first surgery a biologic patch derived from pig intestine was used to widen
the narrowed region of urethra. Several companies produce biological patches
which can be applied in various parts of the body and serve as a scaffold
for the surrounding normal tissues to grow into.
The surgery went very well and resulted in a widened lumen of the urethra,
but unfortunately the stricture reformed several weeks later. A temporary
urinary catheter was placed from the bladder through Marcus' side which
allowed for urine to be suctioned from his bladder using a syringe, and
allowed for time for the surgeons to evaluate other possible procedures to
treat the urethral stricture.
Two options that
were considered were to place a stent, which is a hollow piece of tubing, in
the urethra to keep the lumen open or to try to widen the stricture by
stretching it with a balloon on the end of a catheter. The balloon dilation
procedure was selected as the next step.
The urethra was dilated using the balloon catheter three times, 3 to 4 days
apart. The catheter was placed using fluoroscopy, a form of motion x-ray,
allowing the catheter to be guided to the narrowed region of the urethra.
The balloon was filled with a sterile liquid to stretch the narrowed area. A
contrast agent was included in the fluid so the position of the balloon
could be seen and it could be guided to the narrow region.
The fluid pressure was held in the balloon for 5 minutes, then the
fluid was removed and the catheter withdrawn. The urethra was stretched a
little more each time until the lumen was as wide as the surrounding normal
Marcus is laying
on his side with his head at your left. The bones are white/light gray. A
radio opaque dye which is bright white has been placed in the bladder and urethra. The
picture on your left shows the stricture and the picture on your right shows
the distended balloon in the region of the stricture. The thin white line is
the catheter attached to the balloon.
After 5 weeks the temporary catheter was removed. Marcus spent
almost 7 weeks in the intensive care unit at Washington State over the
course of his multiple treatments and surgeries. He was discharged in late
Marcus is now
able to urinate normally although he does not have full control of his
bladder and wears a diaper in the house. Although Marcus is no longer able
to become a dog guide, his story says his caretaker/owner: "is an amazing
story of faith, perseverance, will to live, incredible talent, love, support
and friendships to be honored. It is also a story of many life lessons
learned by many people. People came out of the woodwork to support Marcus."
spends his time playing with Mavis and Dahlia and going for walks in the
woods and loving life.
Marcus and his
caretaker/owner send their thanks and love for everyone who supported him.
Photos: Sept 2006