my urethrotomy experience, good and bad parts
Posted , 18 users are following.
hello, i am a 22 year old male, underwent a dilation and urethrotomy yesterday morning at york hospital, thought i'd put my experience on here for others incase you are scouring the internet for info haha. i arrived at the hospital at 7:15 am, was wheeled into the theatre and put to sleep at about 11:30am, woke up about 1-1:30pm was discharged at 8:10 pm.
i think i have had a stricture since birth or from before my earliest memory as i have as far as i can remember, always had a less than average stream which got much worse back in august 2013 and even worse a couple months ago, was down to an average of 1.8ml a second, with many problems being made because of the stricture, such as straining, incontinence, high post-void residual, urine pooling = infections, backflow to kidneys, and frequency and urgency, etc etc
but now, wow, i have never experienced such a strong stream since after the procedure. must be like 25-30ml a second now.
i had a short but severe bulbar stricture apparently, i woke up about 2 hours after being put to sleep, was given oxygen through a mask by a nurse who checked under the blankets and was a bit queezy and quickly covered me over, which made me want to see, but i had no strength as i'd just woken up, i checked later when in the other recovery room only to find the cotten disposable underwear with the pad in pretty much soaked in blood, my entire pubic area with dried blood staining ( took about 20 baby wipes to clean it all off after i was able to sit up ), and my 1st, 2nd and 3rd urinations after being transferred to the recovery room were far more blood than urine, like enough blood in them for it to look like it was just blood and no urine, and the following 5 urinations were still at least half blood, i was in the recovery room for 7 hours as they were short staffed and couldnt get round to discharging people fast enough i think.
i felt ok from the anaesthesia and the valium sedative i asked for pre op at about 3pm, but then for a couple hours i experienced what iv very recently learnt to be called hypovolemic shock, i must of lost around 800-1000ml of blood in the recovery room through what had soaked into the disposable cotten padded underwear and blanket and what i had peed out, i have no idea how much i bled during the op but im guessing alot, but when i tried telling a nurse about the sheer blood loss and that i had gone back to feeling lightheaded, faint, breathless, agitated and stressed, pale skin in the mirror, weak, and my heart was pounding in my chest and had almost doubled in rate, i think they thought i was exaggerating and just said " the bleeding is bound to happen from the op and you're still feeling the anaesthesia"
there are 4 stages of hypovolemic shock, and from what i noticed i matched stage 2 100% and stage 3 about 40%. average male adult has about 5.2 litres of blood, http://www.ambulancetechnicianstudy.co.uk/shock.html#.U3lB6_ldWI8
i do have something called haemophilia in which i bleed more than others, although there are different types and mine isnt the bad one that needs regulating with injections, sometimes i hardly bleed at all, my last blood test a few months ago looked like oil in the needle's vial haha
i rested and kept breathing deeply and managed to come around a bit better, although even now i do anything involving more than a slow walk and my heart is pounding and i feel breathless and a bit dizzy.
the assisstant surgeon who i am still not sure as to whether he himself did the cutting or was an assisstant to the urologist i have been seeing for consultations and diagnosis precedures, came to see me very....very breifly after id been in the recovery room about 5 hours, he said that they had to dilate the opening, did the urethrotomy, had a look into bladder, then sort of scurried away before i could ask any questions, the original consultant urologist who has been dealing with me i didnt see after the morning consultation before the op where he explained it all to me to make sure i was still up for the procedure.
the nursing staff in the morning in ward 27 at york hospital were all very nice and kind, even sloppy, as i was very anxious and nervous. but i can't help but feel as though the staff in the afternoon and eavning in a different section of the hospital were just wanting to get me out the door asap and wern't as bothered about my complaints of blood loss and appropriate signs, i know they were understaffed and behind scheduale but still, someone who has haemophilia (a bleeding condition) complaining of blood loss....surely that should ring alarm bells. but basicly they discharged me as soon as i could walk on my own, i was very happy with the morning staff, but the afternoon / eavning staff made me wonder on work ethics. i am still losing about 10ml of blood after every urination but its bound to bleed still, hasnt had time to heal yet, not sure if the newfound force keeps washing away progress though.
