Doctors recommend that after your urethroplasty surgery, you should refrain from sex for four-to-six weeks.
As you might imagine, this can be difficult for some people. I don’t think that the reasons – at least for the first week or two – are all that mysterious. But I have gotten some questions as to why they have to wait the full recommended 4-6 weeks.
So I decided to post my answer below:
Why so long with no nookie?
While nobody ever specifically sat me down and said why, I came to some conclusions on my own. I think they make sense.
First, if you think about what got cut and needs to heal, the first thing that comes to mind is obviously the urethra. Now the erections, themselves, aren’t going to be too much of a problem, since all guys get them during sleep many times a night anyway.
However, think about what you do during sex. Not only is there an erection, but you’re pushing forward and encountering resistance back into your penis and along the urethra. That back pressure is going to put strain on the repair site on the urethra, which until several weeks go by, is only being held together by stitches. If you break one, you’re done. You broke your surgery! It isn’t really worth it to have to go through that again, in my book.
Second, the actions of sex not only push against the penis/stricture repair, but that pressure also goes against the perineum, exactly where they opened you up. And your testicles, which were clamped down so hard during surgery that they bleed internally and swell, are also gonna get squished at pushed/pulled. That takes time to heal. And again, the incision site is right behind there and is also at risk.
So for the first 3 weeks, you’d be nuts to risk opening all that up. It hasn’t healed yet. For the few weeks following that, you’re playing it safe. People heal at different rates. And after 3 weeks, you’re still at risk of doing damage to yourself that MIGHT have to be surgically fixed. Again – is it really worth the risk? You’ll have to make up your own mind on that one:).
I hope that helps!
This makes a lot of sense. Thanks for getting into the nitty gritty detail in your explanation. I am 19 days out of my bulbar end-to-end and I have no pain anymore. Not having pain, while maybe a good sign, probably gives a person a false sense of security and common sense should dictate actions more than anything else.
I have been sitting on hard chairs and also walked around the city today, stupidly all day. My advice, don’t push things, EVEN if you feel fine. Not worth the risks.
Yes! My wife called that “delusions of grandeur:).” Thanks for the comment! Good advice.
Ken
Hi such a great forum here common sense information and genuinely reassuring – Dec 2016 I had buccal urethral plasticy 2.5cm nearer the base of the penis very painful for several weeks even after the catheter was removed 4 weeks post surgery – my biggest disappointment was a definite size reduction of at least 2cm – however urinary function was fine for approximately 3-5 months thrn a gradual return tontge previous symptoms if painful urination etc etc so further examination showed development of more strictures higher up the length towards the end of the penis – so 3 weeks ago this Wednesday just gone I underwent another buccal urethral plasticy this time 3.5cm in length, also needed to have a circumcision before the surgeon could gain adequate access – I was in theatre for around 5 hours, two nights stay with good amounts of pain management on board thank goodness, had tge catheter removed 2 dats ago, but still in a lot of discomfort, I am having several erectiohs daily, driving me mad, I like several of the posts here got little or no information about the timing or dangers of resuming sexual activity, and once again I definitely nitice that my penis is different from what it was prior to the surgery, again I am sure that I have lost some length though not as much as the first time, there is also the positioning of the penis when erected, its just not in the same place but on a positive side it does feel a little thicker – not sure how this is possible? I also concur with the advice given to wait several weeks before any sexual activity, not that I can at present until the pain and discomfort has gone! I hope and pray that I don’t need any further surgery like this, the flow is great at present, just want it to stay that way! Not sure if I can go through this again, especially after having several years of non surgucal and surgucal dilation followed by the two urethral plasticies. Wishing everyone a speedy and successful recovery, thanks for all the posts, thus has been very helpful to me!
Thanks for the comment, Paul. Wow! You’ve been through a lot. I’m amazed your other stricture was not visible the first time around. But now you’ve had this 2nd one, yeah, let’s hope nothing else develops. I’d be very surprised if it did.
One thing to keep in mind is that there are many varieties of urethroplasty – including rebuilding the entire urethra. So even in the unlikely event something else does happen, you can still be treated. Obviously it isn’t ideal or pleasant. But it wouldn’t be life threatening.
Best of luck going forward into the new year!
I have just went through my urethroplasty last week. My age is 31 years. I wanted to know by eating what food items i can strengthen, heal and normalize the surgery area. Please help if any.
