“I’ve been using catheters for fifteen years, and this is the best I’ve ever had.” said the smiling man on my TV. I sat there, dumstruck, with the idea of having to use catheters for fifteen years. Fifteen years? That’s a long, long time. I have urological problems. I have an enlarged prostate that has been problematic for about six years now. So far I have been able to overcome the problems with medication, but the time is coming when I will have to resort to surgery.
Half of my discomfort stems from urologists mishandling catheters. Two of them were so ham fisted that they tore my urethra, creating scar tissue that blocks flow. One of them not only tore the urethra, but penetrated the prostate. That penetration infected, abscessed and has also left scar tissue that further impedes urinary flow. Secondarily, the condition of the urethra is now it’s almost impossible to set a catheter in me without tearing the duct, leading to more scarring. Since the first trauma, the incidence of urinary tract infections has gone from virtually none up to two or three times per year.
So knowing that I have these problems, it seems almost inconceivable that someone would have to continually use catheters, perhaps for decades. As I consider the issues and their incredible discomfort, the technologist in me wonders why anyone should have to consider such a grim future. Given the modern materials, sensors and miniaturization levels we have attained, why haven’t we built a synthetic method to vacate the bladder? In my own head I can easily envision a sensor and processor that could “know” when evacuation was necessary and reinforce the body’s own sense of need. Secondly, the movement of a specific muscle could activate release, keeping the individual in control, much the same as a person with a prosthetic arm can manipulate mechanical fingers. In essence, retain the concept of urination but augmenting it technologically.
We have new materials available to us, including the ability to grow materials with which to replace veins, tissues and even muscles the body will readily accept. The idea of venting the bladder is not particularly complex, little more than draining a bathtub but less than flushing a toilet. So it poses the question of why we aren’t seeing something like this. Seventy percent of males over 70 years old experience urinary issues due to prostate enlargement. Forty percent experience problems by age 50. Considering the number of men affected, one would think that more development would be in progress for such an epidemic set of issues. Perhaps that drugs like Tamsulosin, Finasteride, and Doxozosin are able to provide some relief while bypassing more complex procedures holds research back. Current surgical procedures create their own set of issues and so urologists consider them a last ditch and mostly undesired alternative. Virtually all patients who’ve had surgery became incontinent to some degree. A negative aura hangs over the idea of physical solutions to urological problems.
But as someone who shudders at the thought of catheters, I know I would like to see some research to develop a prosthetic urinary device. As they said of the Six Million Dollar Man, we have the technology. We can rebuild him..