate solution 4%) before handling the new sterile catheter. I also recommend an antibiotic embedded hydrophilic catheter like a MAGIC 3 BY Rochester medical. These caths are perfect for those with compromised immune systems. When a bladder becomes distended it takes a bit of time to regain function if it does at all. The only way to know is to get a urodynsmics study done prescribed by a urologist qualified to read the results. If the detrusor muscle is A-contractile (can not contract),  then he should be cathing and surgery should never be done unless its to open a path so a catheter may pass unrestricted (prostate channelectomy or partial rescetioning). Supra-pubic catheters are not great for those with immune issues bc an open stoma is wide open for a systemic infection so intermittent cathing is best. I wish him well and thank you for looking out for his best interest, there are not enough people out there that care enough to make sure the elderly is protected yes even spouses neglect their own. God bless!  


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Thomas A Suppe RDMS CLT


Invervential urologic radiology , urologic laser surgery, cryotherapy of the prostate and kidney, extracorporal shockwave lithotripsy, holmium laser lithotripsy, urodynamics (video-non video),male infertility, erectile dysfunction, Peyronies disease, hypogonadism ,kidney stones, prostate cancer detection, BPH, voiding dysfunction, bladder cancer and continent diversions.


For the past 20 years performing intervential and diagnostic uro-radiology for a multitude of urologic surgeons from New York, New Jersey, Lousianna and Texas. Founder of DMS medical LLC introducing the Texas Medical Center to the first high power Green Light laser for the treatment of BPH just after its release by the FDA from Laserscope and its sucessful trials at the Mayo Clinc.

American Registery of Diagnostic Medical Sonographers (ARDMS), American Urologic Assocoation (AUA), American Medical Systems (AMS) Laserscope,Oncura, Allergan and Auxilliam pharmaceuticals.

Comprehention of Urologic Ultrasonography for the Resident Physician (Journal of Urology 2012), Author of the syllabus for the uro-radiology residency course at The Scott Dept of Urology at Baylor College of Medicine Houston Texas (2010 to present). Past Clinical Studies: Principal radiology investigator Allergan Inc for "The treatment of BPH with intra-prostatic injections of Botox" with Larry I Lipshultz MD 2011-2012, principal radiology investigator for Allergan Inc for "The treatment of Peyronies disease by intra-lesional penile injections of Botox" with Mohit Khera MD MBA MPH (2011-2012). Current studies: Principal investigator of "Blood pressure risk factors of intra cavernosal injections of Trimix and PGE1 during Penile Duplex's.

BS from Ramapo College of NJ, Registered diagnostic medical sonographer with the ARDMS, 2 year fellowship of Uro-Radiology and intervential sonography at Baylor College of Medicine Houston TX, laser safty officer in state of Texas and certified in KTP, Holmium and Lithium Tri-boride laser systems from Laserscope San Jose, California and American Medical Systems Minnatonka Minnasota, trained and certified by Oncura Inc Isreal in ultrasound guided argon cryotherapy of the prostate and kidney.

Awards and Honors
Honorary instructor of GU ultrasound course 2012 international meeting of the American Urologic Association. Author of the the AUA course for "Ultrasonography of the Testes and Scrotum" 2012.

Past/Present Clients
Baylor College of Medicine (BCM) Lousianna State University (LSU), LSU Medical Center Shreeveport LA, The Methodist Hospital Houston Texas, St Lukes Episcopal Hospital Houston Texas, Memorial Herman Health Systems Houston Texas, Palestine RMC Texas, Doctors Regional Hospital Corpus Christi Texas, Valverde Regional Medical Center DelRio Texas, Current instructor/technologist for two internationally recognized urologists : Larry I Lipshultz MD and Mohit Khera MD, MBA, MPH at Baylor College of Medicine. I served as intervential sonography consultant for Oncura Inc cryotherapy systems. Former lead trainer for Urosource mobile medical services , training new surgeons in PVP or photo-selective vaporization of the prostate for BPH, BNCs and urethral stricture vaporization.

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