End-To-End Urethroplasty
This is it! Six months of wearing a suprapubic catheter (see my post – What Is A Suprapubic Catheter? for more on that) has led to this. I go under the knife tomorrow to repair a urethral stricture (see my post – My Stricure Of The Urethra for what that means). I will post here after it is done and let everyone know how it went.
The reason I had to wait so long is mainly that – according to my doctors – one a urethral stricture is confirmed, its location and size need to be very accurately pinpointed in order to ensure the best and longest-lasting outcome (“for the rest of my life” is what I’m hoping for!). So the bladder needs to rest for 3 months before the most accurate information about the stricture can be obtained.
There are several places along the urethra where the stricture can set up shop. For men, who have a much longer urethra than women, the available locations are many. Is it in the penis? If so, what part – front or further back? If not in the penis, then it could be anywhere along the length or urethra that leads from the base of the penis, through the prostate, all the way to the opening of the bladder.
The location and size determine what kind of surgery will be selected. In 2013, a vast majority of strictures are treated via urethroplasty, which is some form of cutting and rebuilding of the urethra. And there are several very different types of urethroplasty. I described them all in my article, The Treatments For Stricture Of The Urethra, if you care to review them. They vary from the least invasive – end-to-end anastomosis – to the very invasive and complex 2-stage version.
Even within each type, there is a lot of variation. For example, end-to-end anastomosis (see the picture above for the basic idea) has many different variations, from how to access the stricture (cut open the penis or approach from the perineum. BTW, they used the perineal approach on my surgery), to how the excision is performed all the way to how it is re-attached. Then there is the decision of whether or not to augment the repair with a buccal graft (taken from inside the cheek), which cannot really be made until the surgeon has you open and knows how much of the urethra has to be cut out.
So because of the many moving parts and uncertainties involved, it is imperative to know as much as possible about the stricture before trying to fix it.
Letting the bladder rest for 3 months helps to keep it empty, which prevents it from constantly pushing urine across the stricture, which causes not only pain, but inflammation in the area of the stricture. Letting it be allows for a much more accurate picture when they scope you to determine size and location.
Then after that, you have to have the surgery scheduled, which usually takes a few months. So here I am six months in and about to be repaired.
Like I said, I’ll let you know how it went when it’s done. Wish me luck!
Cheers,
Ken
ps – Of course after it’s done, there are four more weeks of catheter time during recovery. Yay!
Hi,
I have just noticed your web site. I too have been suffering from a bulbar urethral stricture for a long time, which really annoyed me. I had 5 months ago an end to end urethroplasty as well which seemed to have failed to some degree since a new scar tissue has been formed in the new connection. I am supposed to have a DVUI next week to remove the scar tissue. According to the surgeon who did the urethroplasty (and will also do the DVUI), chances are high this is a very minimal and very short scaring in the connection thus chances of success with the DVUI are high even in the long run.
I wish you all the best with your urethroplasty tomorrow. This procedure indeed has the highest chances of success.
Eli
Thanks Eli! Mine is done! The doctor, who is one of the best in the country at this surgery (Dr. Thomas Rozanski) did it. I’m so lucky. He said it went great and the stricture was really small. I’m going to write a post about this right now. Sorry to hear you had to have a re-do. End-to-end has a 93% long-term success rate. You must’ve been one of the unlucky 7%. But good luck with your DVIU.
Happy to hear your urethroplasty was a success!
My case was probably a bit complicated since my bulbar urethral stricture was formed due to extensive surgeries for another major problem when I was a baby, so my whole urethra was kind of problematic and scarred. I have seen the doctor who operated me since, and he claims that most likely there is a very minimal tissue scarring where he reconnected the urethra (end-to-end), probably very short (< 1 cm) and not going to deep into the surrounding tissue. Hopefully that is indeed the case. I am aware of the very high rates of long term failure for DVIU and had inquired him about this. He claims that because it's probably so short and minimal then it has a very high rate of success. Anyway he will start with a cystoscopy and only if the scar tissue which is causing the (new) stricture is less than 1 cm he will cut it through (and for <1 cm chances of long term success are reasonable). If this is not the case or if the DVUI eventually also fails (hopefully not!) then I will have to consider a urethroplasty redo, this time in a top medical facility outside of my country. Currently I can urinate but stream is very weak. I use catheters to help empty the bladder completely (very small – 8 FR so it doesn't damage the urethra and doesn't hurt almost). Also I have found that I can quit easily simple expand the stricture using a 10 or even a 12 FR catheter, and then I get relatively good stream. But this is something I have to do about once a day to keep it open like that, and I am aware the long term implication of this (like scarring the urethra further, UTI and so on). I am really hopping for it to be a very minor stricture and for the DVUI to work..
Is this a painful surgery? I have been putting it off for a year but it took 8 years for someone to figure it out. But over all is the surgery a painful ful surgery? Also I have a women doctor who is kind of pushing me to just put my urethra at the base of my scrotum so i will have to sit and pee all the time.
Not going to lie – there is quite a bit of post-op pain for the first few days on this one. But it’s well worth it if other less-invasive and conservative attempts have not worked (dilation, urethrotomy, etc.). The type of urethroplasty you need will usually be determined by where your stricture is and how long it is. The procedure you mentioned is one of the most aggressive ones. And usually the creation of the opening at the base of the scrotum is temporary while they reconstruct your urethra in a two-phase (year-long or more) set of surgeries. I encourage you to seek a second opinion on whether you need this type of surgery. Best of luck!
I’ll be praying for you buddy. I hope it all goes well and you have a speedy recovery.
Thanks Neil! It’s done and the doctors are happy with the result! I was in a LOT of pain following the surgery, but things are calming down now that I’m at home and got pain under control. I’ll give details in the post Im going to write in just a few minutes;).
Ken
I just had end to end in LA, recovery is annoying I’m almost at 3 weeks and catheters to be removed. Not a whole lot of moving around for me. Hoping I haven’t lost an inch and a half like I read everywhere else. This disease has no where near enough success stories on the web and my main concern is they say high long term success rate but nobody has had this done for more than 20-40 years from my knowledge so we could all be screwed in the future.
Nick,
Where did you find the numbers about nobody having had this done in 20-40 years. That is not true at all. The surgery is actually done quite frequently. My doctor alone has performed end-to-end anastomosis urethroplasty many times.
I’m sorry about your frustration. But it sounds like you’re almost done! You mentioned, “catheters.” Does that mean you had multiple? I’ve read that sometimes they leave you with both a suprapubic catheter and one inserted the “normal” way.
Also, since end-to-end is not usually offered to people with strictures longer than 1-2 centimeters, I don’t think you will have to worry about losing length, certainly not an inch and a half. If your stricture had been that large, you would almost certainly have had a much more invasive urethroplasty, probably with a graft from your cheek (buccal graft). Do you mind sharing how long your stricture was?
I’m 6 days into my recovery. It’s been painful and inconvenient, sure. I expected that. But having a recliner and an inflatable donut ring to sit on has been a terrific help. They plan to remove my catheter (it’s up the “normal” way) at the 2 week point. They plan to fill my bladder with contrast dye, have me pee, and observe that under Xray. This is called a “voiding cystourethrogram (VCUG).” Then I’ll go in for regular checks every few months for the first year.
I would imagine you’ll go through something similar. I think you’ll be fine. Good luck!
Ken
Ken,
What I meant was nobody has been living for long enough to really diagnose “long term” success for this kind of procedure. Especially for the graft. Also I am 23 and my stricture was 2.5 cm, no skin graft. It’s been 3 weeks since I got catheters removed and x ray looked great. My stream is getting worse day by day, week flow, Very split stream every morning. I have yet to get a full erection it feels like it wants to but there’s no longer enough urethra to let it expand. Everything is still so tender I could not imagine intercourse. Testicles in constant pinching pain.
