Urethroplasty outside USA

[totaldal]

Pre:
I am a 35 male expat living in Norway. English is my second language so bear with my grammar. I am currently little over 1 week post op. of urethroplasty and I want to share my story. I hope this shed some light and gives a different perceptive of how rest of the world deals with this stricture problem.

To give you a little bit history, in last couple of years I have been noticing a decrease in the urine flow. I never went to see any doctor coz it never bothered me much in anyway. In Last couple of months, the opening reduced further and finally it lead me to go to ER with 1300mL of urine stuck in my bladder. After four failed attempts to insert catheters in normal way, they finally punched in to bladder from outside with Superpubic Catheter. After that they put me in loooong waiting line for further diagnosis through primary medical system, run by government. Fortunately, I do have private insurance on top of that but my insurance only kicks in once the primary diagnosis was done by public doctor. So, I have no choice but wait.

After three months of agony, they have confirmed that there is approx. 2 cm narrow area (stricture) in the bulbular urethra. They also recommended that I should go for urethraplasty. They say that DVIU offers not only temporary fix, considering the stricture length, and it also increase the scar tissue. After that my private insurance could only find a doctor in Sweden. After a quick googling, I found that he is one of the best in Europe. During the discussion with him he agrees with my diagnosis and treatment option.

I faced some opposition from closed ones to not to go with urethraplasty, looking at the risk involved. But, my ER experience was always pushed to towards permanent fix. Fortunately, my wife who saw my situation in ER always rendered strong support. I know Urethroplasty is also not 100% but I hope the chances are much better compared to other treatment options.

On the Big Day: My doctor always prepared me for worst case condition by saying that he may need graft from my cheek to fix this. I was nervous by reading stories on different forums but before going to the operation my doctor said that he may not need graft as he think end to end (Asastomotic) urethroplasty can be done for this stricture length. It was quite relief for me before going to the operation room. The operation took around 2-3 hours and I woke up in recovery room with mild pain at the incision (pernium). No pain from cheek area confirmed that my doctor did not use graft (yeyyy!!). He removed superpubic and place foley catheter in normal way. He also put lot of soft stuffing around the incision to have urethra pointing up and to reduce swelling. He took this out after one day.

Post op: My doctor visited me shortly after my anesthesia wore off to say that everything went well. He also said that I did a good thing by coming to urethraplasty before doing any temporary repair. He said the scar tissue was manageable (I don’t know what that means) and he was easily able to identify narrow part.

I stayed at hospital ward for two days and took a 5 hour flight (got to change flight) to finally reach home. I only took pain killers until I reach home but I have been taking antibiotics ever since. I was in manageable pain and moderate swelling for the first week. This week the pain and swelling, from incision, got subdued to a level that I started sitting in office chair and working on my laptop. Doctor recommended to take shower everyday with some antibacterial liquid (HIBIskrub) for atleast one week. I am going to see my local urologist next Monday and hoping that they take Foley catheter out. I hope I don’t have to wait for another month to do that ;-). My only problem is that every morning I see few drops of thick liquid substance draining around foley insertion. I hope this will not cause any problem in healing the urethra.

If anyone is in my situation wondering whether to go for it or not….my sincere advice is to go for it before you do damage by considering temporary fixes.

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