normally after this procedure people get a catheter to wear for 1-7 days to hold the cut open and let it heal around the catheter, and also to stop infection from the urine, i never got a catheter, i have been peeing straight through the cut for the last 30 or so hours, pain is slowly going away, had to buy some painkillers and stool softeners from a local chemist as i didnt get given anything from the hospital. the consultant said he didn't like putting catheters in as they can be painful and cause more damage, since this morning iv had no pain during urination, but a 5 second delay after finishing and it was excruciating for about 20 seconds in the opening because of the dilation needed to make it possible to get the scope in. it brought tears to my eyes, and i am quite a pain tolerant person, once broke a finger and didn't realise until i saw it directly.
to be honest id of prefferred a catheter, although the consultant said they usually keep people in overnight with one in then take it out in the morning, i think with them being so busy they couldn't afford to do so, im not sure.
i was told by the assistant surgeon pre-op that i would have to self dilate to help prevent the stricture coming back, but as i was being discharged i asked about it, and she said there was nothing in the notes about it and that because of that, i didn't need to, i was happy i didn't have to but i'd rather of taken the necessary steps to help prevent recurrence.
another thing was i wasn't told of any activity restrictions such as sports and other activities, bed rest time, etc etc, iv been walking around to try keep myself up and about but i read that people are normally bed bound for 1-2 days
i also had a large area of no sensation in my penis afterwards too for about 15 hours, that has gone away now thankfully, big releif haha
overall, weighing up the good parts and bad parts, i think it was worthwhile, i am dissapointed from the lack of aftercare and communication post-op so i may go private in the future, but hey, a £2000-£3000 procedure for free, can't be too disgruntled, and i know that the problem is gone for at least a while, recurrance rates are about 50-80% after a year, but short bulbar strictures like mine are usually cured from urethrotomy, i hope so, i don't want to be having to suffer the next step up: urethroplasty.
if you are due to have a urethrotomy, im sorry if iv scared you, i think it was worthwhile, i am glad i had it done 
. will be able to do so much more (once iv fully recovered and healed ) now without having to worry
sorry for wall of text
2 likes, 132 replies
karenwilde ollie64
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ollie64 karenwilde
Posted
i don't like the standard temazepam that they give, first time i had it in october it had a mild - moderate effect but wore off before i went to theatre, and in january i was given a double dose but it hadn't kicked in before they took me down to theatre, its more of a sleep aid than an anti-anxiety, valium or xanax is generally best iv'e heard for anxiety.
theres supposed to be some new blood taking device made in america which is apparently far advanced to standard needles, i hope its real and brought over here
ladha99 ollie64
Posted
ollie64 ladha99
Posted
ollie64 ladha99
Posted
max74393 ollie64
Posted
Firstly may I say thank you for adding all your posts on this forum I have also as others found this very encouraging.
I have recently last Thursday had a Urethraromy and dilatation as I had what the consultant to Skype just quite a nasty structure at the end of my penis where you are in flows out. This was approximately 4 cm long and at the time I had a epidural and was conscious for the procedure the consultant was struggling to gain entry however manage to and dilate and then perform the procedure I have a 16ch 5.3mm catheter inserted and have to have this for a week . I read that you had had this procedure minus the catheter and you feel that if you had had the catheter for a week you wouldn't have been through all of the awful circumstances that you had to go through up to your second procedure . On Friday I am hoping that when I remove the catheter I will be able to urinate and I will be taught to self catheterise so that I can come home and try to get on with this. I have been told that I will need to do this for the sum of eight weeks and then I will go back for another assessment at which point the consultant may decide a Urethraplasti is the next stage. He has told me that this would cure the problem however I have read contradictory information however I do have faith in this consultant…
Can you please tell me now several months after your second Urethatomy are you still managing to your innate nicely with the self catheterisation at home? You had mentioned that if this had been done the first time you wouldn't of had the problems so I am now curious as to how you are getting on many thanks M
billybwoy ollie64
Posted
Thank you so much for your post on this forum. You do not understand how much it has helped me to come to terms with this procedure and also to get a first hand experience of what to expect from the op.
I am 29 years old and went in for my first ever urethrotomy on Oct 15. In all honestly I was very nervous until I came across your post. So here's how it went:
Arrived at the hospital at 8:10am and they asked me they will need a urine sample. This was going to be tough as I had emptied my bladder first thing in the morning. I tried but failed after an hour of trying.