The split stream seems to be more when i wake up with semi erection, it will guarantee split as opposed to i can get a straight stream when not erect at all.
Hoping your success is permanent, mine seems to not have lasted more than 48 hours. The first 48 hours gave me much hope, now it just feels like I lost my life all over again. Stricture is a very serious disease.
I am really sorry to hear that, Nick! Have you spoken with your doctor about this?
I was just perusing forum https://www.medhelp.org/posts/Urology/Recently-had-a-Urethroplasty-done/show/1680722. There are several threads, actually, from guys who have had urethroplasty. A number have reported issues with sexual function early on. Some say their doctors tell them it will improve. Interestingly, most of those folks have not given an update for awhile. Maybe that’s because everything got better and they went about their lives:).
Either way, I wish you luck with your issues. I’d be interested to hear how your doctor assess you at this point. Also, I’m at the 4-week point from my surgery tomorrow and I am still in quite a bit of pain in the testicle/scrotum/perineum area. So is Chris (another recent post-urethroplasty guy here), who had his surgery a week or two before me.
I’ve also heard that you should refrain from sex until the pain and swelling reduces down there. Makes sense to me, though I received no such advice from my docs.
Anyway, I hope things get better for you without having to have the surgery again.
Good luck!
Ken
Nick how much did they cut out? I read a story that a guy had it done and the Dr. took 3in. He got hard but was not big enough to have sex….
I just got an answer back from my doctor saying possibly that from the instruments being in my urethra i have formed a narrowing in the top of my urethra now causing split stream. I take it that means a new stricture? life can’t get any worse at this point with that kind of news right?
The testicle pain and stuff will subside very fast for you guys. I just have aches but all the pain should be gone by the 5th week for you.
Thanks for the update, Nick. So your doctor didn’t say you definitely had another stricture? Did he schedule you for a retrograde to at least confirm it? That would seem the logical move. At least that way the uncertainty part of the equation can be addressed.
Thanks also for the feedback about the testicle pain. That is a relief for those of us not that far along yet.
Good luck!
Ken
My boyfriend just had the surgery..the cheek graft..that coming alone very well.we’re very new to this site .he want to know how do u keep the family jewels..from hanging down without him using pads..
Hi Rosalind. If I understand your question correctly, you can help the testicles/scrotum area heal a bit more quickly if you keep them supported. At first, they had me in pretty tight, supportive “tighty-whities.” After a week or so, I was advised to wear a jock strap (athletic supporter) to keep the “jewels” supported when up and about. And if reclining/resting, he should try not to “let them hang” if NOT wearing the tight underwear. Doc told me if I didn’t have the jock strap, I should lay a rolled up towel under there.
I hope that helps. Best of luck to you both!
I feel pretty great minus the urine spraying and semi fullness, you’ll be in no pain in no time honestly. I flew to the u.s for surgery from canada and he wants to see me again. My family is kind of in shambles and in confusion after this, we were never told about a possible new stricture formation after the place. I would of never done it in the first place had that of been the case. I’m starting to realize as doctors say “rarely” when referring to a complication it does still mean it exists and can happen. Also my sexual function seems to be destroyed as far as I can tell. I can’t get fully erect even though it wants to. Curious to hear more evaluations from you guys as you go on.
Thanks for the info, Nick. I have heard that sexual function that is affected in the short term can, and often does, return over a longer period. check out this thread at MedHelp – https://www.medhelp.org/posts/Urology/Recently-had-a-Urethroplasty-done/show/1680722. Quite a few folks mention their experiences, which can help paint a picture of what can happen after urethroplasty.
I wish you the best of luck on this journey!
Ken
Just wanted to let you know that I just set up a forum on the site! It might make it easier for all of us to keep up with each other rather than having to use the comments sections across multiple posts. Right now I have a “General Discussion” forum and a “Urethral Strictures And Their Treatments” forum. You can find the forums page here: https://livingwithacatheter.com/community-forums/
I’ll be putting this comment on multiple posts so everyone who has been involved in our discussions is aware, so I apologize in advance for the possible duplicate e-mails you may get.
Cheers!
Ken
Im a young fellow only 24 yrs old had a accident 1 1/2 ago had a spt tube in my bladder insert right below my belly button for almos 1 yr went through all test all came out normal went doctors took my catheder urinating was painful and slow .. I suffer this problem for almost 6 months had a spt tube insert again stduies showed which they missed several times there were scar tissue which prevent a rapid flow of urine had surgery down on d 24 now waiting for recovery doctors say it was bad but I was urinating for 6 months slow and on a constant basis they did a procedure where they cut the urethra and basically spliced it .. Which I hope it fixed d problem doctors say it might come bak due to the new scar that might produce d urethra from d surgery what y’all think will it be fix or will I have to undergo another surgery
Hi Jose,
It sounds like you had a urethroplasty. If they “spliced” it, that is essentially what they do in an “end-to-end” type urethroplasty. You can see what that is in my post here: https://livingwithacatheter.com/the-treatments-for-stricture-of-the-urethra/. The chances of the stricture (that is what the scar tissue blocking your urethra is called) coming back after an end-to-end urethroplasty are very low. This has over a 90% long-term success rate. So chances are pretty good that you’ll be OK. So do you have a catheter in now still? Once they take the catheter out after surgery, you should be able to urinate really well. Let us know!
Thanks for commenting!
Ken
I am over a year after my 2nd end to end astamosis , the first one failed as i was still healing from a serious pelvic fracture, in between my first and second op i had 2 dilations both of which did not work and made things worse. After my second op everything was flowing powerfully more so than before my accident, over the past 6 months the flow had reduced to a more natural level. I hope it remains this way. Good luck all.
Vic – I’m sorry to hear about your ordeal, but glad your 2nd fix seems to be working. I just had my 3rd and final flow test 2 weeks ago. Like you, I noticed that the level seemed to have reduced to “normal” levels. But the peak flow (Qmax) was still way up there at 36 mL/sec, at the very high end of normal. So that is supposed to mean there’s a 99% chance this fix will be permanent. Yay! I hope you have similar results. Good luck!
Thanks ken, yes it was a bit of an ordeal, Coma for 2 weeks, serious brain bleed, shattered pelvis requiring 7 screws in an 11 hole plate to close the open book so to speak.
Broken neck requiring a plate and 4 screws, a torn illiac artery coiled to close it, oh and 42 other shattered bones.
A drunk driver hit my camper van while i was asleep, it spun my van and ejected me onto the road where a bus ran me over at 50mph..
That was a little over 2 yrs ago, but i am back swimming, biking, climbing, living independently, but most importantly able to keep doing the things with my 7 year old son that we used to do.
My last flow test my urologist told me my flow was better than his, 42ml sec. up 2ml from my first test. As for the future i here people say ” what about in 10 years, will it come back?” well to those people i say, 10 years is a long time in the medical world.. who knows what may have been invented by then? I am still trying to find equalibrium with my bladder, it has it good days and bad. Yes there has been times when my flow has been weak but i think that was more down to me thinking i needed to go rather than having a full bladder.
Plus, the brain injury also i am sure plays tricks on me.
I am out of the woods but still have a hill ahead to climb, but a least i can see the summit now. I have a top urologist, and cant thank him enough for what he has done for me. He is quite a portly man and waking from one op he asked how i felt and i told him ” like i have been kicked in the nuts by a massive animal,” to which he took a step back ran his hands over his belly and said, ” yes,, that would be me..” Top bloke, after my first op i was voiding into a cardboard thing he was holding. He had told me that due to the location of my injury and what they had to sacrifice that continence would be an issue and i would not be able to stop mid flow. So i gave it a go and stopped the flow, then started it again, his face was horrified, i said ” dont worry, i am doing that, stopping and starting” He said with a huge smile on his face, ” i could kiss you” i told him ” yes but i could think of a better time to do it than now while you have my pecker in your hands! People may get the wrong idea”
That is the most important thing having a surgeon who treats it the same as i do with surfing and climbing,, a way of life, a passion.