Thank you
Hi Tilak. Congrats on your surgery! I don’t think there is anything particular, diet-wise, that will be of any particular benefit. Just a normal well-balanced diet will be fine, and plenty of fluids. In fact, if I had to say one thing, it would be to drink lots of water. This will help keep things moving through the catheter while you recover. Best of luck moving forward!
Hi Paul,
Thank you and this is helpful. I just had an end to end urethroplasty on a 2cm stricture last Saturday, its been a week now, I felt a smaller size during the second day of the recovery, however my doctor did not inform me of this side effect, i was also instructed to take Finasteride 5mg to reduce my testosterone levels to control erections especially during the 1st 4 weeks after surgery. I am disappointed with the p shortening but I hope it will not be that noticeable, my doctor said it will only be 1cm shorter. Its tough especially when I was not informed well prior to surgery. I hope your recovery goes on well.
Seko
My husband had urethroplasty just shy of 2 months ago. His surgeon is insanely hard to get ahold of because he’s the top in the state and the drs in office all give different, and seemingly unknowing answers. I don’t know all the terminology. I know they operated at the perineum. He’s incredibly depressed right now because he can’t willingly get an erection post all catheter removals (had them for a good 5 weeks). He occasionally wakes up with one so they are saying you’re just healing/nerves have to regrow/it takes time/maybe it’s in your head etc. He’s terrified and I don’t know how to help. Zero problems before surgery in this area for him and not a ton of research to ease his mind. We are young and have one child. Planning to have more. Any information you might have gotten from your dr/research regarding this? 🙁
That’s the surgery I had, Nicole. It definitely took me several months before I could get back to normal on that score:-P. There is a LOT of soft-tissue and nerve trauma that needs to heal after this surgery.
First, they have to retract the scrotum and testicles to get them securely out of the way for the duration of the surgery. The retention device they use for that causes swelling and stretching, which I’m sure you noticed. The pain in JUST that area takes many months for some folks before it goes away. For me (and this is not uncommon, despite what the docs told me) it took about 11 months.
Then the have to burrow (my term:-P) from the perineum up through that tissue an those nerves to get to the urethra. Then they have to pull the urethra away from the surrounding tissue, which causes quite a lot of trauma. They then pull the urethra toward the perineum so they can do the procedure. After they stitch up the urethra, they release it and put it back where it belongs, after which they stitch up the incision at the perineum.
So in addition to the direct cutting, all the tissue between the incision and the urethra is damaged.
Basically what I’m saying is that all that damage takes its toll and the healing (for some) can take the better part of a year.
Since you say he is physically capable (the night time erections), I don’t think you have anything to worry about long-term. Function comes back, albeit slower than we’d like. I don’t know of a single person on this site who has permanently lost that ability due to urethroplasty.
BTW, I could never reach my surgeon, for the same reasons you mention. So I was left dealing with the urology clinic and docs who weren’t actually in the room for the surgery. For help on this matter, I talked to my regular doctor and enlisted the assistance of the blue pill. Doctors are more than willing to help with that after urethroplasty, I found.
I hope that helps at least a little!
Cheers,
Ken
Thank you so so much! This definitely reassured him and has made him feel more like there is a light at the end of the tunnel. And your blog in general has been incredibly helpful to us when we were researching beforehand so about the process so thank you for all you’ve done!
You can imagine his panick when this wasn’t a main talking point with his Dr. They were focused more on the big concern which was obviously clearing the stricture for flow purposes. And they brought this up of course but never really gave him a timeline and brushed it off so he kind of expected things to just go back to normal. I know he wants to call the office again Monday and just get some answers about when and what he can do in the meantime. He’s fine utilIzing help until he’s healed but obviously doesn’t want to do anything sooner than he should. Doing this prodedure one time is enough! And to think…his original surgery date was scheduled for 3 weeks before our son was born! So thankful it ended up changing to after…
Thank you again!
Glad it helped!
Thank you Anon, I feel the same way too, I had an end to end urethroplasty surgery on a 2cm stricture, I felt that my doctor did not explain well the side effects after the surgery, but he did mention that after 4 to 6 weeks I can resume sexual activity without any problem, seems that what your husband is going through is different, I am getting worried I have been recovering for a week now.
Seko
Hi Ken,
Thank you so much for this forum.
I had an anastomotic urethroplasty 4 weeks ago. Everything at the repair site is fabulous. Slowly feeling better in the perineum. Still feeling like my testicles are raw but slowly feeling better there as well.
Question I have is that the underside of my penis now has no feeling from a little bit into the scrotal area all the way up to just before the meatus portion.
