Could a flexible cycstoscopy cause a urethral stricture?

Posted , 7 users are following.

I suffer from chronic prostatitis and a tight bladder-neck. I understand that it might not be as bad as BPH but I feel like living like this is hell at the age of 33. I currently have to take FLOmax to help with the hesitancy, slow stream and urgency. It does help to a degree and my stream has improved and my hesitancy has stopped altogether. I had a cystoscopy last September and that came back all clear; it caused no pain or burning and I felt fine afterwards. I saw a new urologist in June and had a second cystoscopy in July. This time is hurt when it went past the external sphincter and prostate and it burnt to pee for about 6 or so hours. 1 month after the scope I have developed what feels like a pinch/burn when I hold my urine and then void (feels like it comes from external sphincter/prostate). The stronger my flow the more the pinch seems to hurt and get worse. I have lots of symptoms - bladder sensitivity, frequency, pelvic pain, feeling of golf-ball stuck in rectum, post void of around 20-50mls. Sometimes I'll get a random stabbing in my urethra or a burn that itches but I can't tell where it's coming from. My penis sometimes feels like it's bruised. When I have finished my urine flow and try to push the last bits out I will get a searing pain that travels through my urethra that is very painful. I leak post ejaculate for a long time after I have finished and this was happening before both scopes.

Manhy of you are more knowlegable than myself. What do you think the chances that this new sysmptom of pinching/burning sometimes is from the second flexible cystoscopy that I had causing a stricture? It was done 2 months ago. Or do you think it's just another symptom from my CPPS/bladder neck. Urologist doesn't want to go up there again and I don't really want a 3rd cystoscopy. So sick of this condition. It makes me feel so depressed. I just want to be happy and active again.

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14 Replies

  • Posted

    Anything that can cause an injury to the urethra can cause stricture. However, the only way to know it's a stricture is with a cystoscope, as far as I know.

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    • Posted

      Have you ruled out a UTI? Possibly cytoscope introduced an infection? easy to check... any fever at all?

      There is some risk of urethral damage or uti from any cytoscope or catheter entry.

      You could get a 3T MRI which would show the condition of your bladder wall as well as any median lobe obstruction. Just in case that is your issue. Might be easier to get that referral from your GP.

      Good luck mate.

      Joe

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    • Posted

      It's definitely caused by that cystoscopy, whether it's UTI or stricture, or something else. Look into symptoms of UTI first to see if you have it. I would not trust the same uro, if he gave me so much pain.

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    • Posted

      Hi, Joe. I am all clear when it comes to a UTI. Had my urine looked at by a lab. I have had an ultra sound on my bladder and the wall is within normal range. I have had two scopes and my prostate is of normal size for my age (33). Median lobe is normal as seen on both scopes. Maybe I just need to accept that it is part of my condition. I have done a lot of searching in forums and it seems a lot of guys my age have the same symptoms and urologists have no idea on how to treat it. I am worried it could be a stricture at the external sphincter but I have looked for research papers on it and it seems it's only cause at that location by BPH surgery like laser surgery.

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  • Posted

    You need to check for a UTI and if you have to go on antibiotics then so be it. Don't take Cipro - very dangerous. If you can get the MRI do it. I would do this before having a third scope. Seems like you may be destined for a bladder neck incision (BNI) to open up the flow. You need to research this and get several opinions if possible. At your age the prostate is not likely to be the issue.

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  • Posted

    Yes, absolutely any urethral procedure can cause a stricture. I had a botched Greenlight Laser procedure that fried my external sphincter, leaving me totally incontinent.I had x-ray images done by a specialist in CA and have attached one of the images.It took 5 more surgeries before I had an implant to restore continence.

    image

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  • Posted

    I'm good now. Having a working artificial sphincter is definitely better than changing wet Depends 8 or 10 times a day. ( Our local landfill appreciates that too.)

    I read an article recently about a study of the flexible endoscopes used for upper GI examinations. They found that after a standard sterilization, 5% of the scopes still had live organisms that could transmit an infection. I have to believe that the flexible scopes used for a cystoscopy of the urethrea probably are not much different. That makes me wonder what sort of infection could be transmitted. Maybe even an STD?

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  • Posted

    After I became incontinent after my Greenlight procedure, I spent some months doing Kegel exercises to try to restore continence.While lying on my back to sleep, I could retain enough urine that I would get up to empty the bladder. At the end of peeing, when the leaking sphincter contracted to try to close, I would feel what to me was a slight sting. Ultimately, that was found to be the stricture at the external sphincter causing my incontinence and, I feel sure, the source of the "stinging" sensation.Also, when I did Kegel exercises, I would often feel that slight stinging sensation.

    Glenn

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    • Posted

      Hi, Glenn. This is the first time I have replied to you. Sorry to hear what you went through; it sounds awful and frustrating. So was it the cystoscopy that caused your external sphincter stricture or was it from the urologist using the laser too close to your external sphincter? I too get that sting when I do some sort of stretch for my pelvic floor. I have done a lot of reading and it does seem that getting a stricture of the external sphincter from a flexible cystoscopy is very rare and there are no papers on it, but it does seem to happen in 4% of people who have treatment for BPH. I have spoken to other men of my age and they too seem to get the sting and burning when urinating but they also have an all clear cystoscopy. The pain does feel the exact same as when the urologist went through the external sphincter with the cystoscopy. I really don't know what to do. I have had the all clear for a UTI. Do I really want to go through another cystoscopy to check for damage from the previous scope? I've had a searing pain in my urethra when urinating towards the end before any of my scopes. This is very frustrating.

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  • Posted

    I can't be certain about the cause, but I think the damage came from the Greenlight procedure. However, there is another possibility. I had the Greenlight procedure on a Thursday, went home, and came back on the next day to have the catheter removed. I was leaking, but not concerned as that was supposedly normal. The next day was Saturday, and close to midnight, I couldn't pee, and I was in agony. I woke my wife who drove me to the ER. It took another hour to get checked in and in an exam room. Then, they insisted on doing an ultrasound after talking to the only available MD. After that, two young nurses came to insert a Foley, and finally got it in after some struggle and more pain. So there's the possibility that the insertion of the Foley catheter did some damage.

    A month later, I was still leaking like a sieve, so the doctor did another cystoscopy, and while he was doing it, he sort of sighed or groaned quietly, and my gut told me something was wrong. I didn't ask, as I was already upset. He scheduled a second TURP procedure which was done a few weeks later. Then he had me do months of PT to no avail. I then started searching for a new doctor.

    I found one who did artificial urinary sphincter (AUS) implants. At this point, I still didn't know I had strictures. An AUS implant was scheduled, and and I went to surgery. The first step was to check to see that I was patent (open). That was when the strictures were discovered, and I woke up to the disappointing news that they weren't able to do the implant because of the strictures. There were multiple surgical attempts to resolve the strictures, and I was finally able to have the implant, which has now been working well for about 21 months.

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