Always wanting to better themselves. True to the Hippocratic oath. Any questions and i would be happy to answer if i can.
Oh and supplements any questions on what i am taking please feel free to ask there are things that the body needs that modern food especially processed does not provide for healing the body, seen as mine has had to heal everywhere then i was a bit concerned that after my last op then maybe my body just didnt have the reserves for healing such delicate tissues when there where bigger issues like back broken in 6 places and all the other things still on the mend. So supplements are a major key in healing as far as i am concerned, my proof, i have a lot of surgeons baffled at my recovery. I wish all of you suffering out there, peace, healing and joy. Stay strong but be weak when you need to be, its o.k.
Oh my god! That’s incredibly horrible. You’re lucky to be even alive! Thanks so much for your reply. I went from holding my hand over my mouth to laughing hysterically. You obviously have an excellent sense of humor, which, I am led to understand, can help tremendously in the healing process. Also, what supplements do you recommend? Because if they were in any way responsible for your unbelievable recovery, I want me some:). Thanks again for your amazing story!
Ken
o.k. supplements: I wont go into the specifics of each supplement but will put them in lists with a heading regarding their target areas, if that makes sense?
All my supps are sourced organic where possible and any tablets are filler free. i would put the name of the company where i get most of them from but i dont want to look like i am trying to advertise.
Reduction of Scare Tissue.
Serrapeptase (emzyme) Hugely important but not until you are sure that the tissues from the op have fully knitted. 6wk
MSM (Methylsulfonylmethane)
Vit c Esta.
Organic Garlic.
Take vit c with the msm to help it metabolize properly.
Healing bones and tissue.
All of the above
Hemp protein
chlorella
Macca powder
pea protein
Barley grass protein.
lots and Lots And Lots of water at least for the first year after surgery.
Can say how much a good diet helps.
I guess i have been lucky regarding my urethral injury, i have had to traverse the whole field in my search for understanding. Also i just look at how my external scares have healed and think, “well the internal ones must be doing at least as good if not better surrounded by all that good stuff.
Thanks Vic!
Ken
My husband had a buccal mucosa urethroplasty last Friday. His stricture measured 15-16cm on the retrograde. Surgery was 7 hours long. He is still in a lot of pain especially his mouth. Just wondering from anyone that has had this procedure who long the pain lasted and what kind of food did you eat?
Thanks for the question, Jennifer. I hope some other readers can answer your question. From what I’ve read though, it is not uncommon for the mouth to be the primary source of pain just like your husband is experiencing. It is also my experience that mouth wounds tend to heal faster than just about anywhere else in the body. So hopefully within a couple of weeks that pain will be gone. The longer lasting mouth complaint, if there is one, has been that there is tightness inside the mouth, which lasts a lot longer than the pain. As for the food, I’m surprised his doctor did not suggest what kind of foods to eat. My suggestion would be to avoid foods with lots of acid or that would otherwise irritate the area. I’d also suggest soft foods that won’t scratch or tear at the area. And as usual, I have to issue the disclaimer that I am not a medical professional. Good luck to you both!
I had my buccal mucosa surgery at the end of June 2013. The mouth pain was by far the worst part of the surgery. I think it hurt for a couple of weeks. I still feel the scar on the inside of my cheek. Every time I feel it I appreciate how lucky I am to be able to pee freely. I haven’t been back to Dr. Meechum out of philadelphia since my initial flow test. But there is no greater feeling than to go to a movie with my 8 year old and finish peeing before he does. Especially since prior to the surgery we would watch 5 or 6 people come and go in the urinal as I half-emptied my bladder, if I had good enough flow to be able to not have to sit down. Great experience.
David, So sorry for the delay in replying. It is fairly common for folks who’ve had your surgery to report that the mouth pain is the worst thing. It’s so awesome that the repair was effective. And I totally know what you mean about movie theaters! We just went to see Guardians of the Galaxy and I only just started to feel like I had to go a little right at the end of the movie, after drinking a massive soft-drink during the show. That would have been impossible for me before my surgery. I used to have to get up at least once in the middle of the show to pee. Sleeping through the night is also novel and nice!
Thanks so much for sharing your story. Good luck moving forward!
Ken
A blunt force trauma on August 17, 2013 has left me with gross hematuria (blood in urine) and so I went to the er where I got MRI taken which did not reveal any problem with me except for bilateral inguinal hernia. And there was no blood in my urine either. Came back home went to sleep but woke up with a painful morning erection. Wheb I went void my bladder I pee nothing but blood and blood clots. Must have been 3 to four ounces. Obviously rushed back to the er where the urine sample they took had no trace of blood at all. I figured that something else is going on. Bleeding only occurs after erections.
By this time I have already gone through cystoscopy and cytology and a variety of blood tests prescribed by a bunch of urologists and nefrologists.
For some reason doctor after doctor kept on ignoring the fact that I was in an accident and this is not a disease. They put me on a variety of antibiotics for almost a year. I was afraid to sleep and wake up with a morning erection. One of the top surgeons said I have prostititus (a rare prostate disease that no one knows anything about).
I feel that being jobless and without an insurance plan kept them uninterested. With no money to pursue further I started looking for alternative medicine which I could afford and found a homeopathic doctor who sounded economical and promising. My bleeding stopped within a week of my starting his prescription which was February 4th, 2014. I was able to return to my normal sexual lifestyle by July. I am an engineer by profession and always (or most of the time) believed in the exactness of modern science. After spending almost a year in pain of peeing blood every morning I was eventually fixed by someone I used to tease as voodoo doctor.
Some of the pain people have reported is referred pain because of the nerves being so close to each other. I have not had the luxury to get my stream tested but after finishing my regiment of prescription I can pee full 6 ounces in under 40 seconds. I am happy with that.
I may be getting better physically it’s the mental state that bothers me. Up until I read Vic’s story I was very upset with whatever was going on. Now I feel it’s just what we got served and we have to deal with it. Thanks for sharing your story vic.
BTW I am 50 years old out of houston tx.
Thanks for your story, Khalid! I am continually amazed at the seeming lack of knowledge in this area of urology! Forget the ER folks! The ones at my ER didn’t even consider a stricture when they tried to jam a Foley up me! It’s very frustrating. I feel your pain. Do you mind sharing what it was that your homeopathic practitioner prescribed?
Good luck moving forward!
Ken
I had 4 to 5 surgeries 23 yrs ago to repair a stricture. The last repair they had to do reconstructive surgery to repair the urethra with tissue from my scrotum. That seemed to work, although my pee stream was never great, I was happy I could urinate. Recently I had blood in my urine and the Urologist gave me a ct scan and a cysto scope. Before he scoped me I told him I had several surgeries repairing a stricture and not to dilate me. Well he was having a hard time getting the scope through to the bladder from all the scare tissue. He eventually got the scope through. After reading the Urologist patient notes he says he dilated me from 12 French to 16 French ( not sure what French means). Now I’m freaking out, worried about the stricture closing up. My urine flow is slowing down and I’m now looking for a GREAT Urologist. Where is yours located. I’m willing to travel. I currently reside in Michigan .
Russ, I’m sorry to hear you may be in for another surgery. My surgeon told me he can only operate on folks with VA benefits now. Not sure if you fall into that category, but if you do, he is in San Antonio. “French”, btw, is a unit of measure for the diameter of a urinary catheter. A catheter of 1 French has an external diameter of 1⁄3 mm. So a 12 Fr catheter has a diameter of 12/3 mm, or 4 mm. a 16 FR cath has a diameter of 5.33 mm. I hope that helps. Good luck!
Russ
Who was the urologist in Michigan? I to live in Michigan So I am wonderimg who you went to. I just had a cysto last week and was told that I would have to have reconstruction sugery. I was told the only place to go was at Beaumont however I have seen that U of M has people who specialize in it. My doctor told me not use the doctor at U of M that I mentioned to him. I am not sure that I want to use the same doctor because he is not open to Q & A. As you know with a sugery like this there are a lot of questions. Let me know who you find and I will let you know also.
