35 years with a urethra stricture

This story is decades long. Jump to the last few paragraphs if you want a summary. I spent a lot of time reading the stories here — thanks Ken!

Thought I would share mine.

1985: went to urinate after dinner and noticed blood. Flow was normal with no straining. Didn’t hurt to urinate. Just traces of blood coming out dripping out into the toilet. Enough to freak me out and warrant a trip to the emergency room with my mom. We waited 3 hours to be seen. Dr. suspect STD but I was still a virgin at 15. Prescribed a dose of anti-biotics nonetheless — recommended me to see a urologist just in case.

Eventually saw the urologist a few weeks/months later. I don’t remember the exact specifics, but I remembered being scoped while there. The DR. was ecstatic —
he saw his first urethra stricture. I remember him even calling over fellow colleagues for a peek. After he pushed the scope thru — said he was going to ‘open up’ some scar tissue that had formed. I don’t remember it hurting at all when he did that.

Went home and peed fire. Flow was normal but it was incredibly painful. The pain eventually subsided over time or I learned how to tolerate it. The pain eventually became nonexistent as the stricture formed and healed. I don’t remember how long it took — maybe a year?

Now how did I get this stricture? I don’t know exactly. But during this time I was doing a lot of biking with a cheap, hard seat. Bunny and curb hops/drops was a thing of the norm. I suspect I landed one to many times hard on my perineum.

At any rate, I was young and still in school. I continued on with my life and put this in the back of my head since I thought that was the end of it.

1993: ripe age of 23 now. Had a job w full insurance and thought I would take care of myself: health, teeth and eyes. I didn’t have any trouble peeing. But knew it was something I had to follow up on after all these years. Made another visit to the urologist; a diff one this time since the original one had moved on.
Long story short: urologist did a urine flow test — said I was barely passing for my age. I don’t remember the number, but he said I was with a passing grade. He suggested DVUI? Told me about it and I said hell no. Wearing a catheter at 23 for a week or two was out of the question for me. Moved on with my life from here on — with this always in the back of my head.

2000: noticed it was taking me longer than others to empty at public urinals. But, shrugged it off: who cares if it took me an extra 30 seconds to pee. At this stage in my life I got heavy involved in mountain biking. Lots of mountain biking. But this time I had paid for good seats — the ones with a slit down the middle to protect and relieve pressure off the perineum.

2018: Started noticing my flow was demonstrably getting weaker. Can still urinate and empty my bladder, but it would take longer and more effort. Kind of dreaded going to the bathroom since it took so long. Going to the urinal was an inconvenience at this point.

2021, May: Woke up one morning and couldn’t urinate. Close your mouth tight then try to blow out — that’s how it felt. Strained just to get a dribble going. Fell into a panic then the flow opened up a bit and returned to a small stream. I went to the nearest clinic to see a DR. He thought it was a UTI. I knew better. Proscribed me some antibiotics. Later that night had another episode where it would lock up to a dribble then open up to a small stream after some straining.

Made an appt. to see a urologist. Long story short, saw the urologist and he confirmed what I knew with a scope: the stricture closed up to the size of a pin point. We went thru the obligatory treatment plans; but he highly suggest I do the urethroplasty. I cringed at the thought and tried to bargain with him on the DVIU. He told me chance of success was very low. And urethroplasty was the way to go. Recommended me to a specialist in the downtown area. Convinced me to at least go talk
to the specialist. I made an appt. reluctantly.

Met with the specialist 3 times over the course of a few weeks. Each time I kept on trying to convince him maybe a DVIU was only needed. He firmly advised against it. Said go straight to the urethroplasty. At this point the only surgery I had was at most a root canal. The idea of being cut into — and down there — was just terrifying to me. It was one of the hardest things I had to go thru.

2021, JUNE: Was able to book the urethroplasty w him in mid June. I felt so fortunate after reading so many horror stories of the wait for this type of surgery. Or maybe I just had good insurance. Nonetheless, the Dr. was able to fit me in. He had me do the VCUG — unpleasant and awkward experience. From the pictures, the Dr. surmised the stricture was 2cm long; bulbar region — most common. He decided on the Buccal mucosal method. Taking a graft from my cheek.

