Urethral strictures, optical internal urethrotomy and Hydraulic Urethral Dilation.
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Has anyone here had an optical internal urethrotomy, and then been instructed to do hydraulic urethral dilation (HUD) for a month following the urethrotomy?
I had never heard of HUD until a man from Tanzania posted a month or two ago that his doctor had directed him to do that procedure. What HUD entails is this: When a man pees, he starts the flow of urine, he stops it by squeezing the urethra near the end of the penis. He said that doing this had been helpful in keeping this stricture from coming back.
I did some on-line searching, and found one obscure study in the East Africa Medical Journal by Mkony CA in December, 1999. The preliminary report claims that for 23 patients who had an OIU, in a followup period of five to seventeen months, only 2 of the 23 patients showed clinical evidence of stricture recurrence.
This is interesting to me because I had a complex stricture at the external urethra, caused by a botched Green Light procedure for BPH. I was left highly incontinent, and the stricture kept be from being able to have an AUS (Artificial Urinary Sphincter) implant. My doctor did a bit of a moonshot by doing a urethrotomy, using a Fr 22 catheter (large for me) for a week, then doing the AUS implant only 5 or 6 weeks later.
This has been a tremendous success for me, as the AUS keeps me essentially dry, except for a few drips if I cough hard. The urethra seems to be patent (open) with no sign of the stricture coming back. When I empty a full bladder (about 400 cc for me), the average flow rate is around 29-30 cc/second. I attribute this to the fact that the urethra down to the cuff of the AUS is under pressure all the time (except for when I open the cuff to pee). So this amounts to constant pressure for much of the urethra, including the stricture area. I am assuming that having the pressure of urine keeping the urethra expanded through some process keeps the stricture from coming back.
I was surprised to find nothing about HUD in western urology journals. If it works, it would seem to be of possible benefit to men with stricture disease. It's a zero cost procedure, following a urethrotomy, so I wonder why it's not used.
Glenn
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rich_27922 glenn77
Posted
glenn77
Posted
Rich,
That has occurred to me too. I purchased a couple of different clamps when I was dealing with the non-stop leaking caused by a botched Greenlight Laser procedure that irreparably damaged the external sphincter; the clamps were so uncomfortable that I only used them a few times.
While a clamp might have been useful to me after a urethrotomy, it probably would not help someone with a stricture that is located anterior to the sphincter. That is, unless the person could cause the sphincter to open and pressurize the urethra down to the clamp for a while.
I intend to discuss this with my doctor, as I'm not sure US doctors are aware of it.
glenn77
Posted
Amend last sentence to, "I intended to discuss the HUD procedure with my doctor as a possibility following a urethrotomy, as the HUD doesn't seem to be known in the US.