So then the nurse came, a very attractive student might I add haha. Got me to change in my gown, this is where the nerves started to kick in as this was very real now and was actually happening.
Next was the anaesthetist turn. Asked me some simple questions and explained everything to me and what he thinks would be best. I just said knock me out cold and wake me up when it's done haha. However you do it, it's up to you lol.
About 11:00am they took me in and gave me the anaesthetic. All I remember was a surgeon explaining the heart to the student nurse and that was it. Next I woke up on my bed in the recovery room at 12:15.
I was actually ok, not out of it when I woke up. Was in no pain at all. All I could see was a catheter in my penis and some dressing covered in blood.
Was discharged about 3 hours later after I had some food and I could drink. Put a tap valve if that's what it's called on my catheter.
So now it's been 5 days since my catheters been in. First day was ok but it is now starting to get very uncomfortable. I can feel the irritation at the tip of my penis the most when I move the catheter. However I think the surgeon also cut my tip as it appears a lot bigger than before. This could be the reason for this, or simply because of the Foley catheter.
However I cannot stress how happy I wil be once they remove this damn thing, it is so hard to walk in it, as it is causing a lot of discomfort. I am also getting the urge to pee feeling more now than the first few days. Is this because of the bladder trying to get rid of the balloon?
So waiting now. 2 more days and the catheter will be removed. I will have to wait and see how my urine flow will be like, but I have been told it will be painful after they remove the catheter.
Will update more once this is done.
earl41296 billybwoy
Posted
Hoping for the best, how have things turned out?
I had a stupid straddle injury on my bicycle and suspect a stricture now...had a catherter for 7 days at the time of the injury to avoid strictures but been experiencing come and go retrograde ejac since then..All of this happened in July and i still have post emptying dribbling. My follow up is only in March!
Anyways, looking forwards to see how you've been!
billybwoy earl41296
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Sorry I've totally forgot to update.
They removed my catheter last Thursday and
billybwoy
Posted
The feeling was strange but not painful at all. Just make sure the nurse takes out all of the saline solution from the balloon which is normally 10ml.
My ability to pass urine now was amazing. It came gushing out with force every time I needed to wee. At some points it almost felt like I would crack the toilet or I can hit a strike at bowling with all the force haha.
However it has now been 2 weeks since the op and a week since the catheter was removed. I have developed some sort of discharge from my penis which is making the tip close and stick together.
I am circumcised so foreskin is not an issue. When ever I now pee I have to split the end together. I was vey concerned with this so I called my consultant and gp. My gp said this is normal as I have had an instrument inserted, and advised me to apply a topical cream called canestan. This has helped a little but I still get the stickyness. I also get a slight sting when I pee near the tip and the stream has also I wouldn't say slowed but I feel it is being obstructed near the tip as it is coming out as a straight line like a squeezed straw tip.
However I can wee a lot better than before and I have an appointment with the consultant this coming Thursday. So i will express my concerns here.
I will update again after I have seen the consultant.
I am also performing ISC which I was absolutely scared off, as before this I have been very healthy without any medical issues. However once you get used to it, it's fine and is not painful at all. Just a strange sensation which you get used to. Hardest part is when you meet resistance near the bladder wall and the catheter slips a little in your hand as you are pushing it through.
max74393 billybwoy
Posted
Thanks for your post. I was very interested to hear that you have just had a urethratomy. I have just had the same procedure with a dilatation and flexible cystoscopy. This was performed with catheter on Thursday of last week and I stayed in hospital overnight. I am now at home with the catheter in for a week and have to go back for my post operative assessment and removal of catheter, at which point I will need to urinate three times and have bladder scanned to see how it is emptying.
I am incredibly active person and I found it very difficult not to try and keep active although I have got a considerable amount of rest over the past few days I've noticed small amounts of blood at the end of the penis where the catheter is inserted after moving around doing chores around the house. And a little puss however I am on Ciprfloxin 500mg for a week.
I am very anxious about the thoughts of self catheterisation however having read your post I'm somewhat reassured. Can you please update as to how you are finding things now and how many times a week or a day are you catheterising to keep things flowing. Also how is the flow now?
Cheers M
billybwoy max74393
Posted
I went to see the consultant last week.
He advised I had a very tight but short stricture near the bendy part of the urethra.