Surgery morning. I don’t remember much. I got on some xanax a week before the surgery since I was experiencing panic attacks. I was already knocked out before being rolled into theater. Surgery last 2.5 hours. Dr. was happy w the outcome. He told me the stricture was longer than he expected 4-5cm rather than 2cm. I was kept overnight for observation. My scrotum was swollen and jellied. Looked like a liquefied blob. There was little to no pain — nor discomfort. Note I was drugged
up at this point. Nothing hard, just Tylenol and Ibuprofen. Allowed me to checkout next day with some prescriptions. I was to wear a catheter for 4 weeks.

In retrospect, I don’t know how I psychologically made it thru 4 weeks with the catheter. It was so medieval looking. So offensive to the heart and mind. I was on short-term disability for the 4 weeks so I took it very easy. Luckily, I didn’t’ have many problems with the catheter and I liken it to a few things:

1. I slept mostly on my back
2. only had a few instance of nighttime erections — yes, those were painful but quickly subsided
3. took the bladder relaxant they gave me regularly to keep away spasms
4. was able to rest and relax for the duration of the catheter; do not rush back to your regular routine
5. working out can wait — don’t be quick to get back into it
6. rarely wore leg bag; just used the bigger nighttime bag thru out the house
7. eat healthy, small meals, lots of fiber
8. avoid pressure on the wound; slouch as much as possible when sitting
9. Now and then there was dull ache caused by the catheter. I just stopped what I was doing and sat down till the ache passed.

I showered once a day with the catheter: at night before bed. It was quite the achievement to get a shower in. I just showered with the bag, carefully not to tug or pull. Then used a fan in the bathroom to help me dry off — really helped a lot
not having to navigate the crevices and valleys with a bath towel. I had to venture out with the leg bag a couple times — mostly dental appointments. It was doable but not something I would pursue regularly: it was just too restrictive and uncomfortable for me. I prefer just lounging around the house with the night bag.

Bowel movements were an interesting challenge. I of course didn’t want to strain being it would inadvertently involve contracting your bladder and making use of your healing urethra. They recommended getting stool softeners. I bought some but never used it.
I relegated myself to a fruit, flax and whey smoothie for lunch every day. Then some sort of soft food for dinner: mostly pasta. Did wonders. Had regular bowel movements each morning w no straining.

The hardest part thus far was the psychological part. I shut off emotionally and mentally just prepared myself to live like this for 4 weeks. I think it’s like accepting and coming to terms with your imprisonment. And before I knew it, 4 weeks were up and it was time to get the catheter removed.

2021, JULY: Had the xray and catheter removed. Beforehand they use the catheter to pump in xx ml of
fluid for xraying as it is emitted from your body by urination. It was a very awkward and semi-painful when the nurse pulled out the catheter. He tried to do it gently and gave me a warning— but I felt the pain and ache of it traveling out of my urethra. After he gave me the go to urinate (while laying sideways on the xray table) for the xray. Nothing. I concentrated. Noting came out. The mind to muscle connection with my bladder had been severed — i started to panic a bit inside. However, I remained calm and concentrated. It feel like minutes, but I’m sure it was only 30-50 seconds and then the stream finally developed and came out forcefully. He said it looked good and I emptied out the same amount he put in. Then my next stop in the day is the surgeon. Long story short, the surgeon was happy with the xrays and sent me home to enjoy the rest of the summer. We would meet up again for a post-op followup in a few months.

At this point I was ecstatic I could begin going back to normal life. Yes, I was looking forward to working out — albeit lightly at first. I was happy I could go on walks around the neighborhood without being hindered by the catheter. My stream was powerful. I had to brace myself each time — it was that strong. Sitting down wasn’t back to normal yet. It was still tender down there. I couldn’t plop down on a stool but I was just happy I can move freely at this point. I could go back to weight training — obviously took it very easy. Dr. told me to refrain from sex for 6 weeks post surgery. I was willing to wait another two weeks.

