About to have an urethral plasty

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I remember when I was about 12yrs old I came out of the bathroom crying because I could not pee (urinate), My parents took me to the emergency and the doctor stuck a catheter in me. That hurt like hell. A cystoscopy followed and this seem to work for about 2yrs. The problem came back again and again and again. In my later years I would get dilated (I called it getting rotor rooted) every 3 months for many years. My specific problem was an extreme burning sensation when I urinated along with a real slow flow. I would hold it in as long as I could. Consequently, I became shy around others in a public bathroom. I could not go with other people in the bathroom. Well, unfortunately I developed an addiction to cocaine so instead of dilation I just always used which numbed the pain of urination. My urologist, after many years, suggested I get an urethral plasty. Well my surgery is scheduled Oct 12th 2017 and I have concerns. I am now clean, that is, I have 2yrs 5months and 24 days clean from all drugs and alcohol. I am very serious about my recovery. I have read that the pain afterwards is cause for the doctor to prescribe narcotics for pain relief. I don't want any narcotics in or around me at any time ever. I need to know an alternative that will accomplish the same results. I have used Toridol for minor pain relief but will it work for serious pain?

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  • Posted

    Where is your stricture located?
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    • Posted

      When my doctor and his nurse put that probe in my penis to show me the stricture I could not see it cause I don't know what to look for, however; he says " yeah there it is" then he had the nurse look right into my penis. Well two weeks later I saw that same nurse at a furniture store. That was awkward. I guess nurses by furniture too. My doctor put an supra pubic catheter in me back in June so I can prevent any more damage. I haven't used my penis for anything in 3months. You know I cant wait for this to be over.

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    • Posted

      Can you tell me about your experience with the supra pubic catheter?   Is it very painful, or difficult to manage?   I believe they drain into a "belly bag" of some sort.  What is the capacity of the bag?

      I ask because I have been highly incontinent since March 10, 2016 when the GreenLight laser procedure for BPH that  I had here in NC left me with strictures that include the sphincter area.  The stricture apparently keeps the sphincter from fully closing.  (Soon after the GL procedure, when I would pee during the night---the bladder does fill while lying on my back--- just as I finished, I could fill the sphincter contracting and there would be a strong momentary sting.  I now attribute that sting to the sphincter stricture being contracted.   Because of the location and length of the strictures, even the top surgeons I've seem leery of doing urethroplasty.   I've been surviving in pull-ups, pads and condom catheters, and they all have problems.  With pull-ups and pads, I have stinging of the wet skin all day (scrotum, penis, meatus) so I worry about breakdown.  With the condom, the adhesive is too sticky, and I've had a couple of tears of the thin penile skin that led to a lot of days for the damage to heal, as I have to revert to the pull ups, and the tear is subject to constant urine, making healing a really challenge.

      Consequently, I wonder if having a supra pubic catheter might be a better way to survive than what I do now.

       

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    • Posted

      I strongly suggest a supra pubic catheter. I used a leg bag during the day and a larger bag while I slept. Even though I slept through the night the night bag was uncomfortable. Now my doctor gave me a cap that I put on the end of catheter. Easy. Comfortable. Manageable. I don't use a bag at all. A mistake I made was to not put the cap on tight and I had two embarrassing accidents. One in a restaurant and the other in a meeting. I was the only one embarrassed everyone else understood. You will get use to a SPC quickly. From what you said it will greatly benefit you and increase your quality of life. It does not look sexy but who cares. You can still enjoy a healthy sex life and feel better about yourself. The discomfort of an SPC insertion only last about 10-14 days after surgery. I took toridol to relieve the pain. Now I will have mine removed one month after my urethral plasty so I cant give you long term info. I have been wearing one for 3 months now. Ask your doctor about having one inserted. In your case I think its necessary, but that's just my opinion. I hope this helps.

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    • Posted

      Thanks Barry for that information.   I guess there would have to be some sort of blocking stent placed in the urethra if I had a SPC implaced, or maybe at the bladder mouth to stop leaking through the urethra..  After 18 months of living in either wet pull-ups, pads, or the condom catheters with a sloshing leg-bag, what you describe sounds like an improvement.   I had attempted to have an AUS (artificial sphincter) implanted twice, and the first time I was fully prepared for surgery and intubated when the stricture was found for the first time.  They have to be able to implant a Foley to do the AUS implant, they say.  I guess it's needed to be able to keep the urethra open and the surgery implant site dry after surgery.

