Successful DVIU, bad scope & now 14 days post-op from EPA. Need encouragement.

[TheProphet]

Hello, all.

I am a 53 year male who for 20 years was treated for BPH by my PCP. He kept saying I had a “boggy” prostate. I eventually referred myself to a urologist, who not only discovered that I had low T, but upon doing a cytoscopy found a stricture in my bulbar urethra that he described as a “Pinhole” in size.

I had a DVIU in December of 2016 after a RUG found a 2 CM stricture in the proximal bulbar urethra. Foley cath was in for 8 days and upon removal, the flow was amazing, unlike anything I had experience in my life.

At my one month checkup, he did a flow test, which was stellar and he said he was encouraged. But then everything went to crap.

Despite the great results, he insisted on doing a scope in April of 2017 in his office. The nurse who prepped me seemed unsure of what she was doing, and I told her that I didn’t think the numbing gel had actually been injected fully. She assured me it was and left.

Doc came in 15 min later, inserted the scope and there was sudden, excruciating pain. Apparently she had not actually injected the gel into my urethra, but only inside the foreskin. Since he was already in, he
continued to advance the scope over my moans and then withdrew it, stating that “things looked pretty tight in there.”

This was confusing to me because my flow was great. But I eventually agreed to another RUG of April this year. He did this one under anesthesia because of my bad experience in his office. Oh, and that nurse no longer works there after I wrote him a detailed letter about what transpired that day.

Forgot to mention. Apparently either her hands, the syringe, or the scope were not fully clean, because 10 days after the scope, I had a bacterial infection to boot. I had to take an antibiotic I am allergic to for this bacteria, by heavily dosing with benedryl and other allergy meds before each dose. The infection finally cleared in 10 days and most of my flow was restored but not all.

The RUG was performed about a month later. It now revealed a 5-7 cm stricture from the proximal bulbar urethra up to the membranous urethra. While I cannot prove it, I am suspecting that the unlubricated cytoscopy may have damaged not only the repaired area, but additional damage was done as the scope advanced.

For the next few months, my flow decreased but was still much improved over what it was prior to the DVIU. But since we had met our deductible, I agreed to have a urethroplasty done on December 7, 2017. In our consult, the doc indicated that it would likely be a BMG harvest from both cheeks due to the size of the stricture.

Upon waking, I was informed that he did not have to do a graft, but instead was able to mobilize the urethra and do an end to end anastamosis. He removed approximately 5 CM of tissue and rejoined the bulbar stump to the membranous stump. I am concerned about that much urethra being taken, plus the operative report said they were able to spare “a portion of the sponge”. That scares me to death, because the bulbospongious muscle is the key to the contractions that force ejaculate out of the urethra and the area where that “feeling of fullness” occurs just prior to orgasm.

The catheter has been a nightmare. The first 10 days I had clear, yellow urine with no blood or clots. But last Monday AM, I woke up with excruciating pain in my bladder and blood in my urine collection bag. Went back to doc, they irrigated the bladder and put me on anti-spasm meds. Two days later, I was now having cloudy urine with what appeared to be small pieces of pink flesh making its way down the drainage tube and still a lot of bladder pain. They then diagnosed me with a bladder infection and put me on Bactrim,a bladder anesthetic, and a muscle relaxer (Valium) to help me sleep.
Bottom line. I’m getting pretty depressed and the foley does not come out until Friday the 29th. If the VCUG shows leakage that day, it means a new one goes back in for 2 more weeks.

I’m not sure I can handle that. What good did this surgery do me if I get a damaged bladder and other side effects in the process of having to repair a DVIU result that may have been damaged by an unlubricated scope?

One more note. Between days 5-10, I was pleasantly surprised to wake up with an erection. It was quite painful, but an encouraging sign. However, ever since the sharp pains and bleeding, plus these new meds, it has not happened since.

That would be the ultimate kick in the crotch. To be able to pee like a race horse but be impotent,and unable to make love to my wife, not to mention any other possible long term side effects such as retrograde ejaculation, chordee, cold glans, penile shortening and the inability to orgasm. He took out a tremendous amount of tissue, over 25 percent of the total urethral length plus part of the bulbosponsious muscle, so how can I optimistically anticipate that all will turn out just fine.

I am deeply depressed at this moment, despite already being on anti-depressants. I’m angry that the most recent problem may have been caused by an incompetent nurse, and angry that didn’t just live with the improved, but not perfect flow, to avoid all of this.

If anyone has any encouraging words, now would be a good time to share them. I am feeling pretty hopeless right now.

[Clayton]

Thanks for sharing. I had a traumatic catheterization as well, during a surgery to remove a cancerous tumor. Unbeknownst to me, I apparently had a urethral stricture all of my life, but had very few signs before my urethra was obliterated. My bladder had been squeezing so much that eventually it would’ve lost it’s ability to function, which made all of this a blessing strangely enough.

The bladder infections after any urinary procedure are extremely common, no matter how careful the doctors and nurses are. Every time I would go to the urologist I would take a few days of antibiotics afterward to prevent one.

Removing large portions of the urethra is a controversial topic, but many studies show that it has very few side-effects when properly done. The penile urethra absolutely can’t be removed without causing problems, but the bulbar can be moved into a straighter line and therefore stretched without worry. If your surgeon was well trained to do this surgery, I would assume he looked at your anatomy and knows that it won’t be an issue.

Don’t be surprised if you have all or some of the sexual problems you mentioned, in the short term that is. I had chordee, cold glans and a loss of length for quite a while, along with pain when erect. As the weeks pass though, the symptoms have lessened or disappeared, and my surgeon assures me that it will all return in time. It’s all very common.

Clayton

[Author]

Posts