Treatment for Urethral Stricture (post optical uretherotomy). Making the right decion.

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Hi & thanks for taking the time to read this,

    I'm a 34yr old Male looking for advice on deciding how best to next treat my urethral stricture. I have been having much difficulty with this & escpecially so since my first surgery 6 months ago. After many years of living with the symptoms (straining, sudden urge to pee, getting up in the night) I decided I needed to do something about my stricture. After several consultations with various people I decided to undergo an optical uretherotomy which I was told would have a 50/50 success rate but ultimately meant I had 'nothing to lose'. 

After the surgery (optical urertherotomny) the doctor said he was pleased with how it went but he would want to see me again to complete it as he felt there was more work that needed to be done. He told me a cut of the stricture was perfomed which i wasn't expecting. 

Since then my life has changed drastically.

I now suffer terribly from retention (something i had never experienced before the surgery), where I physically can't pee at all although I know my bladder is full & I feel like I desperately need to go. The only way I can go is to self catheterise (sc). So today (6months after the surgery) I have to sc at least once a day, sometimes it can be 2 or 3 times. Although I'm now very used to doing it it's a huge annoyance & become something I have to manage very carfeully as wherever I go I always need to make sure I have catheters I can use quickly. Usually after I sc I can pee of once or twice but it seems after that when the bladder has become more streched I get retention.

I don't understand why this is happening nor why having the surgery done it seems to have created this. As I said before I never had a problem of not being able to pee before the surgery.... if anything it was the opposite lol!

The other outcome of the surgery is one that has really hit me hard and one I didn't expect or was I warned may happen. I'm only writing this to make people in the same position as me aware in future when deciciding for themselves what's best to do. Since my surgery I've also developed a slight downwards bend in my erect penis. It's between a 10-20% bend from which I believe (although not proven I guess) is caused by some kind of scarring or trauma from the surgery. Something which apparently wont heal by itself!!! This now seperate issue has caused me much discomfort & grief and has certainly affected my sex life & self esteem.

So going back to my initial advice of  'I had nothing to lose' by undergoing the surgery you can uderstand why I feel slightly let down by that to say the least. 

So what to do next is where I really need help.

I've just had results from a urethrogram confirming I have 'quite a tight but relatively short stricture within the penis. With that in mind I can only see 3 options for me. 

1. Complete the urethrotomy & hope for a more succesful outcome. (baring in mind the reults, which i've just explained, of the previous surgery this option does concern me greatly)

2. Discuss getting urethraplasty surgery done which would hopefully offer a more permanent & positive outcome.

3. Do nothing and just hope things improve.

So what I'd really like at this stage is advice from people who have been in a similar/same position as me and what their results were, bad or good, so I can then make a much more informed decision. I'd also like to know if anyone has had any success with this issue through a private surgery?

Many thanks your advice will be much appreciated

Will

 

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  • Posted

    Hello Will.  I am sorry that your having a problem.  At your age your in the prime of your life and should be enjoying your life.  Didn't your Doctor tell you that anytime they stick anything in the urethra you can get scare tissue.  I'm 60 and I did not know that I had a stricture until last year when I was in the hospital and they came in and forced a catheter in me without telling me.  That another horror story.  I hurt so bad after that.  My urologist found it after a scope.  Over the last 5 years I have had over 20 kidney infection and I had sepsis last year.  I have a infection now and I on ciprofloxacn 1000MG for a month.  This time it hit my prostate.  I found that out when I had a orgasm.  It hurt so bad that I try to stop it but it happen anyway.  My urologist has giving me to options.  A balloon dilation or a end to end urethroplasty.  With the dilation they take a catheter that has a balloon on it and go in and brake up the stricture.  The problem with that it can come back and it can cause more scarce tissue. And you have it done again.  Or being that mine is short have the end to end and get it out. The only thing is the surgery.  Going in through the perineum.  It will take me longer to heal they you if you have that done   And the side effect that could happen.  I'm 60 and still enjoy sex and don't what to lose it.  How big is the stricture and do you trust your Dr.  If they take a 1/2 a inch of the urethra that would be fine but.  I read a story about a men that had a small stricture and when he woke up the doctor took 3 in off and he could not make love to his wife.  The Dr said he had to because the stricture was worst.  To me he had no right to do that. Before anything talk with your doctor.  The bend in your penis I would leave alone. What they do to the penis to fix that is bad  Watch a video on it.   They cut the penis open from the tip to the end to get to the stricture.  What ever you do talk with the doctor and get as much information you can before you do anything.  I go to the doctor on the 11th of January for a scope and we will go from there.   Good luck  Ken            
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  • Posted

    HI Will-

    I'm also to hear about tour condition. I suffered from a 2-3 mm long stricture but it was in a different location than yours (closer to the bladder). I suffered from it for 20+ years and after a fairly recent UTI infection that caused the stricture to "clamp down", I decided to move forward with a bulbar mucosal urethroplasty that took place a month ago today. I'm very satisified with my flow rate and have great hopes for a urethrotomy-free future. The pain and 3 1/2 weeks with a Foley catheter were certainly no fun but I'm hoping that the location of yours and the fact that the surgeon claims that he/she can do an end-to end-urethroplasty would make for a more rapid recovery. I hadn't been planning on a urethroplasty but the attending urologist in the ER (who performed the dilation) strongly recommended a relatively new surgeon who's done an extensive number of the surgeries (300-400). Luckily, she's in my insurance network. If you'd like her name to get a recommendation on a local surgeon, feel free to private message me. 

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    • Posted

      Hey Guy's  I have a stricture in the bulbar area. Never know I had one tell they try to catheter me in the hospital  3X  All they got was blood.  That was 3 years ago and all is doing good now. I have look up the end to end and that looks like it would be good.  I may need it one day  All I worry about is penile shortening  Did your doctor talk to you about that  Don't mind 1 inch but I read about a guy that his doctor told  him thay would not take more then 1 inch  The doctor had a problem and took 3 inches It messed up his sex life   Ken       
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