Is there any information on anyone else’s experience with this? Is it a consequence of post surgery swelling or is it something that could be permanent?
Thx
Hi Bry,
Glad things are going well. There were several areas where I had numbness. Over time, all of that numbness has gone. Of course, everyone is different. As I usually do, I encourage you to try and ask your surgeon or at least someone in Urology for a more authoritative opinion. Keep in mind that a lot of nerves were disturbed during the surgery, and it takes months sometimes for that stuff to get back to normal.
Hope that helps.
Thanks Ken.
Just started trying to contact them today. Both in surgery. Urologists stay super busy.
Cheers
One thing I used to do was to leave a message for a doctor to answer a question. Then a nurse would call me back with the answer. Another thing I did sometimes was to physically go to Urology and ask to see a nurse so I could “ask a quick question.” that worked every time.
Try some of those tactics:).
Hi Bry,
I am experiencing the same thing too, my doctor would not even respond to emails, its hard to reach them.
Sultan
Ken,
I can’t post on the other page for some reason anymore but have some good insight on the incontinence stuff, post urethraplasty– I’ve dealt with a bit of it, however, as it was explained to me, in my case, with the buccal graft, it’s essentially holding that segment of my urethra open permanently, along with having opened up more space. So because I now have a small segment that never fully closes after peeing (normally urethra is like a flap and closes up overall after using the restroom), it leaves an opening for any leftover pee from the bladder to slowly make its way out.
In my case, I can be out of the bathroom for like 3-4 mins and notice a last bit of urine seep out. I can remedy this using incontinence pads for men during work days or just using a piece of toilet paper smacked between my opening and the underwear I have on. Am I thrilled with this? No… however, I’m more thrilled with having had the surgery and not being blocked anymore.
I’m going to look into pelvic floor exercises for the long-term– I suspect overall, all my muscles down there weakened mightily from all the straining I was doing before surgery and then the trauma from post surgery. I’ll be at my 6 month mark August 11th.
Thanks!
I also found this official info on a Dept of Urology Website/Detroit University— Minimal urinary leakage after voiding was common and may be an expected result of decreased urethral elasticity as a result of stricture disease or its treatments. It is so common that likely all patients should be warned before urethroplasty surgery, as surgery seems to cause or unmask it clinically in a certain percentage.” Website link: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382005000400004
Thanks Phil. Do you have any other sources that say it’s “common?” Even according to the source you referenced, it came down to 17% reported (if I read it right).
I should also point out that in this 12 year old article, results were all self-reported (anecdotal evidence), which is problematic when trying to claim scientific causality. Just a few reasons for this include the fact that there is no solid definition for the term “post-void leak.” There was also no blind comparison with a control group which would determine whether the urethroplasty patients experienced a statistically higher rate than the same population of men who did not have urethroplasty.
I try to ensure people understand that any claims made on this site are either backed up by repeatable, peer-reviewed clinical hard data, or declared to be only the experiences reported by individuals – anecdotal evidence. In a lot of cases I can only provide my own personal experience on things. they happened to me. They may happen to you. But they may not.
What I don’t want to do is frighten people by making them think something is likely to happen to them when it isn’t backed up by any hard science.
Thanks Phil. That is interesting that your doctor said using the buccal graft would increase the odds of incontinence. I should clarify for folks though that there isn’t technically a valve function going on with a flap or any kind in the urethra. But you’re right that the urethra itself does play an important role in helping to “turn off” the flow between trips to the bathroom. Here’s something from the National Institutes of Health that explains how “Three sets of muscles work together like a dam, keeping urine in the bladder between trips to the bathroom.” Yes, the muscles of the urethra itself are part of that equation. So I can certainly believe that replacing a significant portion of those muscles with non-urethral tissue from the inside of your cheek could make it more difficult for that piece of the puzzle to do its job.
Interesting. Thanks for the info!
Ken
yeah– I was thinking that too… but the way he drew out what my particular case was, it really makes sense as to why I can get some drips well after I leave the bathroom. Kind of annoying as I mentioned but the alternative was to keep suffering as I was. That being said, have you known of anyone who had to do pelvic floor exercises to lessen any leakage after urethraplasty?
yeah– I was thinking that too… but the way he drew out what my particular case was, it really makes sense as to why I can get some drips well after I leave the bathroom.
Kind of annoying as I mentioned but the alternative was to keep suffering as I was. That being said, have you known of anyone who had to do pelvic floor exercises to lessen any leakage after urethraplasty?
