Living With A Urinary Catheter › Forums › Urethral Strictures And Their Treatments › 7 months post-op and very frustrated with pain levels and sexual side-effects
Tagged: anastomosis, ejaculation, end-to-end, erection, orgasm, pain, scrotal pain, Sexual dysfunction, tension, urethroplasty, viagra
- This topic has 7 replies, 8 voices, and was last updated 3 years, 3 months ago by mattbl.
June 22, 2018 at 5:27 am #1803TheProphetParticipant
As with many of you, I got the standard info from my surgeon about the possible side-effects as a result of urethroplasty surgery. I had an anastomosis (end to end) done for a 6 CM stricture in the proximal urethra close to the prostate. When he told me that he did the end to end repair, I was shocked because that seemed too long based upon everything I had read and that should have required a buccal graft. He assured me that there was plenty of “length” there, but admitted that he had to excise part of the “bulb” of the penis during the reconnection process.
The surgery was on December 7th. Within a week I developed severe bladder spasms as my body apparently didn’t like the foley that I had to wear for three weeks and my scrotum looked like a giant purple eggplant. I was placed on both anti-spams meds plus pain-killers as I was experiencing some excruciating pain and discomfort. This lasted for two weeks. They finally decided to take a urine sample and then discovered that I had a UTI caused by pseudomonas aeriginosa, a bacteria that apparently got into my bladder during the actual surgery because it normally does not live there. Now I was going in every day for an antibiotic bladder wash of gentamycin to try to control the bacteria until I could get the catheter out on the 29th.
On Friday, December 29, (22 days post op) I went in for a VCUG. The radiologist was fantastic. She walked me through the process and removed the catheter after filling me with contrast solution in a quick and pain-free manner. Once the catheter was removed, she stood the table up, handed me a plastic urinal and signaled for me to void. The images came out well, and for the first time in 3 weeks, I was catheter and pain-free in my urinary tract, although things were still pretty swollen and painful at the incision point and in my scrotum.
2 hours later at my surgeons office, I thought I would have a mental breakdown. The VCUG revealed a very slight leak at the repair site and my surgeon recommended that the foley go back in for at least a week.
So now, after only two hours without a catheter and the spasm/pain associated with it, I had to have it put back in? Seeing my obvious distress, and due to the fact that I still had an active, nasty bacteria in my bladder, he personally reinstalled a new foley and put me in the hospital for 5 days so I could get IV antibiotics and 24/7 pain control. That was very physically and emotionally draining as I had to be in there during the holidays and during my wedding anniversary. I was really regretting having this surgery. Between the pain from the incision site, and the constant attempts by my bladder to expel the foley catheter, I was one miserable individual. But I’ll give the doc credit. Upon my request, he left orders with the nursing staff that I was not to be bothered for routine vitals/blood draws if I were asleep. That was my condition for agreeing to be put in the hospital. That was the bright spot in that visit. When they found me awake, they would do all “routine” work at the same time, honoring the request to allow me to sleep. They kept me drugged up, and even gave me belladonna suppositories to help stop/quell the spasms I was having due to the foley. It sucked being there, but the nursing staff was amazing.
On January 5th, I had another VCUG. In contrast to the first one just a week prior, this one was excruciating and painful, as well as humiliating. I experienced severe burning during the time my bladder was being filled with contrast, he then didn’t warn me to tell me he was pulling the foley out, thus I was still somewhat “clamped down” from the burning that was going on. He also did it excruciatingly slow, making it feel like shards of glass were traveling down my urethra. After it was out, I curled into a fetal position with my urehtra on fire and asked him to give me a few minutes to calm down.
When I signaled I was ready, I expected him to rotate the table into a vertical position, just like the previous week, but he did not. Instead, he expected me to urinate while flat on my back and without a urinal!!! Not only was that humiliating, but it was disgusting and unsanitary. There was no pad on the table, I had no urinal, and was only wearing a hospital gown. When I objected because I would soak my gown, my 4 inch incision and the table, he simply said “we have more gowns.”
Humiliated by this request, I refused to urinate all over myself. He finally relented and agreed to stand the table up, but i still had to ask for a plastic urinal. Of course, with things still being numb, my urethra on fire, my hands shaking from both pain and anger (and embarrassment) it took me a few tries to get hooked up, after which I was finally able to void. Pics were taken and I was finally allowed to step down.
Being somewhat weak in the knees, and still quasi-doubled over from the painful foley pull, I sat in a chair in the xray room for about 10 minutes to gather myself before I felt well enough to walk back to the dressing room. At least three times, the radiologist kept getting in my face, stating “I don’t understand why you are having so much pain”. I finally advised him not to repeat that a 4th time. I could not explain the “why”, just that I was in extreme pain and I wanted him to leave me alone.
