Living With A Urinary Catheter › Forums › Urethral Strictures And Their Treatments › My urethroplasty and a few sexual health questions
- This topic has 7 replies, 3 voices, and was last updated 4 years, 7 months ago by JohnB.
June 9, 2018 at 8:26 pm #1791
I’m a big worrier, so this site has been a good help to me through this process – as many of you know this surgery isn’t an easy one to come to grips with. Because i’ve taken so much knowledge from here I wanted to give back by telling my experience as well as ask a few questions. This is a SUPER long write up; but I hope it at least helps someone.
I’m 5 days post-op for my end-to-end anastomosis to repair a 1cm stricture in the bulbar urethra (perineum approach) and from what the surgeon said it was a success.
I was originally diagnosed with a stricture 5 years ago via cystoscopy – all in the same appointment I had my consolation, cystoscopy, and dilation and was sent away with a catheter for a week. The dilatation helped for about a month and then the stricture slowly returned – I just ignored it for the next 5 years because the pain with urination was my status quo and i was afraid that surgery was needed.
I’ve never been obstructed; I went in to be evaluated because it has burned when I peed since i was about 5yr old – some times bad enough where i just wouldn’t go and would try again later. What prompted my visit to the urologist the second time was new drops of frank blood post urination.
This time i had a CT scan to confirm it wasn’t from my kidneys or bladder, then a cystoscopy where the stricture was (again) confirmed. 2 weeks after that i had my consultation with the surgeon, 2 weeks after that i had a RUG, and 2 weeks after that I had my surgery…
I don’t like to wait in anticipation about these things. I didn’t do the surgery originally because i was scared of it, and to be honest because i was embarrassed about having all these clothed people poking at my junk.
I arrived that day at the hospital; within 10 mins of check in i was taken to a back room with many many beds all decided by curtains and walls, with many nurses and doctors about. They let me go to the bathroom and then told me to strip down to a gown, hat, and socks. The nurse started the IV, put on velcro feet cozy (that would be hooked to an air pump to promote blood flow during surgery) and then i rested in bed. My nurse anesthetist came by and answered questions for me, then the anesthesiologist, and then the Dr. and her resident, and then the nurse that would be helping with the surgery – so I met everyone that was working on me in surgery and that was comforting.
I was VERY nervous about anesthesia; they didn’t give me any drugs before hand (i asked) but they did load me up with a heavy dose in the IV catheter right before rolling me in to the surgical theater… it was a big help since i was mostly worried about being rolled in and them putting the mask on me.
They had me transfer my self onto the surgical table and as soon as i was down they put the mask on me. I was out within 3 breaths – there was no fighting against it or uncomfortable feeling with getting anesthesia.
I woke up what seemed like 5 minutes later (it was a 3.5 hr surgery in total), I have a few little memories (mostly feelings about being happy and relieved that the surgery was over) and then i woke up completely; maybe 30 seconds after reaching full consciousness i started to feel pain – it went from a 6 to a 7 and the nurse gave me IV drugs, then it kept rising to an 8 and she gave me more drugs, then it went down to about a 5 or 6 and stayed there.
The pain was mostly a constant ache. I also experienced the urethral mussels clenching down hard against the catheter when ever i would move and that was pretty darn uncomfortable but would be over in a few seconds.
Erectile disfunction was a big worry of mine but I actually started getting erections just 12 hours after surgery; they were little stubby things but that’s to be expected with they kind of drama it just went through. Every day since my erections have improved a little – i’ve gained back probably an inch of what was missing that first day. Erections are not painful for me but when they get really hard there is some discomfort and i DO want them to go away.
Day 2 and 3 i really just wanted to lay in bed; felt really tired and got dizzy when i would stand. by day 4 i could get out of bed on my own (i needed help before). I walked around for about 2 hours day 4. I also got my first bladder spasm on day 4 and a few blood clots.
Today I can sit on a soft chair with my but angled back mostly comfortable. Scrotal swelling seems to be subsiding some; but they are still huge and turning blackish.