The moral of the story, some added drippage or not, I recommend to anyone on the fence of this to absolutely get the surgery…. it’s a no brainer… Leaking out isn’t going to hurt your health whereas retaining urine most certainly will. But make no mistake, post drippage can be a side effect depending on the circumstances of your stricture/location, etc.
The other aspect of mine was my stricture happened to be in an extremely narrow region to begin with– so my buccal graft essentially added a permanent expansion to my urethra that never flattens out or will close up– it’s a permanent fixture now with that cheek tissue and adds to the risk for leaking more.
Hope this helps a little bit.
Thanks Phil!
Ken
Hi Ken. Back again to ask, albeit I have a feeling the answer will be the same. Just hoping to hear this is normal as we are worried. My husband has hit the 6 month mark post perineal urethroplasty. Erections aren’t back alone but with viagra (as of last a full pill). Insurance doesn’t cover it so it’s incredibly expensive. Scared to have this be long term. 30. One baby and wanting more. The surgeon said it could take 6 months to a year. Husband is saying he remembers them saying he should be able to get an erection by 6 months but maintaining could be longer. I don’t remember them divvying it up like that and am trying to reassure. He does have an added layer of risk due to another health complication but had no trouble before surgery so they were optimistic. This is causing a level of depression which lord knows isn’t helping. He says he is still numb behind his scrotum. But thinks it might be reducing… Is that normal this far out or is that a sign there is permanent nerve damage? He describes trying to get an erection like he can feel the Blood moving that way and then it’s like it’s blocked. He didn’t wear tight underwear post surgery due to the pain and now I’m paranoid that could’ve done damage. We are making an appointment to get updates because he’s not due to go back until March which will be 9-10 months out. He mad because he feels like this was a mistake and he should’ve just kept going in and getting dialated whenever he’d get blocked. They told him that would only cause more damage in the long run. He obviously feels like this is worse. To say we are both worried is an understatement at this age and stage in our lives. I’m trying so hard to reassure him but it doesn’t help that I’m scared too. 🙁 Thanks for any knowledge you have. I know it’s all so dependent on each individual…
– Anon
I’m sorry to hear things aren’t coming back as quickly as you’d hoped. This particular issue is highly individual. This was a very serious and invasive surgery where the recovery is long. It’s not unusual for the guy not to be able to even sit down without pain for up to a year. That’s about how long it took me. So it isn’t unusual to still not be back to normal at the 6 month point. I think the best thing is to just try to be patient. Things will continue to improve. for the next several months. Hang in there.
Thank you thank you. He is (as you can imagine) terribly worried about this and of course there’s a part of me worried too. But so good to hear it’s normal to not be back. Most of his drs agree but there is one that is kind of negative and is less positive when we bring this up. Tells him this isn’t typical even though others tell him it could be a year. That one Dr of course makes him freak out and assume he is one of the small percentage of people that have long term issues. I’m just trying to be as reassuring as I can be and trying to find positive research to share with him.
Out of curiosity, I asked my urologist if it’s okay to have sex after getting my catheter removed (3 weeks after my BMG urethroplasty), and he was very confident in saying that just to be safe, another three weeks of celibate are needed. AND by celibate he meant all sexual activity is banned. Erections are fine (not much can be done about them anyway, except for medication), but acting upon them is a bad idea. Of course I demanded to know why, because if it would be just “good practice” I was sure that I would ingnore this, being a healthy male in my prime years. What he told me was very convincing, tough – the surgery site is probably still stitched up after three weeks, and in case of an orgasm, the bulbospongiosus muscle contracts, which in turn could lead to the stitches breaking (as Ken wrote in this post – that is the worst thing that could happen, because it breaks the surgery), or the muscle itself could become damaged and need even more time to recover. The muscle is also responsible for erections – if you ask me, I’m not risking my newly-done urethra OR my ability to perform after the healing is done.
Jakub,
Yeah, there is no reason to risk the surgery for that. It can certainly wait a few weeks.
I just got my catheter removed today and I’ve already voided twice. It is absolutely unbelievable how free and painless the event is. I’m definitely holding out on sex because I don’t want to do anything that will put my recovery at risk. Although my erections are normal and I have morning wood (pleasantly unpleasant with the catheter) My wife completely understands my decision because it has been a hard road. I see no need to risk it all at the final 100 ft.
The issue I am having now is psychological. The years have conditioned me to expect pain every time I urinate. There is no pain but I still dread it. I know this will fade with time but at the moment, I fear a sudden onset of pain and dread the feeling of trying to void and nothing coming out.