I was finally mobile, was able to dress and then I drove myself to my surgeon. Thankfully, the images showed that the leak had healed and I didn’t have to wear the foley any longer. A week later, the urine test revealed that the bacteria had been defeated and I could now concentrate on healing and getting back to “normal”.
Flash forward 7 month. I am still miserable and quite pessimistic as some of my biggest fears are being realized. Despite having no sexual dysfunction prior to the surgery even with a stricture, I am now having a problem getting and keeping an erection long enough to make love to my wife. The doc prescribed viagra which solved that issue, but now I’m finding that I can never seem to get to the “trigger” point to reach an orgasm and ejaculate. When I can finally get to that point, it is anti-climatic. As a virile, vigorous and potent father of five, this aspect of my relationship with my wife has never been an issue until now. Now, I can’t even get excited without a little blue pill and even then, can’t finish with a bang without significant manual stimulation. I’m feeling very inadequate and useless in that area right now, and while my wife does not admit it, she misses that part of our relationship.
I had a DVIU a year prior to the urethroplasty and have always had very forceful ejaculations. They were even better after the DVIU, but some scar tissue formed and created another stricture, but not as severe as the first one. Unfortunately, after this more invasive repair, when I do eventually reach an orgasm, the ejaculation is barely a dribble and nothing to write home about. On top of it all, I am also experiencing post-void dribble, severe pain in two specific spots in my scrotum and on one side of the shaft of my penis, numbness in the most-important places on my member and pain during intercourse. There is a tightness between my scrotum and anus if I pull my erection toward my stomach. I had none of these issues prior to my second surgery, and now everything that could have gone wrong seems to be going wrong.
I’m a wreak, and quite depressed over this whole thing, regretting the day I agreed to this surgery.
I spoke with my doctor today. The best he had for me was that it would take more “time” for all the nerves to regenerate down there and for the sensitivity to return, but he is quite puzzled by my inability to reach orgasm. I am desperate to find answers somewhere out there before my entire sex life is ruined.
This has been my biggest fear from the beginning. That I would be able to piss like a race horse, but that things that were not broken before would end up broken. That is exactly where things stand at this point and now the most intimate, sensual part of any marriage is just an exercise in frustration and sorrow. I’m feeling very inadequate and useless in this area now, and am now on anti-depressants to cope
The surgeon is now referring me for pelvic floor therapy. He believes that scar tissue may be causing an issue and that some of the muscles involved in proper sexual functioning need to be retrained and or toned. And of course, he still keeps saying that it may take another 6-18 months for me to regain full functionality.
6-18 months? I will lose my mind by that time. My wife of 34 years doesn’t look a day over 40 and not being able to be with her in that way is giving my self-esteem a punch in the gut. Had I known that the road to recovery would be fraught with this many obstacles, I would never have opted for this surgery until it got to the point that I could not urinate. I’m really regretting letting him do the surgery, and questioning the use of an end-to-end repair for such a long stricture. He admitted that he had to take part of the bulbospogiosis muscle/tissue, which in my mind, since it plays such a critical role in the expulsion of semen, that this may be the cause for the lack of power when I can finally achieve an orgasm.
I’m really desperate for some encouragement here, which is why I have been so transparent and blunt with my descriptions. Those of you who are a year or more out from surgery…does it ever get better, or is this just the new paradigm and the prognosis given me from the get-go just a fantasy expectation to convince me to have the surgery? I’m feeling pretty deceived, used and robbed of a part of my life that was perfectly fine prior to my surgery.
Please give me some encouragement. Don’t lie to me….I can handle the truth, but still feel somewhat robbed by the lack of progress in my recovery. I’m taking the first vacation I’ve had in 9 years later this summer with my wife, and the prospect of still not being able to perform is terrifying me at this point.
Sorry for the long entry…there is more that I could add to this sordid tale, but this is enough trauma for anyone to have to read at this point. Any hope out there? I’m listening.
TheProphetJune 26, 2018 at 8:27 pm #1804barryParticipant
Any chance some of your issue is psychological? The mind is powerful. If you think things aren’t right “down there” it’s hard to orgasm.July 17, 2018 at 9:01 pm #1824poortonykrauseParticipant
I had the surgery too and ejaculation is definitely less projectile now. I think it’s just because the pathway is all wonky from the repair and it takes the semen longer to travel through it. That being said, it’s also more pleasurable. Before I could feel the obstruction when I came. Now it’s not as uncomfortable. So, if your concern is that using the muscle that facilitates ejaculation you lost force then I can assure you that you would have had the same result with a buccal mucosa graft, because that is what I had. They even ask you on the follow-up surveys about whether your ejaculations have decreased and if you need to manually push the cum out by sitting on your perineaum. It’s a common side effect. However, I haven’t heard of surgeons using that muscle, or any other, to patch up a stricture before, so you might want to get a second opinion from another experienced doctor—mine was Dr. Joel German in Orange County. As far as intimate life goes, it’s going to be affected by a major surgery down there regardless. Since you have only had dilations before you’ve never experienced such a major change in sensation. It’s going to take some getting used to. Unless your doctor really messed up I’m sure you are just going through an adjustment process and things will improve. The pain you described in relation to your VCUG is not unfamiliar to me, nor is the burning when pissing the first time. It takes some getting used to, and every body is different.September 18, 2018 at 5:04 pm #1860Canada3Participant
I had a long reconstruction too and am experiencing some frustrations concerning the sexual side effects. Erections came back, although it took time. Morning erections are just a pleasant memory now. A 4 month follow up with scope showed everything was healing nicely and it sounds like it was a success.