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  • Posted

    Barry,

    I am sorry that you have had to live with this so long, but hope you have a successful surgical repair.  It's a shame that the repair was not done sooner.  I trust that you will have someone who is really good at urethroplasty surgery. (I recently saw a specialist in Irvine, CA for my strictures, but they are so complex and located where it doesn't seem to be a good path for me.)   Be sure to discuss your addiction history with your doctor, and ask about the use of butran transdermal patches, as that is reportedly less addictive.  Also, you may try non-addictive drugs like Tylenol see if that gives adequate relief.

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    • Posted

      Thanks for that information. I have never heard of a butran transdermal patch. My doctor knows about my addiction as I rejected perceset after my SPC insertion. I took toridol which is a pain reliever not a pain killer. Recovery is about coping with life on life's terms where addiction is all about doping to get through life.

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  • Posted

    Your description of your stricture sounds like I could have written the same account of myself. Your symptoms and therapy are almost identical to what I experienced. I had the same stream and painful urination for many years before I finally needed to have corrective surgery. My repair was the type where oral mucosa replaced the resected portion of the penile urethra. My urethroplasty was done at the insistence of a urologist who said I was losing bladder tone because of the straining necessary to void. As an RN, I know that everyone's pain threshold is different. I required morphine the first night post-op and after that I managed on over the counter meds. I had an indwelling catheter for about 4 weeks and a magnificent stream once it was removed! The stream has since reduced but the painful urination is gone and no more straining is necessary. I no longer fear going to a public restroom as you too described! I still feel that I empty more completely if I sit, which has been described in the literature, but overall quality of life is so much better. Good luck to you in your stricture repair. I wish you all the best!  

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    • Posted

      Thank you for that empathy. I will have and catheter in me too for 4 weeks after surgery. I had an SPC insertion back in June so I will have two catheters coming out of me. Not very sexy believe me. I'm glad I'm single. I will be so happy when it is over.

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  • Posted

    Hi Barry

    I had urethra plays nine weeks ago. I too am s recovering alcoholic and addict. Couldn't quite believe it when I read your post.  I have loads of stuff to share with you if you're interested mail me 

    Best wishes

    Sarah 

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    • Posted

      Sarah, I am so interested in what you can share with me. I go to NA meetings and in my home group I had a burning desire last night because I am afraid of what can happen. I have heard many addicts with years of recovery go back out due to a medical situation because they released their addiction all over again. Sarah, if I go out I don't know if I could come back. I need you.

      Serenity for the both of us.

      Barry

       

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    • Posted

      My surgery has been postponed due to scar tissue end to end in my urethra which was discovered while in surgery for the urethroplasty. It is rescheduled for Nov 9th. The doctor would not give me an epidermal so I had to take narcotics. I woke up high as hell. I felt like s**t. I am so glad I don't do that anymore. I don't feel the need to use either. 

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  • Posted

    I'm so sorry that you are having a problem.  You do not say what kind of urethral plasty you are having.  End to end or the one with the graft.  In 2014 I found out I have a stricture just before the prostate.  It is ok for now.  But I have look up surgery just in case.  I would never have a end to end urethral plasty because of penile shorten from the end to end.  The doctors try not to take more then a inch but one man on here the doctor took 3 inch's.  He was a mess after.  Please talk with you doctor and make sure what he is going to do.  Your young and have your whole life a head of you.  Take care   Ken     

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    • Posted

      I don't know yet what kind of urethral plasty the doctor will perform. He said according to the length of the stricture he will make his determination. I have researched the procedure and discovered there are many options. The recommended one I believe is the buccal mucosa? I think. I can tell you this if the doctor takes 3 inches from me I will beat his ass plain and simple. I'm glad you told me that. That's the first question I'm gonna ask. And believe me I will be very blunt. Thank you.

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    • Posted

      Barry  That does not sound right.  He should know before he goes in and cuts you open.  He should have a idea of how big it is from the dilations.  The one recommended is the one with the graft.  I would tell him that is the one you want. ( That is the one I would do if mine get worst )  Not sign the paper and you do what you want.  It's your body and you have to live with the out come not him.  Once he start cutting your not going to get it back  Please put your foot down and don't let him talk you into anything you can't deal with and you should not have to......Ken       

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    • Posted

      Kenneth, I have a pre-surgery appointment on Oct 2 which will last 3hrs. So I will know exactly what I need to know. I will have many educated questions. 4 months prior to the surgery he put in an SPC and I was instructed not to use my penis to  urinate at all so that from what I understand the scar tissue could heal. I have followed  his instructions. I have trust in my doctor and faith in God as I live in his will. I will definitely let you know what I learn. Thanks for the heads up. 
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