That’s great, Jonathan! thanks for the update. And yes, I’m confident that fear will subside quite soon. Merry Christmas!!
Thank you Ken and Merry Christmas.
I really need to give props to my urologist, Dr. Arthur L Burnett of Johns Hopkins Hospital. He is the top dog there and he knows his medicine. He has over 350 articles, several Youtube videos and a very pleasant bedside manner. He is Director of the Science Laboratory in Neurology, Professor and Director of Urology and the male consultant clinic. He understands men’s biological issues and is very intuitive in practice and conversation. This man wears many hats but still finds time to practice medicine. I’ve read that he does over 100 of these procedures a year has been doing so for several decades. I am very happy that this man is passing his knowledge on to students as a professor in the field of urology. So if anyone is looking for a good urologist, I cannot recommend him enough.
Thanks for mentioning him here, Jonathan! He sounds amazing.
Hello Doctor
Iam 37 and did my bulber urethroplasty just 3 weeks ago with my urine catheter left.Sir my fear is how feel very pain when ever I walk or I wake up from the sleep to empty my catheter and l let my surgen and prescribe me a ketese tab 25mg but still esperience thesame pain, please sir advice me with surgession thanks
So sorry for the late reply! I only just found out that the site stopped notifying me when someone makes a comment. Did this ever get fixed for you? BTW, I am not a doctor!
My son had urethroplasty epa surgery 5 weeks ago because of a sports injury. He is 19years old, this has been extremely hard for him to go through because he is very active and now he has not been able to do anything. The problem is he still has his catheter. Looking for more information on why it hasn’t healed enough to pass the dye test to take out the catheter, he still has a small leak where the stitches are in his urethra. His doctor says that some people heal differently but I haven’t seen any info on this happening. Is there anyone who has gone through this? What is the long term issues on having a catheter in that long with this kind of surgery? What if it doesn’t heal right since it is taking so long? He is a full time student and in the ROTC military program and doesn’t know how this will affect his life.
Hi Linda. I understand how frustrating it can be to deal with a catheter. I had mine for 6 months – primarily before the actual surgery. I didn’t have the leaking issue, but it isn’t as uncommon as it may seem.
From my experience I can tell you that there is nothing to worry about long term from having had a catheter in for that long. There are people who live for years with a catheter. In fact some will never be rid of them. There may be short term issues, like a need to retrain his bladder. Though at his age, that isn’t likely to be a problem. Heck, I was 49 when after 6 months I was finally catheter free and I didn’t have to do any bladder retraining. I was able to got the normal 4 hours or so in between having to pee.
Also, there have actually been a few folks here who had to have their catheters in for longer because of the leaking around the are of the stitches. It definitely happens. Your doctor is right about it taking longer for some people. It depends on so many possible factors – the individual, the type of surgery, the location of the surgery (where in the urethra), etc.
I know it’s frustrating. But you did the right thing by having the urethroplasty for him. It’s the only known high probability long-term fix.
My advice would be to take things one step at a time. There are infinite “what ifs.” But the odds are he will heal (if he hasn’t already) and the next time he’s checked he can be done with the catheters.
Beyond that, I would just be guessing. You’d have to ask his urologist about next steps in the *unlikely* event that he is not healed very soon.
I hope that helps at least a little. Best of luck to both of you!!
Thank you so much for the reassurance that it will take time and he has to be patient. This is hard for a teenager to handle. They will be checking him on a weekly basis. So we are hoping next week he will get the good news that he is all healed and they will take the catheter out. Thanks again, I really appreciate it!
You’re welcome, Linda. Best of luck!!
Ken,
Thanks for all of your sharing, and everyone else sharing here also. Throughout your time and experience, has penis shortening been noticed? I am looking into the procedure now and am doing my research.
Hi John,
Glad to help! No noticeable shortening here. Several years ago, sometimes you’d hear about problems. But I think those were issues in poorly done procedures. Odds are very good that you shouldn’t have to worry about that. Hope that helps.
Well I had mine done yesterday, feeling pretty good today. No grafting from mouth, just a little over 1cm removed and urethra reconnected. Not much pain or discomfort at all, more worried about keeping the catheter bag away from my dog.
Congratulations, John! That’s great that you have so little pain. Wow, good for you. If keeping your dog away from your bag is your biggest issue, I’d say you are in a good place :-). Thanks for posting!