My urine flow has been good since I've had the procedure and I am catheterising every 2/3 days.
billybwoy
Posted
I do have to push it through the stricture area. Not painful but it is a little tight still. I use a size 16 so making sure that goes through every 2/3 days so it doesn't close up.
In regards to your catheter which you have in place now. Keep it clean and wipe it with antibacterial wipes. Do you have a tap valve on the end?
I struggled with it to be honest. I tried to live a normal life with it in, but my penis tip was sore from the cath rubbing. Blood and discharge is normal as long as it is only a small amount.
You may also get some blood clots in your catheter which may block the flow a little. Just keep drinking plenty of fluids and you should be ok.
Urethroplasty was discussed with me also, but my consultant advised we should try and manage it for a while whilst I can and able to do so before we go for the more extensive surgery.
Feel free to ask me any other questions. I'll be happy to answer.
max74393 billybwoy
Posted
Thanks for that. Yes I have a catheter with a tap but I have a leg bag and also a night bag to attach to the end which I am getting used to. The catheter is uncomfortable at the end of my penis and j have suffered with a little constipation but quick change of diet and a glass of prune juice with meals is helping.
It feels weird going for a number two with catheter in. I have a very small amount of blood and very minimal puss to be honest. What size was the catheter that you had? Mine is a 16ch which is 5.3mm. I have looked and there seems to be larger ones.
I also get a weird feeling in my bladder when it is draining or when I need a number two and it is sensitised by touching my penis but will go if I have a trump lol.
I feel better about the ISC after you have described. Do you have another appointment with the consultant scheduled for a flow test in a few weeks? I have my cats being removed next week and as long as I am peeing ok without it I can then start ISC which I am told will be twice a day for 8 weeks then a flow test.
Thanks for your help. Also whereabouts are you in UK?
Cheers M
billybwoy max74393
Posted
I never really got to grips with the leg bag. Didn't use it to be honest, but improbably should have. The night bag is a saviour otherwise you'd be up every hour at night.
If you do suffer a lot at the tip, call the urology department at your hospital. They can provide an anaesthetic gel which kind of numbs the area for a bit so you can't feel it.
Yeah I believe mine was also a 16 5.33mm.
No more flow tests. Consultant said come back and see me in 6 months and we'll see how your getting on. Hopefully I will be alright without any issues.
I am in Nottingham, UK
max74393 billybwoy
Posted
I am based in Nottingham also under Mr Mann at City Hospital. I wash the leg bag each time I shower which is twice a day and have been using Calex antibac wipes on it to keep it clean. I am a little worried about bacteria around the value etc but I have to move around and I haven't always been wearing it under my joggers. As far as the night bag is concerned I find that the easiet especially as I do not have to worry about it too much however it seems that I expel a lot morenurune at night than in the day - what did you find? Probably because my body needs it less at night.
Did you have any blockages in the week you had the catheter? I have noticed it slow down at times and then drop 100ml yesterday evening after I got rid of some wind lol.
Is your flow really good now then with the 2 to 3 day isc? Also are you finding life is getting back to normal with day to day stuff?
Cheers m
billybwoy max74393
Posted
I had my op in Derby actually under mr Singh.
Keeping good hygiene is important to making sure you don't get any infections. And I definitely filled the bag more at night than the day. Perhaps when your more relaxed it drains more easier.
I was ok for the first few days, but the last 4 days I started getting some bladder spasms and also the urge to pee a lot more. I also had some blood clots in my catheter but made sure this pushed through after drinking plenty of fluids.
My flow is good now I am really happy with the outcome. I am living a normal life, but taking things easy. No sport, heavy lifting and protecting the Crown Jewels at all times haha.
I was surprised how I went from peeing in 4@ seconds to peeing in 10 seconds the same volume of urine.
You should be ok hopefully. No need to worry at all, trust me, I did all of that.
How long did it used to take you to pee before the op?
Billy
max74393 billybwoy
Posted
Thanks again I have to say really helps to be able to talk someone who has had exactly the same as I. It used to take me circa 3mins to have a pee as I knew I had an issue but left it so long as I am not a fan of hospitals and had, had a failed cystoscopy before that was very painful.
I have just given the leg bag a good soapy clean in the shower and cleaned valve etc and bag with antibacterial wipes.
How long did you live with the slow peeing before going to docs etc? What was the first pee like when they removed the catheter? Did they tell you that theyight send you home with a catheter if your first few pees weren't any good?
