Stricture's.....Which way to go???

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I have a urinary stricture just before the prostate.  I will be seeing how bad it is on the 7th of December having a scope.        I have been having trouble peeing slow and have to force myself.  Now I will have to pic a procedure My uologist has talked about 2 procedure.  One is Balloon Dilation and the other Urethroplasty.  With the balloon it sometimes comes back.  But with the urethroplasty it will be fixed.  At 60 do I what to have something done every year or just get it over with and fix it.  One is less evasive and the other is major surgery.  Has anyone had these done I would like your input on them please Ken

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  • Posted

    I have done the ballon catheter thing twice and it always came back. I had also pain which never ever reduced. I suggest you should do it once and for all.

    Do u have pain though??

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    • Posted

      Thank you for your reply  I have no pain other that when I pee  I have to force myself to go...Ken
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  • Posted

    I had regular dilation 20 years ago, and it was great for a few months, then came back worse. Month ago I had basically a single cut along the top inside through the structure. It's been free and clear since but that was only a month ago. Insist on keeping a catheter in for at least a week. It'll allow the cut to heal open and free flowing. That's what I missed the first time.
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    • Posted

      What type of Urethroplasty did you have.  I know that a catheter is put in for it to heal.  You said a single cut.  Did you have a graft put on it?  The cut they use to get to it is something Groin to the anus. What about the healing time.  Ken 
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  • Posted

    I am 70 years old male. I had my first urethrotomy when I was 25 years old. I had regular (annual) urethrotomies until I was 60 years old. I was then persuaded by my Urologist to undertake self dilation. This worked very well  such that I did not have to visit my Urologist for the next 10 years. I had another urethrotomy last year and am continuing with my self dilation (self catheterisation). I have no problems. The mistake I made the last time was that I was lazy about carrying out regular self catheterisation and hence the stricture came back. Self catheterisation is easy and painless. I do it about two to three times a week. It takes about five minutes to do and only requires a source of very clean (perhaps sterile) water.

    I would be very careful about urethroplasty - especially as it is so close to the prostrate.

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  • Posted

    Hi Ken thanks for your message,

    Your consultant would really be having to perform a cystoscopy prior to offering a solution. Until they have explored your urethra they cannot tell you what the problem is whether it is a stricture or not and what the size of it is and how large the narrowing is. I am based in the Midlands and from what I have learned from the Nottinghamshire area is that following a cystoscopy a dilatation at the same time can occur with a follow-up of self catheterisation. From what I have learned urethroplasty is the best fix for this problem and has a much higher success rate than anything else. The dilatation alone has very poor success rates I have just had a dilatation and urethrotomy which is the procedure wear a coat is made along the scar tissue inside the urethra. I am now a week down the line and my flow has slowed somewhat but is still at an acceptable level and I am having to self catheterise twice a day for eight weeks at that stage I will then have a follow-up appointment and a flow test. My consultant seems to think that a urethroplasty is the way forward and I am of the same mind .

    I hope this information helps a little please do not hesitate to ask any more questions thanks

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    • Posted

      Hey max

      Do u experience pain while urinating or even when u have sex or so?

      I have been dilated and was on self catheter for 2-3 years then I left because it never really made a difference to me. However my urine flow has decreased and I have to use a lot of force like giving birth lol. Anyways my main question is to know if the pain is regular in everyone because pain is the only think that's killing.

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    • Posted

      Hi Ladha,

      I used to experience pain arond where the stricture area was when I use dto go an urinate. I also used to get a lot of pelvic pain in the groin and penis inbetween urinating however I would say that it was a niggling pain rather thann anything else.

      Can i ask how long has it been since you stopped self dilating (self catheterisation) and how long did it take for your flow to slow down from stopping? As far as I know you could go on peeing like you are for a long time however the pressure of having to push is obsviously causing you pain and also the risk of not emptying your bladder and UTI's following from that.

      I very rarely had erection pain and my stritcure is recokened to be 4cm long so on the larger side.

      Having had the operation to cut the scar tissue two weeks ago my penis hurts slightly when erect and i havent been brave enough to give it a test drive yet either ;-)

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    • Posted

      Thanks for the information.  My urologist knows of the stricture.  He found it last year when thy tryed to catheter me in the hospital..  He's checking now because I had a uro-lift done in April and he think because the equipment they use is bigger then the scope it could have tore the stricture and made it worse.  We will see on the December 7th.  That was the 2 opinions he gave me.Ken
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    • Posted

      Max you said you had it cut out which procedure.  Did they go through the penis or the groin??  Ken 
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  • Posted

    I have had two cystoscopies this year about 4 months apart because of strictures after my urethra was severely damaged when the medical instrument used during a TURP damaged the urethra as it was removed. (I am 61 years old. I had the cystoscopies when I was 60.)

    In the second cystoscopy, the urologist created an opening the size of a 20 catheter. I use a 14 catheter when I self-cath twice a day.

    As long as I self-cath twice daily, I am able to urinate without any problem, and the catheters are 100% covered by a minimal insurance policy (Ohio's expansion of Medicaid through the Affordable Care Act) since they are a medical necessity.

    It took me a while to get accustomed to the idea of self-cathing twice daily, but once I got past that stigma in my head (thanks to a Roman Catholic upbringing), I have had absolutely no difficulty urinating.

    Consider the self-catheterization process. It has worked extremely well for me.

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