Your experience has been very similar to mine. I’m 38 and had a stricture for the majority of my life, but it was never diagnosed. I had spots of blood after urination for as long as I could remember and one urologist just assumed it was non bacterial prostatitis, because In was in my early twenties at the time. I was able to still urinate without any major complications until a couple of years ago. It was getting to the point where I had to strain during urination and started experiencing retention whenever I drank a few beers.
I finally had to address these symptoms, so I tried supplements for prostatitis, thinking my prostate was inflamed. The supplements actually helped to prevent bouts of retention, but I started to experience more painful urination and blood after urination. My doctor referred me to a urologist, who happened to be a surgeon as well.
The urologist scheduled me for a CT scan and a cystoscopy. The CT scan was first and revealed that my right kidney suffers from atrophy and had fluid around it, but my other kidney is in great shape and has compensated for the lack of the other one. The cystoscope couldn’t be used, because a stricture was blocking it. The urologist was shocked that I could somehow urinate on my own and scheduled me for an emergency DVIU. This was done last April and I had to wear a catheter for a week. After the catheter was removed, I have never felt better while urinating. My urologist told me that a stricture would most likely return, however he hoped that it would be several years. Unfortunately, this past April the bleeding returned after urination, but I still had a decent flow. The cystoscopy revealed the inevitable…another stricture. My urologist said that my options were another DVIU, self catherization, or an urethoplasty. At my age, he had concerns with another DVIU and self catheterization, because he said this could cause more scar tissue to form and make things much worse. I opted for the urethoplasty with a buccal graft, because he has performed this type of surgery a few times and this would allow me to stay home.
The surgery was performed in the middle of July and I returned home less than 24 hours after the procedure. I really didn’t have much pain and was able to eat normally a couple of days later. After a week or so after the surgery I noticed that the stitches started to dissolve in the incision of the perineum and left a very noticeable wound. This concerned me, so I had it checked out and was told that it would eventually heal. I had the RUG 3 weeks post surgery and it revealed a very minimal leak of the contrast dye in the bulbar urethra. The urologist felt like it would heal on its own and the catheter was removed.
Everything was going well, except for the incision site. My urologist said it wasn’t healing normally and was concerned a fistula may have developed, preventing the wound to heal. If a fistula formed, then it would require a more extensive procedure, which would also include another urethoplasty. I had another RUG at the end of October, which revealed that the urethoplasty was successful and there wasn’t a fistula…great news.
The wound still hasn’t healed completely at the incision site. I still feel it’s because of the stitches dissolving too quickly and the area it’s located. Because I have to sit on it, this area is difficult to heal. They didn’t want to re-stitch it and felt it would be best to heal on its own in order to prevent the risk of infection. The good news is that it’s not painful and my urination has never been better and I don’t have any other complications.
I’d definitively recommend an urethoplasty if you have a substantial structure. If I could do it all over again, I probably would have elected to use a surgeon with more experience to help prevent any possible complications. However, I’m thankful for my urologist being able to cure the stricture and I’m confident that my surgical wound will completely heal, but it will just take some patience.
