Some of the comments are from people who have had a bad ...
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Some of the comments are from people who have had a bad experience or a more severe condition. therefore I thought I would add a comment from someone who has had a mild condition and what I think was a fairly straightforward treatment in case you are due to undergo this process and are worried. Even in a mild case such as mine it isn't pleasant, but once you're over the squeemishness, if it's a mild condition it needn't be a total nightmare as long as you know what to expect. Ask lots of questions.
I was diagnosed with a very short double stricture when I was 21 while at University. It still isn't clear whether this was congenital or caused by a bike crash. I had a urethrotomy and was kept in hospital for two nights with a catheter in. I hadn't been told this might happen so I was a bit shocked and unprepared and it made me think it was more serious than it was. However, it was just precautionary and it wasn't THAT uncomfortable, although of course I only had two incidences of morning glory to deal with.
The op was effective for about 5 years but then recurred - I had not been told to catheterise in the intervening period. I was referred to a different hospital where the consultant had less experience of the condition, so i was a bit wary. It took two attempts for the urethrotomy to work this time (less skill from the surgeon or bad luck? hard to say). however, in both ops i was under for less than 10 minutes. Only on the second time was I kept in overnight with a catheter to try to make sure the operation was a success.
The doc told me this time that if the op didn't work they would have to do a more dramatic surgery which involved cutting the length of the penis to "mobilise the urethra" and excise the affected area (the urethroplasty referred to above). I later found out that this was only one option given the short length of my stricture and usually is applied to more severe cases. I still resent the panic that this caused.
To avoid this more extensive op I have had to self catheterise once a month (initially every three days then gradually longer and longer intervals). This is really not too bad and personally i think is more bearable than a more serious op. It's now 5 years later and there is still a noticable deterioration of flow over the course of the month between self-catheterisations.
the worst part for me was the test as the urethrotomy is fairly quick. For the first test they used ultrasound and this was embarassing but not intrusive or painful. The second time they attempted to force a liquid backwards up the urethra that shows up on x-ray. I was made to lie on a table while they used a syringe to inject the liquid - they then stood me up and tried to record me on x-ray urinating. This was very uncomfortable and sufficiently unnatural and unsettling that I all but fainted and couldn't urinate. However, on reflection, my reaction was due to lack of knowledge about the process and therefore fear. The process is undignified, but it was over fairly quickly (half an hour).
In summary I would say:
- self catheterisation isn't that bad so should be considered if it works for you. It's not comfortable but it takes very little time and is sufficiently spaced out that I don't really think about it in between. You'll get used to it! I have only had one infection since catheterising, which resulted from using bottled water in India. In future I will take sterilising tablets even to fairly nice hotels!
- the worst part for me was the test. I would recommend asking your doc for advice on whether they can use an ultrasound. They may say no as it doesn't pick up other pathologies that might underly the condition, but ask the question.
Hope this is helpful to anyone newly diagnosed. Clearly everyone's condition is different but the point is that it can work out OK and that using a catheter regularly needn't be a trauma.
[i:d72322ffb6]This message was automatically imported from the original Patient Experience[/i:d72322ffb6]
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Guest
Posted
I have found the self catherterising very painfull and generaly horrible (but have only done it twice so far).
Please could you tell me if it gets easier with time? Also how are you getting on now? Do you still have to self catherterise?
Any reply would be appreciated. Thanks, J
medexperience
Posted
Please could you tell me if it gets easier with time? Also how are you getting on now? Do you still have to self catherterise?[/quote:a65a7c3dfd]
Can't speak from personal experience, because catheterization was impossible following my urethrotomy. But here's some relevant discussion in the literature:
[quote:a65a7c3dfd]Self-catheterization is a traumatic maneuver that most patients view with considerable disdain as a [b:a65a7c3dfd]painful, time-consuming, embarrassing, difficult and unnatural[/b:a65a7c3dfd] practice they would gladly abandon if given the choice. False passages will develop in most cases over time, further complicating the problem. Today we can and must do better.