Hey guys I just saw my Doctor on Monday. I have what he refers to as a challenging stricture no clue as to how this happened. I have 3 seperate places in my urethra that are scarred. I have bulbar and penile but I have my surgery coming up next Thursday I am glad though because I have had a SP tube in for 6 months now. My fiance and I just had a baby boy in July so I want to be able to enjoy doing things with them as I cantnwith a SP tube its just very uncomfortable. My Doctor who is Dr. Alex Vanni out of Lahey clinic in Burlington Mass which I have heard is regarded as one of the best in the country in urology. He told me though that the surgery will take about 6-7 hours and he will need to take skin from both sides of my cheeks and possibly one from under my tounge I am hoping and praying that this is going to work. Note that I am 26 and have been dealing with this since I was 15 years old and have had multiple dialation surgeries that have been unsuccessful. What I question is now that I have learned that urethral reconstruction has been around for some time why didn’t any of my stupid Doctors say anything about it? The only one that did was 4 years ago when I had a dialation the Doctor said I may need to have it reconstructed and made it seem much worse then it really is. If he had explained to me 4 years ago what this surgery consisted of, I wouldn’t have hesitated. I live in a small town though in Western Mass and I guess the Doctors aren’t as skilled. So now after waking up one day not being able to pee one bit and 6 months later with a SP tube I am finally ready to take this next step and be on my road to recovery. I am hoping for the best and honsestly I am pretty confident and I am confident in my Doctor wish me luck guys.
Hi Dustin. Happy New Year!
I was also really surprised at how little awareness there is for urethroplasty. Even after I had it, the urologists in the clinic seemed unsure as to what was normal in terms of recovery. It seems to just be a very rare thing for folks to specialize in. But it’s good that you seem to have found a great doctor and I wish you the best of luck with your surgery!!
Ken
Any follow up to this Dustin? I also have surgery (urethral reconstruction)with Doctor Vanni due Feb 2020.
I have been assured he is a fantastic surgeon by my Urologists up here in NH. He has told me I will need grafts from my inner cheek and given me the greatest reassurances that all will be good.
I have urethroplasty surgery tomorrow at Duke. I really don’t know what to expect and starting to freak out a little.
Jason,
There is a lot of info here about it. But if you don’t get a chance to read through it all, there is plenty to help for AFTER the procedure. Best of luck tomorrow! A lot of us have gone through it.
Cheers!
Ken
Ken, thanks for maintaining this thread. I had a SP tube inserted Dec. 2, then a simple urethraplasty (sp) four weeks ago on Dec. 18. Was told by the Dr. Morey (UTSouthwestern in Dallas) that he might have to take a graft from my cheek but got lucky. Did have a bleeding problem which added two hours to the two hour surgery. Recovery took about 90 minutes and I was sent home. I was wheeled out to my SUV and I had to climb up into the passenger seat on my own. Large GM SUV so climb wasn’t insignificant considering my condition. Laid the seat back and slept most of the way home. Climbed out on my own, walked the length of the house to back bedroom and slept off the last of the meds from surgery. Pain meds were adequate to keep the pain at bay (no mouth trauma) and I thought I was home free. No problem, this was just a little day surgery procedure right.
When my head finally cleared the next day, my testicles were the size of a large orange/small grapefruit and black and blue. Used my iphone to take a picture so I could see the damage.
I have been taking a generic Cardura for years for prostrate issues and it has some blood thinning qualities. I was told to stop taking aspirin and any other blood thinners prior to the surgery but I did not think about the Cardura. That oversight may have led to my bleeding so much during surgery. Also, about 18-20 days I turned on my side a little one night and felt a sharp pain at my SP site. The next day I had dark bloody urine and numerous clots as long as 3 inches. I took it very easy, pushed even more fluids than I had been, quit taking the Cardura and everything cleared up in 48 hours.
Can’t wait for the dye flow rate test next Friday. I am so ready to get rid of these catheters. If the dye shows a leak, the catheter will be reinserted.
I am not advising you to stop taking Cardura or it’s generic, but do ask your surgeon if he considers it a potential bleeding risk.
This is addressed to everyone, but especially you young guys with an active sex life. Look around and find a person who specializes in this procedure. My Urologist has long been considered one of the best in the Dallas/Fort Worth area. I was lucky because he knew Dr. Morey who had twenty years of reconstructive urethra surgery in the Military before joining UT Southwestern. This is “micro-surgery” and very involved. A lot is riding on the eyes, hands and experience of your surgeon. A little slip might result in life changing abilities for you.
Thanks Joe! I Hope your recovery continues to be positive. And thanks so much for your tip about the meds and the doctor. My doc was also a military doctor for his first career and now teaches in the San Antonio medical center. Though I believe his practice is mainly for the VA at the moment.
Anyway, thanks again for your comment!
Ken
Hi Joe,
How is your recovery? It has been almost six months since your operation. I am considering using Dr. Morey as well.
Dave
My urethroplasty is over. It was a 3cm stricture and bigger than the doctor thought. Dr. Lentz here at Duke has been great. Not much pain in my scrotum just in my mouth. Sure hope this works and takes care of my problem long term. I couldn’t think of getting up and walking right now. Ken thanks for the information on this procedure and best wishes.
That’s great, Jason! The odds are really good that it will take. Best of luck in your recovery!
Ken
Hi Jason – we live here in PA and are looking for a good doc to do my sons(24) urethroplasty and was considering Dr. Lentz. I was just wondering about an update on yourself. How are u doing? And how was your experience w/ dr. Lentz for follow up treatment. My son has a 3cm bulbous stricture- he has suffered with it most of his life…was just diagnosed in August. Not sure what caused it. He has been putting off the surgery but can no longer wait! Thanks for your time. And thanx to Ken too 🙂
I have had 2 of these surgery the last one my Dr split my head open hole length of head and left it that way I have to seat to pee after 2 months no better anyone ever heard of this
Greg,
That sounds like a 2-stage surgery. Are you sure it is intended to be finished? You should absolutely ask your doctor about this. That sounds horrible.
I hope you get it resolved.
Ken
I was injured getting a turp that I did not need (miss diagnosis)I am going in for my 3rd Urethrotomy for scaring.My first surgeon told me after 5 surgerys I would end up with bag on my side(yuc) probably am not a candidate for reconstruction.My procedure calls for incision of bladder neck contracture direct-invision internal Urethrotomy.All this has taken place in the last year.70years old,future looks to be full of pain and discuss.04/02/2016
Dan, I’m so sorry to hear that! I don’t know why they are saying you’re not a candidate for urethroplasty/reconstruction. If they are doing urethrotomy (which has a really low success rate for lasting any length of time), then it seems like you should be a candidate. I’m not a medical professional, but I would get a 2nd opinion if I were you. It’s not a bad idea just in general when it comes to major surgery and invasive procedures.
Best of luck to you! 70 is not that old anymore. I hope you get a better prognosis and that whatever happens, this will be over for you as soon as possible.
Let us know how it goes!
Cheers,
Ken
Thank you Ken.There has been no mention of reconstruction only a bag,just recently found info on internet.What the hell is it with doctors,first one injuries me,then I am in surgery every 2 or 3 months,very painful and can not move on with my life.When strictures go bad .can not even get a cath in.Urethrotomy tomorrow.Very nervous,just have to man up.I will stay in contact,so nice to have found this site.Good luck and God Bless.
Finally getting around to respond,my new doctor found part of my urolift in my bladder,a stone formed around it and blocked me from urinating.Doctor told me to self cath for 90 days.For now I have no strictures.Thank god I finally found a great doctor.Good luck to everyone dealing with these problems. (Can not believe the difference in doctors some do not seem to care at all.)