Few notes at this time:
1. still tender and numb down there. A strange feeling indeed
2. sitting on hard surfaces or applying too much pressure was no-no. I mostly used a standing desk for work purposes
3. erections were semi-hard — at 85%
4. when i finally had sex, ejaculations were not very forceful — it kind of spurt and dribbled out. An improvement as far as I was concerned from when it was mostly blocked.
5. post dribble after urination. This is pretty common but I was not aware of this nor did the surgeon tell me
6. I weight train and started back slowly — didn’t want to over do it. Had no problems here other than reduced strength and intensity
7. I didn’t have any post-op pain. Just numbness really. Nothing alarming.
8. the fire hose stream abated after a few months — slowly tapering down to a ‘regular’ force. I suspect this is your urethra contracting a bit post catheter and your bladder has calibrated to the removal of the blockage.

One thing I did experience beginning in September 3 months post-op, 2 months post-catheter out: stomach tightness and bloat. Hard to describe. It felt like I over ate and my stomach was full and extended. It didn’t bother me when laying down
or sleeping. Just when I’m up and about — the tightness and bloat in my abs. Very weird feeling! It didn’t cause a lot of pain — just discomfort. And quickly abated when i sat down and relaxed my abs. This was with me for the better part
of a month thru September.

2021, OCT: Saw the Dr. for the first follow-up post catheter. This was the 4-month mark post surgery. I told him about the stomach tightness and bloat. He assured me it had nothing to do w the surgery. At any rate, at this point most of the tightness and bloat had abated. It was still there, but at a much lessor degree.
The Doctor scoped me and had a big grin on his face. He said ‘he could drive a truck thru my urethra.’ LOL, urology humor, I thought to myself. He said the wound was healing splendidly. I inquired about a uro-flow test. He said the wound was so patent it was unneeded. And I was to
come back in a year from now for the final check-up: if I cleared the yearly checkup, he would set me free out into the world. 🙂

2022, MAR: So here I am posting and sharing my experience with the urethroplasty at 9 months. How are things? Pretty well for the most part.

1. I am emptying my bladder a lot faster than before. There is no hesitation either.
2. Urinating less often and I sleep thru the night without being bothered by a bathroom trip
3. still occasional numbness down there — no pain though
4. the dribble is still there. But I found a quick way around it: just squeeze my thighs together to help squeeze out the remainder. So far it’s worked perfectly and can be executed quickly
5. bloating and tightness in stomach? comes and goes still. Not bad, just notice it from time to time. I expressed it to my general Dr. and he seemed unconcerned.
6. weight lifting and strength is back 100%. I am very fit now
7. I’ve always had perfect blood tests. but had blood test done and my liver tests came back slightly elevated: ELT and EST. General Dr. said it could be due to the stress from all the meds. And that we will keep an eye on it moving forward.
8. sex and erections back to normal aside from the weaker ejaculation.

Overall I am satisfied w the outcome. However, if I could have, I would have gone the rest of my life with the stricture and weaker stream. I DID NOT WANT THIS SURGERY. The inconvenience of a slower stream was acceptable to me. I didn’t have any other problems associated with the stricture as many has expressed in this forum. I was able to empty my bladder albeit
slower than normal.

Unfortunately, the stricture decided to close off a few times and gave me no choice but to deal with it surgically. I am thankful it gave me ‘warning shots’ so I had time to get things in motion to correct the problem.
I am glad I went straight for the gold standard: urethroplasty.

I cannot imagine going thru all this and suffering a near 100% chance of it returning within a few years/months with the other options. Go for the gold standard if you can!

Now I just sit and wait and hope that is the end of it. I took out the mountain bike and did a few laps. I experienced no pain nor discomfort. However, it is important you have a seat with a deep channel down the middle AND you adjust your seat correctly. It’s crucial
most of your weight is supported by your buttocks and not resting on the perineum. In addition to the deep channel down the middle, you can slightly angle the nose downward when installing the seat —- this activates usage of the arms and butt more. I also suggest more time on your legs and off the saddle, this is more doable when biking trails than road. I figure with these measures, I don’t have to give up biking entirely.

• This topic was modified 1 year, 6 months ago by Dank.