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Hi, I’m here for the first time, and I found the site while searching for answers on urethral stricture. I have dealt with urethral stricture for the better part of my adult life and had 2 urethrotomies, several years apart, neither of which was a long-term success. I’ve known for some time that I would need to pursue some other treatment but have just recently decided it needs to be soon, both because my urine flow has gotten worse recently and because I have a second child on the way and would like to have this issue out of the way.
My understanding is that the “standard of care”, and really my only option at this point, is a urethroplasty. I have what I understand to be a bulbar stricture, but also what I believe the doctor called a “membranous” stricture, close to the urethral sphincter. I’ve spoken with and had tests done by Dr. Gelman in Orange, CA, and he seems to be a leading expert in this area.
My conundrum is that I live in Ohio, and dealing with travel costs and arrangements (and the difficulty of traveling home for recovery with tubes coming out of me, and returning to have them removed), is making me very reticent to agree to do the surgery so far from home. Is it even possible to get or sit on a plane with a couple tubes coming out of you like that?
I’m wondering how you guys would go about finding a good doctor who does this procedure well (I only want to do this once!) and how you recommend vetting a doctor to make sure he’s the guy to go with. Also, any specific recommendations for a doctor in Ohio or a neighboring state would be greatly appreciated. I’ve been told by a couple sources that the guy here in Ohio who all the other local urologists send this kind of thing to is Christopher McClung. So he comes highly recommended, and I’ve set up an appointment with him. Dr. Gelman stresses over and over that he ONLY does this and that as a result his success rates are higher than guys who have multiple specialties, but like I said, McClung is local and seems to have quite a reputation.
My case, as Dr. Gelman told me after running some tests, is more complicated due to the secondary, membranous stricture, which is deeper in, next to or around the urethral sphincter. He said a graft is difficult in that area because the composition of the tissues that far in is different. He also said that getting to the area would likely mean sacrificing one of the two blood supplies to it, and the sphincter muscle there would likely be a loss (which he wasn’t too worried about because the bladder also has a sphincter).
Anyway – that was long winded, but any thoughts on finding and vetting a doc would be helpful. Kind of in a time crunch, as I need to make a decision within a week or so (ideally).
TURNS is a organization of doctors that specialize in urinary reconstructive surgery. I am using Dr. Alsikafi in Gurnee, IL. I am 73 and have a stricture due to radiation treatment. The stricture is located at the bottom of the prostate down thru the sphincter valve. Dr. Alsikafi has done many of these operations successfully. I live in Naples, FL and travel to see this doctor. Currently I am using a catheter. I am at the beginning stage of the process.
THE PROCESS:
-Consultation.
-Bladder pressure test (make sure the bladder is functioning).
-Insertion of a super pubic catheter (must be in place for one month).
-Operation (Super pubic and urethra tube remain in for one month.)
-Urethrogram and removal of tubes.
-Three month visual check.
TURNS Website: http://www.turnsresearch.orgPlease keep us updated.
Correction:
http://www.turnsresearch.orgSmall town guy,
I went to see Dr. Gelman after having 3 failed urethroplasties from other surgeons. He is by far the best doctor I have ever had. No amount of money is worth the health problems you will have from failed surgeries. He sees the toughest cases (including mine) and is straightforward. He doesn’t promise anything but if I could do it all over again, I would have went to him first. I had my surgery with him about a year and half ago and haven’t had any problems urinating since. I am by no means 100 percent, but I am doing the best I have been since my accident.
If you have any questions regarding the surgery process or Dr. Gelman, feel free to send me a pm at my email nml5129@gmail.com. I am not active on this forum. Hope this helps
Nick
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