***I feel good today. And I am happy I had the surgery – I just want to not worry so much about the future of my sexual health***
For anyone interested my operation was by Dr. Sarah Faris, who is an associate professor of urologic surgery at the University of Chicago. She is a very level headed woman, if not a bit straight to the point, and answered all of my questions (i had literally a page and a half of them typed up before my consultation haha). She specializes in male urologic issues, and does many stricture repairs including urethoplasty (I think she said she did 50 urethoplastys just last year).
I only on day 5 post-op and am getting like 10 erections a day – how do/did you guys manage this?
I have numbness on my scrotum witch is to to be expected; but i also have it running up the underside of my penis from the base almost all the way to the meatus – has any one else experienced this and did it resolve?
Ejaculation is my biggest worry as of right now; especially because studies seem to be a mixed bag on the subject. I asked my surgeon about this and she said she never had a patient complain to her, but she also doesn’t frequently ask about it directly. I’m just worry that it’s not going to feel as good, or be as fulfilling, since they split the bulbospongiosus muscle in the procedure. The dr. said that i have a lot of healthy blood flow down there and that i should be fine but i’m still worried. Any words of encouragement? Is your ejaculation at least as good as before?
Even tho i’m getting erections, my glands do not appear to be fully inflating. I know it’s only day 4 – but has this improved for most of you?
I got my first bladder spasm on day 4 and some small blood clots and what looked like mucus ended up in my collection bag – this is normal right?
Lastly, my incision goes from my balls to literally my anus (like, it’s in the crater a bit lol) – is anyone else this long? I’m just having thoughts about them dissecting too much and doing extra damage – but what do i know, i’m obviously not a surgeon.
Thank you for you comments and words of encouragement – i’ve set up email notifications and will try to respond to anyone who has questions about my progress.June 14, 2018 at 3:31 pm #1793
Emailed my surgeon with some questions; she said the erections are fine, even if i’m getting that many of them a day. Said that theres no evidence of erections during healing causing issues with sexual function down the line (I.e making it not heal correctly).
I also asked about the numbness on the underside of my penis – she said that the skin numbness is likely from the incision that was made and the nerves that innervate the skin. She said they do not typically affect the perineal nerve during a urethroplasty. (the perineal nerve is the one that give feeling to the underside of your penis). She said that the numbness can last a few months after surgery but sensation should return over time.
A day or 2 after getting the email from her i felt really good and decided to get out of the house. I was out for about 4 hours; but that was 90% siting/driving (i got a hair cut and then visited people at my office). That night i ditched the jockstrap and slept commando – i found that one of the problems with getting erections is that the jock is so tight that it rubs on your penis and stimulates it more (for me).
I later found out that if you cut a hole in the front of the jock for your penis to stick out of; then your testicles will be well supported and you can get erections with out the uncomfortable rubbing on the jock – it’s helped me a lot while sleeping.
Anyway… I didn’t sleep with anything on the night and i woke up in the morning with a jumbo-egg sized swelling on the right side of my incision just underneath my right testicle (it was pushing the testicle up). I put in an urgent call to my surgeon and spoke with/sent some photos to the resident on call that day – he said it looked like a hematoma and shouldn’t be anything to worry about.
The next day i get a call from the surgeons assistant and she said that the surgeon saw the photos and wanted me to come in for an exam. :/
Thankfully the exam was uneventful; she said that it looked like a seroma/edema (which is basically fluid buildup under the skin). She couldn’t guarantee it wasn’t something more but after seeing it in person she said she was relieved and not worried.
She told me i need to take it easy and wear supportive and compressive underwear (jockstraps) and ice the area. With the exception of the seroma everything is healing up wonderfully. I did get some light bleeding (more like blood residue), and a little bit of white discharge which i thought could be puss from around the catheter this morning but it was just a small amount and it seemed to go away quickly, so i’m just gonna watch that. Can’t wait to get this catheter out – 2 more weeks!June 19, 2018 at 5:07 am #1796CatheterChrisParticipant
9 days left man! I’m 4 months post surgery, same exact type/incision as yours.
I can confidently say that happy days of good peeing are ahead!
I had the same concerns as you in regards to my sexual performance and ejaculating. It’s going to be a little odd at first, and you will definitely notice a decline in sensation, and your ejaculation volume and strength will take a hit. But as you’ve been told the recovery process for this procedure extends past the catheterization period.