That’s awesome you found the right doctor! It does make a huge difference. Good luck with the recovery from the stone!
Ken
Ken,
First of all thank you so much for such a great motivated and informative thread. I am not good in English but I will try my best to share my experience having the same issue.
When I was 14 years old I had a car accident. The nurse inserted a catheter and when it was removed I had burning whenever I go to pee. As time passes my urine flow gets slower. I felt shame to discuss this issue with anyone.
Now I am 24 Yrs old and the first time I faced urine blockage in November 2015 and after every 2-3 weeks, my urine gets blocked. Dr says its UTI but after changing Dr, he suggested me to do urethrogram and in reports long stricture is found and Dr told me for operation but I was afraid. My one army friend prescribed to go for homeopathy medicine then I started homeo, in first-week flow was bit good but not normal. But last week again urine blocked and now it comes like drops but when I force its bit fine. Today I meet another homeo Dr. He is claiming that it will take time butt will be okay.
Before reading your article I left the hope to have normal pee because of so many comments of delitation but now I am motivated for Urethroplasty. But still bit scared.
I have a question, after how many days I will be able to go for Job? After Urethroplasty.
Hi Rumi. Thanks for sharing your story! It sounds like you are on the right path. IF you have a diagnosis of urethral stricture, then the best way to be certain that it is fixed for the long term is urethroplasty. Dilation and other treatments MAY work in the short term. But urethroplasty has a high probability of lasting permanently.
As for work – I’d say that depends on what kind of work. If the work is mostly at a computer or in an office, you could probably return in a week or two after surgery. IF you worked from a home office, you could start working again after a few days. The problem is that you’ll have a catheter in for about 2 weeks after surgery, and you need to let things heal. You don’t want to risk tearing stitches or anything. If your job is very active, like lifting heavy things or very active, you should probably wait a few more weeks.
I hope that helps. Good luck with your surgery! Let us know what happens.
Cheers,
Ken
Ken,
Thank you so much for your reply. I am Asst Manger in TCS (Courier Company ) and most of my work are related to Computer. I will go for surgery after few days inshaALLAH.
Sure I will share complete detail to help people like me 🙂
You’re welcome! And thank YOU for sharing.
Cheers!
Ken
I will be having Urethroplasty by Dr. Gretzer this coming Tuesday April 26 at Banner UA Medical Center. Doctor has done this procedure with, per him, 95%
success. I will post an update after surgery. Praying this works as I am weary of
self caf for so long.
Thanks for posting, Walter. Best of luck with your surgery! And if you wouldn’t mind, can you let us know how it goes after it’s all done?
Cheers!
Ken
Hi Ken,
After stage 1 of the 2-stage process, how long will it be before one can start a computer type job from home?
How are you doing? Everything back to normal, Urology-wise?
Dave
Hi Dave. I don’t have any experience with a 2-stage urethroplasty. From what I have read, the time between stages is several months up to a full year. So I believe it wouldn’t be very long – a couple of weeks would be my guess. But this is just a guess. Maybe someone else who has had a 2-stage can answer this.
As far as how things are with me, I seem to still be fully recovered. I’m always keeping an eye out for the symptoms. But so far so good. Thanks for asking.
Cheers!
Ken
Hi Ken I am 19 years old and had an end to end urethroplasty around 3 weeks ago I got the catheter out a few days ago and the flow seems strong but there is some blood in the urine every time I pee. The doctor said the surgery went very well. They used the perineal incision to reach my stricture due to the fact that it was close to my bladder. From the incision they said it was normal that a lot of “old” blood from the surgery would leak out from the incision for a while after surgery because of hematoma during surgery. Well it’s been 3 weeks and I’m still having dark “old” blood coming from the incision. I was wondering if you experienced the same thing and how long it took for this to stop?
Thanks,
-Chris D
Hi Chris. First of all, congrats on getting through the surgery and the stricture problems before it! I did not have any actual blood from my incision point, nor did I have any in the urine after the surgery. Not being a doctor, I can’t say if that is in the realm of “expected” or “normal.” But I highly encourage you to ask your doctor’s office immediately. I learned to never hold my tongue when I had a question. I would say that my urologist’s office probably got sick of my asking questions all the time, but I think they were learning stuff too:-P. So in this case, I think you should call your urologist’s office immediately. Whenever there is blood coming from your body, you’re right to question it, I think.
I’l love to hear what they say and how this plays out. Can you let us know?
Best of luck! I hope this is nothing serious.
Cheers,
Ken
Chris,
One other thing that My wife just reminded me of. If the blood is “dark,” as you say, it may well be that “old” blood the doc told you about. But if you see bright red blood, I would encourage you to either call the doc or even go to the emergency room immediately, because that is not old blood at that point.
Ken
Thanks for the response Ken.
I called the doctors office and they said it was normal they didn’t have much else to say unfortunately and my doctor wasnt there so I had to talk to someone else. I have an appointment on the 20th so I should get all my questions answered there. But one other question I had was, when you got your catheter out was your flow very strong right away or did it take a little bit? Also I have blood in my urine towards the end of my void everytime.
Thanks,
Chris D
Hi Chris. Thanks for the update. After I got my catheter out, my stream was very strong. And I did not have blood in my urine after that either. But that isn’t to say it’s a huge problem if it does take time and if there is some blood in your urine like you say. The fact that the folks at the doc’s office didn’t think it was very much to worry about just now is a good sign, I think. It’s great that you have that appointment on the 20th. Hope things heal up soon.
Cheers!
Ken
Hi guys,
I just had my substitute urethroplasty done on Aug 1st 2016 and it took 4 hours.
.
The surgeon (Dr Selva) was mentioned as the best urologist specialist in Malaysia by lot of other urologists. So, I’m glad that I did the surgery with him in charge.
.
My stricture was about 9.5-10cm across the urethra and it caused the Doctor to takes both of my cheeks tissue to make the new urethra.
.
I have to use the catheter for 3weeks (21 days) and will be back in the hospital for check up on Aug.24th.2016. Hopefully, along the time waiting for that golden day (to dislodge the catheter) to come I will have a wonderful recovery period.
.
The balls are bruised, so it’s quite hard for me to sit well. The Doctor told me that I have to make a lot of movements, (considering I’m an amputee, I’m using walking frame to move) I instead play to move from bed to chairs many time. As long as it’s a physical movement, it will help me to recover soon and better.
.
Hoping for everyone to have a successful surgery and a wonderful recovery. Back to life stronger!
Wow Haqimie. That’s pretty intense and amazing! Thanks for posting. Best of luck moving forward. Keep us posted on your recovery!
Cheers!
Ken
hi haqimi hasim. how are you today?
i am very interested about your doctor. could you please give me more information about dr. selva?
Hi Ken, I am 80 years old and in top physical shape except for urology problems. About 16 years ago, I had radiation seeds inserted in my prostate to counter cancer. The cancer is gone but the seeds are still there. Now I am told that the seeds are responsible for a stricture and I am scheduled for anastomotic urethroplasty in 2 weeks. I have put up with the suprapubic catheter for 4 and 1/2 months and am eager to get rid of it – although with the big bag I am able to sleep for 7 hours straight each night. I have had various operations over the years but this is the first that I am really scared about.
Thanks for maintaining this thread, Ken.
Jim
You’re welcome Jim. It was my hope that this site could help folks.
It sounds like you’re in a similar situation to mine – living with a suprapubic catheter for several months prior to anastomotic urethroplasty surgery. I used to think 80 was old. But not anymore:). A lot of folks of all ages here have gone through exactly what you’re about to, and though no surgery is a walk in the park, the odds are hugely in your favor for this surgery to result in a fix that will last you the rest of your life. You’ll probably be stunned at how well you can pee when it’s done:).
Best of luck. And please keep us informed as to how it goes!
