my urethrotomy experience, good and bad parts

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

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