The lack of ejaculation power is noticeable and nothing comes out until I sit on a hard surface. Peeing is the same thing after voiding. It is kinda embarrassing and has made clothes washing more essential. My surgeon suggested pushing the skin literally below the testicles (near the incision point in my case). It works some of the time.
Personally, I’m interested if anyone else is experiencing these issues. If so did they go away with time or was intervention with exercise/ retraining as mentioned above? I would also be curious if people are experiencing any discomfort at the incision site rather then repair? I have noticed some days I can feel the site.December 5, 2018 at 10:56 pm #1912seanParticipant
Everything you have mentioned I have and still experience after almost 12 months since my graft which was 8 cms. I dribble after voiding unless I use both hands squeezing either side of the lower area of the scrotum, this also is the only way of expelling any sieman after ejeculation which never finds its own way out due to its path being too tight whilst I have an errection in place, I can move my penis up or down which helps it to flow with force so the power is there but not the path.
All the above aside I feel like I’m sitting on a swollen peranium sometimes but I think I cause that by squeezing too hard expelling urine!
I’m very pleased to be able to pee well after a year and not have to keep rushing into A&E to have a catheter rammed into me at what ever cost to me in order to urinate when I was unable to even pass a drop sometimes.
I understand people’s frustration but for all the above problems I’m very pleased that my surgeon was able to pull off such a complicated procedure.
I hope you all find a way to live with your various issues and enjoy what is a very short time on this planet.
All the best SeanJanuary 8, 2019 at 2:17 pm #1925RossParticipant
Firstly I want to put out a bro-hug (no gay) to you for your terrible road. I was welling up reading it. Sucks.
Are you at liberty to say where you had the surgery?
I had surgery in 2009 and had some residual male flimsiness issues. Did you have weight gain after your surgery? I was a bit of a fat f**k before the surgery and I think I slid into a metabolic syndrome with a good deal of weight. My free testosterone was in the crapper.
I went to Boston and they injected (I guess) IV Viara right into the warrior which was a barrel of laughs but it went up which dispelled a blood flow “drainage” issue. I was a limp d**k for like a year and it hit better. It will get better.
Big thing is the mental game bro. My wife sounds like yours,,hotter now than the day I met her in ‘87. Easier said to flush your brain pan of all the nonsense but eventually you will get back to Gladiator status without the help of the pull. I have a vial of some locked in my gun vault that I’m sure are stale as shit by now.
I’m just now getting some post-voiding blood and that old, pre-surgery pain is creeping back. My original surgeon (who is one lucky fella) never discussed options, prognosis,. Long term, etc. being that he was the only guy in my area who could do it, his whole MO was shitty. So needles to say I’m going elsewhere.
Let me know how you’re doing brother. The fight is always easier when you have bros on your 6.
PeaceDecember 1, 2019 at 10:50 am #2616SekoParticipant
Does 2 cm end to end urethroplasty have the same complications or less common?December 19, 2019 at 8:30 pm #2660mattblParticipant
Everyone is different, Seko.
I had an end-to-end, not sure of the total distance. They removed at least 0.7cm of crushed tissue (I crushed my urethra in a straddle injury). But, the surgeon said it was a difficult surgery so it sounds like the actual end-to-end distance was longer (I was too out of it, post-surgery, to think to ask).
2cm sounds like a lot, though.
I’m 10 weeks post-surgery and am having issues with getting an erection. I get about half an erection but the glans and end of my shaft aren’t filling with blood. I can masturbate but not have sex, as of yet. It’s been very slowly getting better as time has gone on.
I don’t have forceful ejaculations anymore, but I do not have an issue with it making its way out. I expel all semen, it just doesn’t come out with any real force.
Urination is mostly ok. I dribble a bit but haven’t had to squeeze anything out and don’t have an issue with it coming out when I sit down. I can get most of the urine out, but if I don’t take the time to make sure I’m flexing my pelvic floor and shaking, I can get some dribble right after I zip up my pants. I’ve also taken to using a bit of toilet paper to wipe the tip when I go in the middle of the night, just to be sure.
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