Cheers,
Ken
Hi Ken your blog is so motivating. So here I’m 5th day post my urethroplasty surgery, there is swelling on my scortum, do u have any idea as to how long will it take the swelling to come down.
Thanks Ron! The swelling is normal, as amazingly discolored and extreme as it may seem. And it will reduce back down to close to normal size within 2 weeks, normally. I still had some tissue that looked misshapen under there for awhile after that, and there will be pain down there for a lot longer. At least for a lot of folks. See my post about it here: https://livingwithacatheter.com/lingering-pain-scrotum-8-months-urethroplasty/ It may seem unreasonable to have discomfort for so long. But knowing that it isn’t uncommon, and having a certain expectation, can really help. I know it helped me.
Here’s to fast healing!
Ken
Hi Ken,
My 6-hour anastomotic urethroplasty surgery on October 20 was successful. I had to have SP and Foley catheters for 4 weeks but now nearly 2 months after they were removed I am doing well, frequently sleeping all night instead of getting up 3 or 4 times a night to go to the toilet. The first 2 days were real trouble, I had no control at all. But then it got better each week. I still have to use the Depends Shields because of drip after urination. But my surgeon Dr Rosenstein at Kaiser San Jose told me that the drip will eventually go away. I had many thoughts about whether or not to have the operation but now I am very glad that I did.
Again I thank you for maintaining this thread.
Jim
Thanks for the news, Jim! I’m glad things are going well. And I’m also glad you found the site helpful along the way. that’s why I did this.
Good luck moving forward!
Ken
hey Ken, after two days of my urethroplasty
surgery, the main catether was remove by itself when the affected place hasn’t heal, what can I do?
Hi Peter. I would absolutely contact your doctor as soon as possible. You should not be without a catheter before the surgical site has had a chance to heal.
I hope that helps.
Ken
okay ken, they said they will re-take that surgery but not now.
I should be continue use the suprapubic catheter for now.
Thanks
Aha! OK, you do have a catheter. So they put both kinds in – transurethral and SP? Good. Yeah the problem of having no cath after the surgery is that your bladder is pushing urine through the urethra, which is bad for a healing wound. But as long as you have the SP, that’s much better than having no catheter.
Good luck!
Ken
Thanks
Hi Ken,
Are you still monitoring this page? I have many questions.
Yes, Steve. What’s up?
Ken
Excellent forum, glad that I ran across. I have endured stricture issues my entire life, started when I was about 4-5 yrs old and I am 52 now.
Initially treated with dilation, dviu in ’88 and open urethroplasty in ’02. Kidney stone in ’16 that I could not pass after it dropped into the bladder and then stuck in the urethra, surgically removed, now have scarring and decreasing flow over the past year. Had a cystoscopy today, since area is small, will have dviu in 3-4 weeks. Although dviu’s do not have a high long term success rate, hoping that since the area is small, the outcome will be good.
Although I had no problems with my urethroplasty, no pain, easy recovery etc. worst part was my mouth hurting from the taking of the tissue. I want to avoid doing a second go around if at all possible.
I am fortunate that I have had the same Dr. at Baylor College of Medicine in Houston since ’02 and his speciality is urology trauma.
I was basically free of any issues until the kidney stone, so I would highly recommend discussing with your Dr. about being checked for kidney stones on a regular basis, as these little fellows can cause lots of issues for those of us with stricture disease.
Thanks for the comment Ken! And good luck going forward!
Ken
My 16 year old son is going in for a buccal graph reconstruction on April 5th. What tips can you give me for post op care. I’m totally freaking out. Thanks for this blog.
Hi Laura. I did not have the buccal graft for my surgery. So I don’t have any personal experience with that. Does anyone else here have any tips for that?
As for the reconstruction itself, do you know what kind it is? For example – an end-to-end (usually for strictures that are pretty small) or something different?
Either way, if your son has been having pain and difficulty in life due to the stricture, urethroplasty is the best possible fix for a young person and should last him the rest of his life.
Glad you find the site helpful!
Ken
Hi Laura,
I had buccal graft done in ’02. Like any other surgery, will want to keep the incision and drainage tube area clean. They should remove the drainage tube after 24 hrs. Other than just a little sore, I did not have pain in the genitials. I never took any pain medicine.
The harvesting of the graft was the worst part, extremely sore with swelling for about a week. Stitches in the mouth will dissolve. Also a low grade fever for 2-3 days. This procedure has a high success rate so don’t worry, he should be fine. This surgery is usually several hours in length, mine was about 6 hours if I remember correctly. Ask the surgeon for leg bag with the Catheter. After a few days you are going to have a hard time keeping him still. No driving, no lifting, no straining…..have him take a mild laxative pill everyday. He will appreciate this little tip !! Just remember that the repair is internal and take it easy to allow the graft to heal. Play a lot of Xbox, watch tv…….Just Take It Easy !!
Thanks Ken!
Ken do you still monitor this page? I’m in day five of my recovery from urethroplasty, very small stricture in bulbar area, and I’m getting erections all night, can this cause the urethra to stretch and ruin the fixed part?
Hi Marc. Yes I do:). And to answer your question – not really. Keep in mind that I’m not a doctor or nurse. Also, everyone is different and there are no guarantees. But nocturnal erections are normal and expected, and therefore planned for. Urethroplasty wouldn’t have a 90+ percent success rate if nocturnal erections were a huge problem. So I wouldn’t worry about that.
I hope that helps. Good luck moving forward!
Ken
Hey everyone. Could you help me out? I put together a VERY short survey tor subscribers on this site to help me understand how I can help folks with their catheter problems better. It would really be a help to me if you could take just a couple of minutes (seriously 🙂 ) to do this survey. If you can do this, just click here to go to the survey. Thanks so much!!
Ken
Hi Ken,
What is your flow rate like now? Any sign of recurring stricture?
It’s back to normal now. No sign of recurrence.
Thank you so much for the posts! I seriously read a very real post of a young gentleman on a site talking about suicide if he could not get helpful responses shortly. It was quite disheartening. I myself am 42 1/2 years old, employed, married, one 6 year old son, and a daughter on the way. I am and have always been an extremely active, healthy person. Multiple UTI’s and the discovery of a stricture. To complicate it appears I had a Hypospadias repair when I was too young to remember. Everything has worked just fine sexually and urinating until now. Off and on urination issues, left testicle pain, bloating, one horrible experience with a urologist that destroyed me with pain and a doom and gloom prediction. Finally wised up and jumped on the internet for doctor reviews. The new urologist started the process of a cystoscope. When they started to administer pain meds they discovered and diagnosed there was a stricture I need to be referred to a Jeremy Byers in Salt Lake City for. A bit scared of the unknown, but hanging in there. Surgery appears the only option.
Hi Clint. Sorry to hear about your experience. But it’s good that you seem to have found a good doctor. A lot of folks, including me, have had the surgery to repair a stricture – urethroplasty. Try not to be talked into “urethrotomy,” which is faster, less invasive, but also will likely see you back in to have it done again and again over the years. Urethroplasty is the only long-term high-success rate option at this point. Best of luck moving forward!
Have read through with interest. Am having a Urethroplasty on Monday 30th of October. It’s to sort a bulbar stricture. Not looking forward to it one bit. Long story but will be my tenth op, but the last was two years ago so the passage of time from the last does not help fear. My story is a little different as I was diagnosed with Urethra cancer in 2014. Had a BMG for the effected area but it had spread to my groin nodes and broken out of one into tissue. Radio chemo etc and fully dissections across my groin now my cancer came from a stricture and this current stricture is ok but they want to improve stream but also ensure this one does not go the same as the other . Not having lymph nodes means more complications re infection and alike .
Wow, Kevin That sounds tough. My heart goes out to you! I was lucky in comparison, having the bulbar stricture but no cancer. But speaking strictly for the bublar stricture part of it, a lasting fix for that is a very doable thing. As you probably know from the many stories here, it isn’t quick, but it als isn’t the worst surgery I’ve ever had. Dealing with the catheter for 2 weeks afterward isn’t a cake walk. But you’ll be surprised how fast that part of it goes. The lingering discomfort in the scrotum for some folks can last several months. But it DOES settle and go away after that. Have faith in that.
