URETHROPLASTY
Posted , 4 users are following.
All started beginning this year (Jan 2018) was diagnosed with lichen sclerosus, which after a few weeks got inside my urethra, causing urethral stricture. Went to 2 different urologists and 2 cystoscopy, second one gave me a UTI, caused by ISD, which I did find just too painful. So I was advised to undergo Suprapubic Catheter Surgery followed by Urethroplasty. Yesterday I went for the first procedure, and getting out of theater I was told that there was no need to place the Suprapubic Catheter as flow was still ok...., and I will see my current urologist in 2 weeks time. What I was told after this surgery is that I might need a BNI, bladder neck incision and also to widen urethra at the top entry area..., I really just hope I do not have to self cath again, just too painful...., would rather go for the urethral reconstruction. I wonder if the Urethrotomy would be enough to avoid self cath....??
0 likes, 11 replies
kenneth1955 carlo86905
Posted
Hey Buddy
You do not say how old you are and what size is the stricture and were it is. Where is the stricture at what part of the urethra.
So you did not have the suprapubic catheter because your flow is still good. So why are they going to do a urethroplasty if you can still pee. That BNI does not make since either if your still peeing the bladder nick is fine
What about a balloon dilation. That is what I would will do if my stricture get any worse. I have a stricture just before my prostate. I would never have them cut me in that area to much can go wrong. It can get you problem with erection and the healing time. What type are they going to do a end to end or a graft.
The graft is better because that would open open up the urethra. With the end to end does the doctor tell you about penile shorting. One man on here had it done and they took 3 ins. He had trouble having sex
Please think before you do anything............Good Luck........Ken
carlo86905 kenneth1955
Posted
hi Ken, thanks for your reply, I m 43ys, by balloon dilation you mean intermittent catheterization ? my strictures are mainly caused by the LS, both at the bladder neck and at the tip entry. After my UTI, my Urologist was keen for the Urethroplasty as the optimal remedy.
The issue with having sex is the boiling sensation, which I would say is a combo of quite a bit of instrumentation in my urethra in the last 3 months. Not playing any contact sports anymore as the smallest impact we ll b lethal. In ten days time I have a follow up appointment with my Urologist so we ll go through the extent of the strictures and how to proceed, just hope I wont need the intermittent dialatation or catheterization as was cause of my UTI, and so painful..
kenneth1955 carlo86905
Posted
Sorry
So your saying sex is off the table for now to pain full. To much in and out with the instruments do you know that can cause a stricture in it self. That is how I got mine kidney stone surgery.
The dilation is a balloon catheter but when it is put in to were the stricture is and then the balloon is blow up to make the stricture bigger. I do not think that you can have that.
I do not want to scare you but have you look at the pictures when they do a penis urethroplasty they are going to have to cut it out and re put you together. You have to look at the picture so you know what is going on. and what is going to be done to you.
Good luck.......Ken
carlo86905 kenneth1955
Posted
i can see is a massive reconstruction, but the other options: dialations, urethrotomy, striches are quite recurrent, not with urethroplasty, I might be fine if LS qoes away...
now taking Tamsulosin to widen the urethra and bladder neck, lets see what it does.....
kenneth1955 carlo86905
Posted
Carlo
It is good that you are aware of what you have to go through. Get what you have to to make it help you pee better but I would stay away from any bladder neck surgery. If the pills work for you then that is great.
I know I take a muscles relaxer for the external sphincter. It will help with relaxing everything in that area and it does not give you retro. At your young age that may be a problem. At 63 I find it a problem I'm not giving up on anything.
You do know if they go in and start doing stuff to your bladder neck it can cause you more problems then what you need. Leaking. scaring which are more strictures and retro because the bladder neck will not close right.
What ever you do make sure you have it explained and be aware of everything.
Peace and Love............Ken
carlo86905 kenneth1955
Posted
hi Ken, how are your infections going ? I just received medical report on my latest cystoscopy + (attempted) insertion of suprabic catheter, the insertion was decided against due to location of both stricture, at the top (meatus and the bulbous urethra next to the bladder mouth)
Had procedure last Monday, today s Thursday, intense urethral boiling sensation is back, crossing my fingers is not another infection...., might just be the stricture getting tighter and irritated, considering they went through 3 cystocopies and 1 UTI in less then 4 months lol, and LS getting inside the urethra.
This boiling sensation, is a big pain, will need strong pain killers to sleep, next week I m seeing again my current Urologist who is planning 2 procedures, opening of meatus at the top, and maybe BNI.....
My current flow is ok, burning stricture are not affecting speed, they are causing big boiling pain at any time
kenneth1955 carlo86905
Posted
Hey Carlos
Doing much better. They think it's a kidney stone again. I have past 3 or 4 small stones in the last 8 month's. I'm on Cipro for 14 days. Will see my doctor on the 7th
I feel sorry that you will have to have your meatus cut and then put back together no man should have to have that done. That is going to be very painful. I tried finding the other one but it is before the bladder. How are they going to do that.
Mine is at the bulbar urethra. That is a lot to go through and a lot to put your urethra through. What ever you do make sure he explains it before you have any surgery. And do not let him touch your bladder neck that will cause you more problem. They are going to have to open your up to do that one. If that is what you are going to have to have tell him you want the graft one not the end to end.
I know sex is not your concern right now but one day after all this is done you want to be able to enjoy yourself. With a end to end you have penile shorting. I don't think you want that. I have watch both surgery's and it is a lot to have done.
Let me know after you talk to the doctor. Make sure you have your question marked down so you can ask him and you don't forget.
Good luck buddy.I will say a prayer for you....Ken
carlo86905 kenneth1955
Posted
LS is a little-understood condition of unknown aetiology. Observations have suggested an autoimmune pathology possibly related to chronic irritation of the urethra with urinary extravasation into the corpus spongiosum. If caught early, it has been shown to regress with steroids or potent anti-immune therapy. In the case of obstruction and irritation of the urethra, progression may occur. It is unclear whether early management of the obstruction arrests progression. Certainly patients presenting late may have involvement of the whole urethra.
Management involves a stepwise approach. The notion that circumcision is “curative” in more than 95% of patients with only foreskin involvement is probably inaccurate as recent data suggest a lag of more than 10 years for LS occurrence in the glans and urethra. Urethroplasty is feasible in these patients and should use oral mucosa. More data are required to determine whether there is a significant difference between the one- and two-stage approaches. Finally, a perineal urethrostomy may be appropriate for certain patients. With each of the management options, there is not one which can claim to “cure” the condition and therefore long-term follow-up is warranted.
carlo86905
Posted
LS is the main problem, inflaming and injuring urethral walls, from there the ultra boiling pain, without necessary narrowing further the urethra.
Living with this pain vs urethroplasty , aint any good options,
in some cases LS does disappear...after aprox 2ys
no wonder is the top nightmare for Urologists worldwide, affecting only a 10% of patients...
kenneth1955 carlo86905
Posted
My Friend
I am sorry for what you have to go through. But you have to do all the research and ask your doctor everything. Make a list before you go. You want to know all the good and the bad.
At 43 you need to know. By the way do you have any kids????
Just wondering........Ken
marko19 carlo86905
Posted
mine would be a lot furter in than urs, known as a torterous urethra,id love to be able to pass a cathether but far to narrow,tight n sore,cant understand everthing else is fine,erection,ejaculation nearly to much lol