Urethral Stricture is Now an Open Surgical Disease
Allen Morey
Department of Urology
University of Texas Southwestern Medical Center
Dallas, Texas
0022-5347/09/1813-0953/0 Vol. 181, 953-955, March 2009
THE JOURNAL OF UROLOGY®[/quote:a65a7c3dfd]
[quote:a65a7c3dfd]... the stricture [b:a65a7c3dfd]inevitably recurs when the patient stops[/b:a65a7c3dfd] self-obturation, regardless of how long it has been used
CAMPBELL-WALSH UROLOGY 9th ed.
CHAPTER 110. Surgery of the Penis and Urethra
http://www.fk.uwks.ac.id/elib/Arsip/E-Library/e-book/UROLOGY%20AND%20NEPROLOGY/CAMPBELL%20-%20Urology/chap110.pdf
e.g. as cited in article by Cetti, Greenwell & Venn in UROLOGY NEWS • Volume 10 Number 3 • MARCH/APRIL 2006[/quote:a65a7c3dfd]
[quote:a65a7c3dfd]EDITORIAL: TREATMENT OF RECURRENT URETHRAL STRICTURES
... there is no point whatsoever in repeating the procedure in the hope of achieving cure by urethrotomy alone
Euan Milroy
Institute of Urology
The Middlesex Hospital
London
The Journal of Urology
Vol. 156, 78-79, July 1996[/quote:a65a7c3dfd]
[quote:a65a7c3dfd]Current concepts in the management of anterior urethral strictures
Being subjected to intermittent self catheterization is [b:a65a7c3dfd]far from satisfactory[/b:a65a7c3dfd] when cure is the goal.
A. Mungadi and N. H. Mbibu
Nigerian Journal of Surgical Research, Vol. 8, No. 3-4, Jul-Dec, 2006, pp. 103-110
http://www.bioline.org.br/request?sr06025[/quote:a65a7c3dfd]
[quote:a65a7c3dfd]EDITORIAL COMMENT
... this article also casts doubt on the practice of self-catheterization to try to keep strictures open after urethrotomy. Of these patients [b:a65a7c3dfd]73% had recurrence on a self-catheterization regimen and another 18% had so much pain with catheter passage that they had to abandon it[/b:a65a7c3dfd]. Again, few reconstructive urologists attempt this maneuver since it always seems to fail, not to mention that it [b:a65a7c3dfd]unnecessarily condemns the patient to a lifetime of painful self-catheterization[/b:a65a7c3dfd], which would not be necessary after surgical cure by open urethroplasty. An excellent study by Greenwell et al suggests that self-catheterization has no value, at least for anterior strictures,1 and the current authors add doubt about its usefulness for posterior urethral distraction injuries. This [b:a65a7c3dfd]suboptimal management scheme[/b:a65a7c3dfd] remains wildly popular, judging by the referral population seen at our clinic, despite the real doubts as to its efficacy. It is another specter [b:a65a7c3dfd]in need of a stake to the heart[/b:a65a7c3dfd], in my opinion.
Richard A. Santucci
Department of Urology
Wayne State University School of Medicine
Detroit, Michigan
THE JOURNAL OF UROLOGY®
Copyright © 2007 by AMERICAN UROLOGICAL ASSOCIATION
Vol. 178, 1656-1658, October 2007[/quote:a65a7c3dfd]
sandra4910 Guest
Posted
I have been self catherterizing for the past 20 years, I had my bladder removed and a new one made from my upper ileum, at the time I was 38, of course I have had water infections over the years, however more importantly my quality of life increased and water infections are contained with antibiotics, I did not suffer and still do not, but had the operation never been carried out, I would be 20 years down the road, living in pain, exhaustion, depression, it was a no contender decision, life a 'normal' life or be in and out of hospital.