Best of luck to you!!
Ken
Thanks Ken. Well I have been up for most of the night and have decided to cancel the operation. I have had catheters in before for periods of time but it’s the swelling etc and complications that I am really concerned about, especially as I have lymphedema already in my leg and scrotum and penis
Thanks for listening
Well Kevin, I wish you ball the best in getting these issues resolved. It sounds like there might be a better time in the future to revisit this – when the pain and swelling you describe has gone down.
Good luck for a speedy resolution!
Thanks Ken.
Your typo did make me chuckle !! I plan to see my local urologist this week . Really nice guy that first diagnosed me. By way of background I have had catheters on 4 ocassuons three for periods of 10 -12 days. First two were ok but the last one fior some reason very uncomfortable. I have been researching stents as a less invasive procedure and thus not causing me further issues. A new stent has just been developed which you have in for twelve months which expands the urethra and stops the scar tissue contracting post a dilation . It’s brand spanking new and intial trails have just been published with 75-80 success thus avoiding the need for Urethroplasty. Hopeful . Should have mentioned I have a local urologist but have to travel to the U.K. for most treatments and see another there
LOL! Oops :-P. That sounds fascinating. Do you have a reference for the clinical results for this stent?
Hi see this link
https://www.rmmj.org.il/userimages/724/1/PublishFiles/751OnlineFirst.pdf
Kevin
Thank you!!
Ken
Well I saw my local urologist today. Not keen on the stent. Anyway will carry out a dilation for me to give me time to consider all. Also will book a CT surveillance scan re my past cancer . Kevin
Thanks – keep us updated! Yeah, I gotta say – the idea of stent makes me a bit leery too. It’ll be interesting to see how it plays out in terms of success and complications or lack of.
I go in for nose surgery tomorrow morning:-P. Not as involved as the other thing.
1 week removed from urethroplasty on Dec 20th at UC Davis in Sacramento . Some bruising and some swelling of testicles. No buccal for mine . There were layers of scar tissue to removed. Two times in life had strictures, one as a minor. I’m 48 now.. Minor “weepage” from incision . Some blood at tip where catheter is coming out but has subsided. There is some pain , kind of a burning feeling at times on scrotum area. Moved in bed wrong 2 nights ago and caused that burning ripping feeling again but went away quick. I’m taking my meds as prescribed, antibiotics, stool softener and anti spasm stuff. I’ve taken one single pain pill for two hour ride home, none since. Everyday is incrementally better except for the cath. Follow up is 2nd week in January.
Hello Ken,
I am a 25 year old male who had a dilation several years ago which initially worked quite well, I was one of the lucky ones. I think it’s slowly failing now though as I’m getting the frequent serious urgency to urinate more often than I should.
This is going to sound really vein, I know I shouldn’t care too much about this but I can’t help that it does bother me. Has your penis changed visually? Does it have a large scar now? I am very much a grower when I get an erection, and I am worried that if I have surgery that I’m going to have problems getting it up afterwards.
What was your experience? Has your erection changed for the worse? Is it softer or shorter now?
Hi Luke. My own situation did not result in any scarring or change of appearance because the stricture was pretty far back along the urethra. They go in through the perineum (“taint” for lack of a less crass word :-P) and repair the stricture that way. The penis is not involved. A lot of strictures can be treated that way. But not all. If the stricture is closer to the tip, it could involve direct surgery on the penis itself. Also, though it did take awhile to get back to it, all functions are normal.
I hope that helps answer your question. Good luck with this!
Hi Ken/All
Can any plz suggest me the best surgeon in australia so that i get my urethroplasty done.
I want to live my life normal..
One small question will the dribbling or urine go away, as I am suffering from stricture from 15 years now and dribling aswell i want to get rid of all these things…
Please help me…
Thanks
James
Hi James – So sorry to hear of such a long time with the stricture. As I’m sure you’re aware, Australia is large. Where in Australia are you? I don’t know of any of the surgeons there experienced in urethroplasty, since I’m in the US. But others here might. Also, a Google search for your region and “urethroplasty” would also be a good place to start.
It should take care of the pain for sure. Also the dribbling, though a little of that is not completely abnormal, depending on your age.
Best of luck!
Hi ken
Thanks for your reply,
I am in Sydney.. I tried searching online but didn’t get any surgeon who had great reviews on this.
What do you reckon shall i come to usa for this.
Can you refer me to the best surgeon there please…
I am 27 now and I hate this dribbling problem.
And lastly, comparing these two end to end or buccal urrthroplasty which one is best and solve above 90% of my problem.
I want dribbling to go away and what about erectile dysfuntion.
I have seen many replies here but didnt had one with erectile dysfunction so does that mean there less/ no chances of this?
Your response will be highly appreciated.
Thanks
James
James, have you seen a urologist there at all – of any kind? The problems you’re describing don’t sound to me like a stricture. Have you been diagnosed with a urethral stricture?
Yes I had been diagnosed with stricture and i had urethrotomy few times…Lol, dribbling is always there after several urethrotomy and i was just asking about the side effect erectile disfunction which anyone can face after urethroplasty..
Got it. OK. Well I do think urethroplasty would help. But erectile dysfunction is not at all a certain thing. For the first few months after the surgery, it was difficult to get all the way up. But it eventually improved until I could. So I wouldn’t let the fear of permanent ED stop you from getting your stricture permanently fixed. Hope that helps.
Thanks Ken, Feels good now…
Thanks alot will update after my plasty…
Awesome. Thanks James!
Hi Ken
I trust all is well with you. Had my scan in Dec all ok re cancer however needed my stricture cut open which was carried out in Dec. since then I have been daily carrying out self catheterization. It seems to be working and keeping all open nicely . Consultant now not keen on a urethaplasty as could cause major issues post all I have had done.
Best Kevin
Hi Kevin. Glad to hear the procedure is working so far. It sounds like a urethrotomy, which has about a 50% long term effectiveness. It sounds like you may be one of the lucky few. Since you’ve already had the procedure, then yes, it would be redundant to ALSO have urethroplasty as long as you stay stricture-free. Good luck moving forward!
Hi Ken, I’m a 36 yr old guy and I’ve been suffering with difficulties peeing since I was 19. Doctors blamed it on prostatitis initially and then on bladder neck sclerosis. I had two minor surgeries in 2008 and 2013 and a full cut in 2017 that left me with a bulbar stenosis and the need for a dviu. After last surgery I peed very good and symptoms subsided for a couple of weeks, but eventually returned and even if flow is not as bad as before I always have to push and I got this awful sensation of having a foreign body in my urethra (more on the left side) and dribble a lot. I can’t sleep again, I lost my job and alone. I’m very fit and active but this time I can’t seem to push through. I scheduled an appointment with a surgeon that is specialized in urethroplasty (I live in Italy btw). I think the stricture was there all the time, but they failed to find it, because I always felt like a “pop” and a sting along the urethra when I started peeing when all this begun. After the dviu my erection improved but now I’m at square one again. Any advice? Thanks for this site.
Hi Luca. It sounds like you had the typical recurrence after a urthrotomy, which is only 50% effective or so. If so, and if your problem is caused by a stricture, then you will likely need urethroplasty, which has a 90%+ long-term effectiveness. It is good you are seeing a urology surgeon. He/she will probably tell you the same. The good news is that if it is all being caused by a stricture, everything will finally be OK after you heal up from the urethroplasty, assuming that is what is called for. Best of luck! Can you post back when you find out?
Daniel, I had Urethroplasty 4 weeks ago went to my 3 weeks appt excited about getting tubes out, but there was a leakage and decided to leave tube another week. I went yesterday and unfortunately my stream was weak and doctor found a stricture on the retrograde xRay.