Gradually the feeling has started to come back, and my ejaculations are the best they’ve ever been. I’d say im about 90 percent back to my pre surgery feeling. I’f anything sex is much better now that i can fully ejaculate without my stricture.
Just focus on what you can control and take care of yourself, take it easy and ease into all sexual activities.June 19, 2018 at 1:20 pm #1797
Chris, thanks so much for the encouraging words. I hope over the next month or 2 you get the rest of the feeling back; regardless it sounds like you’re happy and that this surgery has been a good thing for your sexual function rather than one that hurt it – so that’s nice to hear.
I have another call into my surgeon because I started to get a little blood (it’s a small amount) and a lot of mucus/white discharge from around my catheter again. This recovery process has been really frustrating for me – I felt so good a couple of days after the surgery and then I got this big edema (it’s fluid filled tissue – feels like a really hard mass the size of an egg) under my right testicle connecting to the flesh on the right of my incision; the surgeon said it’s nothing to worry about. It just doesn’t feel right that this would pop up a week after surgery. 🙁 I just hope everything is healing fine.June 27, 2018 at 5:02 pm #1807
UPDATE: Catheter is out!!! The surgeon reviewed the RUG x-ray and said that she couldn’t even find the repair site – things had healed that well. Really pleased with that.
Said 1 more week with no sex and then take it slow from there. I still have some of that swelling i mentioned previously (hard ridge-like swelling parallel to the incision) but it’s about 70% resolved and the Dr. examined again and told me she wasn’t worried.
Catheter is out and now i’m retraining my bladder – it’s not a fun feeling after having your bladder empty for 3 weeks, to have it filled up again, but i’m trying to hold it as long as i can to help things stretch out.
Problem list: Swelling near incision, and numbness on underside of penis. I hope in a few months when i give my next update that i’m all better and feeling normal!
Stay positive guys, John B.June 27, 2018 at 8:31 pm #1808heyitsmeParticipant
johnB thanks for the update. But you left out the most important part… How is the stream???June 27, 2018 at 9:40 pm #1809
Hey HIM, the stream is great! My problem was never with retention (luckily). Pre-op I had an intense burning 80% of the time when I would urinate. No burning to speak of and the stream is more forceful too!
My bladder IS a mess though; and when I let it fill up too much it starts to burn and I start to get spasms (yikes!); and when I’m done urinating my bladder keeps clutching down trying to make more come out. Really uncomfortable.
BUT it’s all to be expected after 3 weeks with a cath. I’m not worried, it will relax over the next few days I’m sure.
I’m so used to having to “push” urine out I’m sure that’s part of my problem too – damn bladder’s too strong. 😉
I feel myself tense up just before the urine is released, in antipitation of “the burn”, but the burn never comes. Puts a smile on my face. 🙂
John B.August 12, 2018 at 4:10 pm #1833
UPDATE: 2 and a half months post-op and feeling down. Catheter has been out for a month and a half – very shortly after it was removed (maybe a week?) i felt my stream weaken; and to my dismay the burning sensation when urinating, which was my chief complaint, has seemed to intermittently return, albeit not as badly.
The most sensitive part of my penis, the area between my circumcision scar and the base of my glands, the part that used to create an electric feeling of pleasure, is still numbed (i can feel that it’s being touched but there is little “sensation”.
My ejaculation is, for the most part, no better or worse – although I think it’s less satisfying. It’s difficult to explain but it’s like… tense. Each throb doesn’t relax completely before the next. Or perhaps i’m mistaking the feeling for part of the mussels not working at all.
My glands seem cold and pale colored sometimes, and when erect they were big and glossy before; now they seem reluctant to puff up until the very end.
It’s hard to put into words how exactly i’m feeling about it… I’m not “disappointed” i had the surgery – i’m not “disappointed” with my care team or surgeon (in fact i’m quite happy with them) – i just feel like i’ve lost function that’s important to me.
As a polar question, yes, everything still works fine… but it’s like eating a cake with too little frosting, sure it’s still a cake… it’s just not a very good one.
I’m struggling to hold onto the thread of hope that is, “maybe it will heal with more time”.
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