Also are out a drinker and have you had a beer yet? Lol
max
billybwoy max74393
Posted
I'm happy to discuss anything I've been through with you to help make your experience easier if I can
I had the issue for about a year. Went to the Drs about 6 months ago and they sent me home and said your young, just drink plenty of water you'll be fine. :@
It then got a little worse 2 months later so I went Drs again and they referred me to the urologist. Did a flow test and he advised it looks like I have a stricture. That's when he told me I will have to go under the scope to see what the issue is. (My worrying & anxiety started at this point).
However I have never pee'd so fast in my life the first time they removed the catheter. I was reluctant to go and was trying my best to hold back with fear it will be a lot painful. No pain at all. All urine came out with the last few mil some blood which is normal.
Honestly I thought I was going to crack the toilet haha. It's not as fast as that now but still at 70% if that was a 100%.
They told me on the days might have to go back with a catheter if I was not emptying sufficiently and I was praying it all went well. Thankfully it did.
I don't drink so I can't help you on that I'm afraid. Ask your consultant when you see him. Don't feel afraid to ask any questions no matter how stupid. Get all the answers you need whilst you got the consultant in front of you.
After I see the consultant on Thursday last week, I asked about sexual function and activity. He said back to normal. Again j was afraid it may be painful when I ejaculate. I told him I'm going to take the fella for a test drive and I did. All back to normal and I'm so much happier now
max74393 billybwoy
Posted
Yes I will ask the consultant when I see them about any questions that I have I must say the catheter is uncomfortable on day four as you said and quite irritating at the end of my Willy. I've been giving it a good clean every few hours and washing my hands well beforehand although it is almost like in itching irritation which is the worst but hey I suppose there is something in there that is not normal so will take a bit of getting used to.
So how long now have you been doing ISC? Have you had any days where it has felt tighter than others you said you were doing every 2 to 3 days so I assume you've only done this process 3 or 4 times now?
Also did you have any moments when you thought the catheter had slowed down a bit? I have noticed this and then suddenly speeding up but as you say I've been drinking plenty of water and clear liquids so seems to help.
Cheers M
billybwoy max74393
Posted
Your catheter will slow down at some points. This may be due to some blood clots which may be in your bladder. I had a blood clot which obstructed the flow and at one point completely blocked the catheter. However drinking plenty of fluids helped push it through and I could see the clots in my bag.
I have done ISC about 7 times now. Sometimes it feels tight, but I gently push the catheter through and j intend to keep the routine up and even do it more regular if I have to. I don't want it closing up anytime soon. The key from what I have read is not to get lazy with ISC or else the stricture will come back.
And the catheters are not like the one you will have in at the moment. They are disposable ones and a lot easier to handle. Especially the Lo-Fric ones which I use.
Billy
max74393 billybwoy
Posted
Thanks for all your support over the last few days. I wanted to update you on today's experience. I have been today to have my catheter removed and it was successful. Crack the pan is more or less bang on! I had 3 pee's over 200ml and it was a pleasure!
I was shown how to self catheterise and I have 14 size disposable catheters to take home which are the low friction ones as you mentioned. I need to self catheterise twice A day for eight weeks and then I have an appointment in the new year and the flow test and hopefully touchwood will need to slow down with the catheterisation. My stricture is near the front of my penis and I have a very small one halfway down I just wanted to know do you have to catheterise all the way through your sphincter into the bladder? As I'm sure you will appreciate this is the most uncomfortable part of that process aside from that I have done it twice today and would prefer to have this side of the process rather than wearing a catheter day to day.
Thanks again Billy all the best Max
karenwilde billybwoy
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karenwilde billybwoy
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max74393 karenwilde
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I would very much doubt that the pain course from the urethrotomy cause pain from the Naval down it sounds more like the hernia to me. I had this procedure two weeks ago and although my flow rate has slowed down somewhat I do not get any pain around the naval area perhaps a tiny amount in the penis and a little in the groin.
From reading your previous post it looks to me like a urethroplasty is the way forward for your son and I am sure that the hospital will be able to find a solution to help with your son pulling at the catheter. I would push as much as you can to get this procedure sorted ASAP if it is right for you that is!
Is your son self catheterising?
Thanks Max
karenwilde max74393
Posted