Oh no! So do they have to repeat the surgery?
Ken Thank you for your quick response. Not sure what is next, my stricture was long and complex my doctor is out in vacation for 2 weeks. His apprentice saw me and she thinks since my urethra is very thin there was not enough blood supply in a portion of the repair area and started to close down.
Do you think they might have to repeat the surgery and how long doI need to wait ?
I’m praying for a miracle that in 2 weeks the repair area heals and opens up.
I don’t know Daniel. There is no way for me to know and I would not dare guess what might need to be done for your situation. Best of luck though. I hope you don’t have to go through the surgery again.
Hi, I am from the uk and just had my urethroplasty last week, I had a 2.5cm stricture which required a buccall graft. I am nervous to find out if this has fixed my stricture as my urologist wanted me to stop taking my aspirin but my anethisist would not allow me to stop it so my urologist said that blood thinners reduce chance of the graft taking. Anyone had a urethroplasty while taking blood thinners? I also had 2 urethrotomys overvlast 2 years. Any advice would be appreciated it’s a great Forum you have created
Congrats on the surgery, Jamie. Keeping in mind I’m not a medical professional…I think the primary concern before ANY surgery (not just urethroplasty) with blood-thinning medications is the potential for the blood not to clot properly. That’s obviously important. But after the surgery, docs (mine at least) have let me start taking Motrin again like 12 hours afterward. It isn’t going to stop the graft from “taking.” If you’ve made it through the surgery successfully, you should be fine (again, I don’t know your situation and am not a medical pro). I hope that helps. Post back when you get your catheter out and have started peeing normally again!
Thanks for your reply. I have another ten days day before catheter comes out… the procedure wasn’t as bad as I thought it was going to be, was a little uncomfortable afterwards on my mouth and perinium but much better already. They wanted me to stop taking the aspirin for 7 days before the op but I was advised against this by my anethisist I just hope that doesn’t mean the surgery will be a fail as On the day my urologist had said there can be a reduced chance of blood clotting which the graft needs to bed in so fingers crossed it still works.
Hi! How long was your recovery time. It was your procedure done with robotic assistance. I had 2 surgeries trying to repair the damage that a kidney stone did to my urethra because it was embedded for 5 months and after 2 fail attempts I’m looking for a good doctor in the San Antonio area that will take me. I’m 43 yrs old and tired of using stents.
Hi Silvia. That’s not a cut & dried answer, really. After the catheter came out, I still could not sit down properly. I used a donut pillow for much too long also. But the pain in the perineum area was too much and sitting normally was just too painful. It turns out I was actually prolonging things though. The donut pillow actually put pressure in the wrong area. And I developed terrible hemorrhoids, not knowing that’s what was wrong. I thought it was part of the trauma. So in my case, I wasn’t fully recovered (in terms of not having any more pain) until about 11 months after the surgery. However, if I’d done what I should have – gotten off the donut pillow after 3-4 weeks post-cath-removal – it probably would nave been only a few months. Also, I was able to do pretty much anything after a few weeks. It was just that there was pain involved “down there” – not horrible pain, just really irritating discomfort. Technically, things were healed enough to function after a few weeks. But the discomfort lingered for months. Does that help at all?
Yes, I can figure mine is going to be totally different and more time consuming women urethra is shorter than a men so I don’t know how it would be, I was reading on some articles and some can have skin implant so it would heal better but don’t know if is going to be a choice in my case I try to make an appointment with Dr. Thomas but nothing available until August I just hope he can see me sooner having a catheter/ stent is not fun at all.
You’re right. It’s not what I would call fun. Best of luck!
I appreciate it, Thanks again.
Hi, all I have today had my catheter removed 3 weeks after urethroplasty with Buccal graft… I never had a cystogram test as surgeon for some reason decided It was not needed. After catheter removed I was kept in for a few hours to make sure I was able to empty my bladder which I am thankfully only retaining around 90mm although my output is only around 200 mm which they say is fine. Stream seems good but the issue I am finding is I need to pea like every half hour and at the end of it I still get the urge to pea for about 10 seconds or so, they assure me this can happen due to bladder trying to get back to normal after having catheter in for 3 weeks, anyone else experience this after catheter removal?
Hi Jamie. Sorry to hear about that. But I know they are right when they say it can take awhile for your bladder to “retrain.” I didn’t have that issue – I was lucky. And I had a catheter in for 6 months. But my mom only had a catheter in for a few hours during a surgery, and it took the better part of a year for her bladder to get back to normal. So yes, it can happen for sure. But don’t be shy about going back periodically and letting them know how things are going. Hopefully this will start getting better and better.
Thanks, to be honest the bladder thing improved dramatically yesterday after a few hours it seemed fairly normal, however after having an unbelievable stream yesterday I was really feeling good. Had a great sleep but when I woke and urinated stream already is reduced from yesterday so I am now back to the worried stage.
Sorry to hear about that – the last part I mean. The rest sounds encouraging. Definitely call or visit your doctor/urologist office. One thing I learned during my ordeal was not to ever hesitate to call or go in and tell them when I was worried about something.
Thanks Ken, I did call the hospital I was discharged from but they say as long as am still urinating then they would wait normal to my follow up visit, unless I couldn’t go at all, today my first pea was back to being really strong but a few hours later it’s a little reduced again. A mean it’s still much wider a stream than pre-surgery and as having had stricture for what must have been years am unsure what normal urinating is like I.Edoes people stream fluctuate in terms of force and also the amount of urime that actually comes out. It’s mainly because after 2 urethtrotomys the strictures came back so that’s why I am so worried.
I am glad you called them. Their advice is sound, though I still recommend never hesitating to call if you feel worried or something seems wrong, even now. To answer your question, yes! Stream strength does vary even after a surgery. I find that after I’ve been sleeping, the stream can be weaker. It definitely varies for me. I understand the suspicion after the failed urethrotomies though. I’d feel the same way if I’d been through that. So at this point, I think that unless something else changes, it’s OK to follow the advice of waiting until the follow-up.
i got dviu and i have a problem after catetherized. i cant poop. when i got an urge to poop and try, i feel like peeing and my penis hurt. so my urge to poop went. what should i do? is it a common problem?
Hi Evan. I don’t have any experience with that, and have never heard of it happening. So I can’t provide any help on that score at all. My only advice is to contact a nurse or doctor – preferably someone associated with your procedure – and get help from them. That’s always the best advice anyway, cine very few of us are actual medical pros of any kind. I know that isn’t very helpful. All I can say is that I do not think it is normal and you should contact the nurses/docs on this one.
Hi Ken, Thanks for keeping this thread going.
Im 48 and from the UK I have a stricture but it is not causing me any real ‘extra’ problems as I have MS and because of this I already have problems with my bladder (never fully emptying, very low flow, urgency, incontinenceience ect)
For the past several years I’ve managed this with the use of conveens and a leg bag and im happy to continue with this method.
My question is if I don’t have the stricture opened up do you think it’s likely to block my urethra altogether?
At the moment my peeing is as it has been for the last 10 years (not great) and i know if i didnt have the stricture my issues would be exactly the same.
I don’t want to make things worse by messing around when I have nothing to gain from treatment.
Many thanks for taking the time to read this.
Andy.
Great question, Andy. Im not a fan of getting surgery if it isn’t going to really fix (or come close to) fixing a problem. If you don’t think you’ll gain a huge amount of benefit from having the stricture fixed, then I think it is very reasonable to not subject yourself to the risk of a urethroplasty. I did wake up one morning completely unable to pee – as in NOTHING. I went to the ER and that’s when my whole problem really started. So it is possible that at some point, your stricture may completely block your urethra. At that point, at least SOME procedure will need to be done. But until then, you might be better off continuing as you are. Remember, my advice is just my opinion as a regular non-medical guy :-). Hope that is some help.