second urethrotomy tomorrow for obliterative bulbar stricture

Ignore the top paragraph, i deleted the description of the procedure, thought it was a bit much haha. Although if you are looking for details you can Google the procedure.

All the best Ollie

i had my first urethrotomy in Feb 2014, the Doc said it was upto me to go with urethoplasty but I chose against it.

Nov 2014, I started notcing blood in the urine again so went back to Doc and in Dec 2014 Doc did cystoscopy and dilated the stricture which had scarred from the urethrotomy.

2 days after cystoscopy I noticed significant bleeding post urinating.

Went for a flow test and Doc said flow is good and that blood should heal.

I think the scar has torn as I've never bled this much even with the original stricture.

Got to wait 8weeks to see if it heals then I can elect for urethroplasty.

My doc has always maintained that urethrotomy is low risk but also low success rates and better to do urethoplasty.

Good luck with your urethotomy but dont be surprised if you are back under the knife getting urethoplasty done.

 

Got cancelled.....

Got there, nurses did the checks, chatted to anesthetist and urologist, i was second on the list.

Then I got told they hadn't been able to get a bed for me to have in the extended stay area or possibly overnight incase i had delayed bleeding like I did last time.

If I went ahead with it it would of been in, done, wake up, on my feet, out the door.

Last time I had delayed bleeding for a few hours post op and lost about a litre in recovery room, so it would of been ideal to have a bed so they could monitor me for bleeding. Didn't want to get home and find i was bleeding out and die haha.

Even though I said last week at the pre op assessment "I'll need a bed for a while post op" 

So i was given the choice of 3-4 weeks to get back in for urethrotomy, or change to urethroplasty which would be 8-12 weeks but a 80-90% permanent cure rate as opposed to urethrotomies 95% recurral rate. And also my stricture was more complex, he'd of had to pierce the middle and hope the blade didnt catch any nerves or the sphincter or go through the wall into the blood supply, then place a guidewire through that hole and carry on as a normal urethrotomy.

After all this mess up, i needed my suprapubic catheter changing as I only had 2 weeks left on its 12 week allowance, so we thought we'd replace it there instead while I was there, i asked if I could have a more comfortable latex one preferably with a hydrogel coating. They didn't have any, only the uncomfortable all silicone ones, so I asked them to arrange a district nurse to come out and change it.

Set off home, got in a taxi, was half way home, the hospital ringing, district nurses aren't allowed to do the first change, has to be in the hospital by the urologist... Turned the taxi around and went back, f***ing he'll i wish they'd of put me to sleep to do it, I'm a very pain tolerant person ( crushed a finger end between some dumbells at gym once and barely realised I'd done it)  but felt like I'd been stabbed every time it moved, was instantly in tears, man tears,  ,  if I was given a mandatory choice between having that SPC change pain again or being kicked in the testicles, id hands down choose the nutcracker. Did not expect a simple SPC change to be so painful, was shivering in pain as he was doing it. 

All this because they simply had no beds available, this is at york, although the over abundance of patients is happening in quite a few places.

i don't blame the nurses they do a great job, i blame the people higher up for not hiring enough staff and workforce and not being rush ready for winters illness. And not investing enough into equiptment and facilities, 2 of the machines that check blood prssure, heart rate, little thing on wheels they pull round to do those then push back, usually one in every bay, two of those broke on front of me. Took 3 machines to take my blood pressure.

Would really of liked to just have it all over and done with for at least 6 months ( possibly longer as this time they were going to put me on a self dilation regime to keep it open) but now I'm waiting a further 8-12 weeks. Yay.

Changed back to urethrotomy, also been rescheduled for a week on Monday after complaining. ( the fact that in may as a none urgent, time I waited for this op was 8 weeks, urgent status this time 10-12 weeks.... " Jackie chan wtf face")

I would prefer to be rid of the whole problem but frankly I don't feel ready to take the risks of the open plasty, with my stricture being so deep and pretty much a high chance of something being damaged due to the location.

Plus I will be losing 1.5 or nearly 2 grand in loss of wages if i waited the 8-16 weeks, as I'm now on statutory sick pay... Which is crap. And I'm cannot afford that. So I'm pretty much forced to choose the temporary urethrotomy for now, if it recurs again I'll go with the plasty.

Will update with how it goes when iv had the urethrotomy on the 19th, IF the bed issue doesn't happen again haha, if it does I'll just sit in the walk in centre for days until they see to me haha.

best of luck mate

Got it done, was looking like it was going to get cancelled again because they'd overlooked the reason it got cancelled last time, the haemophilia bleeding condition and need for monitoring, i was first on list but had to be put to last out of 3 as I needed a sedative to calm me and prevent panic attacks but they came to take me down 30 mins after taking them all they hadn't really taken full effect, was 1 big room with all the staff in there, i started to have a panic attack so they quickly gave me gas which knocked me out slowly after a minute, i tried fighting it without meaning to but it worked, then they will of given the actual anaesthetic after that.

Apparently was all good, re opened it, they used a flexi scope in through belly stoma for a second viewing angle with the stricture being a full seal, he made a small hole in it and placed a guidewire and did the standard 12 o clock incision. Apparently it had gotten a bit longer since last time, about 2 cm as apposed to 1 cm.

Left a 22f catheter in place which I'll have for a week. And get removed back here then a flow test.

Since I entered a trial they will check up on me every 3 months for results and things.

Gonna get some sleep now. Or at least try, got a loud snorer in next bay to me.

Will update again soon