I just had the same procedure done 2 weeks ago 1cm with no graft I am curious about when you got your catheter taken out and how long it took you to get back to normal or if you’ve had any issues I know everyone is different but I feel like we had the same surgery
Hi Gary,
My catheter was taken out about 10 days after the surgery. I peed like a racehorse for a few weeks after. then things gradually returned to normal over a period of months on that score. Not any issues I can think of. Though it did take a lot longer than the docs expected for the pain in my scrotum (mostly surface/skin pain) to go away – like 11 months. That isn’t uncommon. I’m back normal on all fronts now though. Best of luck in your recovery!
Hi Ken,
I’ve just completed my end-to-end surgery a week ago and am really appreciating all the knowledge and experiences being shared here. I’ll be applying a lot of the caution you and others have recommended.
One question related to physical activity – other than sex & masturbation – how long until you were able to get back to working out? I play a lot of soccer and want to get back ASAP while also playing it safe. I’ve looked around but can’t find any info, and I noticed in one of your posts around 5 weeks post-surgery that you were lifting and working out?
Do you, or does anyone out there know the recommended timeline before resuming sports (assuming you’ve had the catheter removed at 3 weeks and given another 3 weeks for sex rest…I’m hoping this will be the case for me but time will tell.
Thanks,
Mike
P.S. like many others this has been a long road for me, beginning with my first laser surgery 20 years ago, followed by numerous dilations (including self-catheterization – yay fun), now culminating in the full on surgery. I am so thankful for modern medicine and am hopeful for a good outcome.
Hi Mike,
I was able to do most things after they removed the catheter, which was 10 days after the surgeries. I had trouble for months sitting down due to the testicle/scrotum pain. But most of that was due to nerve healing and skin stuff. I avoided jogging because of the up and down bouncing that happens 😛 for about another month, though I did walk my normal route with no trouble. The only reason, really, to avoid lifting stuff for a good month after surgery is so that you don’t rip something open that’s recently been cut and sewn. If you are an avid lifter, you are likely aware of the strain that goes on in the core and down in the vital areas. My advice is 4 weeks for heavy lifting. I was doing pushups and situps just fine though after the cath was removed. Hope that helps.
Thanks Ken!
You’re welcome, Mike!
Its been almost 3 weeks since my urethroplasty. My stricture was 2cm in length so no bucal graft was necessary/done. Cathetar was removed after 2 weeks without any VCUG. The symptoms that I am experiencing now include some urinary drops that continue to leak after 2-3 mins of voiding. Also, I do notice sometimes before urinating the stream would be slow or irregular for the first 2-3 seconds before my stream becomes full & strong. At times I also notice an obstruction for a second which opens up followed by a very strong stream.
Maybe I am being paranoid or overly sensitive or the fact that I am still healing, but would appreciate if anyone else experienced these symptoms.
Its been 19 days post surgery and I still feel stiches at the perineum site and minor pain in scrotum when sitting on harder surface. Also I still have an awkward walk due to sensitivity and tenderness in scrotum.
Appreciate any suggestions.
Hi Sidd, did you have an end to end surgery on the 2cm stricture? Any penile shortening you noticed because I had the same with 2cm stricture and do notice penile shortening.
Thanks
Thanks Ken for all the inputs you’ve been making here. God bless you. I’ll be going in for urethroplasty in a few weeks. Please what are the crucial things that I should know before that time. I already have an spc but I have been having some pain in the urethra after emptying my bladder through the spc. I usually need to tighten my muscles very well so that urine doesn’t come out from the urethra while the spc is open when voiding. When I move my bowels, I feel a great urge to urinate even when my bladder is empty and that gives me some terrible pain in the bladder and urethra. Currently I’m on antibiotics to treat uti. The stricture is at the bulbar region.
Hi Dibu. Some of the questions to ask I’ve outlined in the post here: https://livingwithacatheter.com/questions-ask-urethroplasty/. I never had the urge to urinate when I had the SPC except one time. And it turned out that my tube was very thin and had gotten twisted, blocking the SPC so the urine had nowhere else to go except through the urethra. I didn’t usually have any urine coming out of the penis except for very little dribbles when I was sitting down to do #2 :-P. but that was only drips. Are you sure you don’t have a blockage in the SPC somewhere?
Also, I assume you’ll be getting a perineum approach since your stricture is in the bulbar region. If that is so, then expect there to be lots of swelling in the scrotum/testicles for several days afterwards. This is mainly from the clamp they use to keep the scrotum out of the way for the hours they’ll be doing the surgery. This is normal. And for a lot of guys, it takes a LOT longer for the pain down there (not awful but definitely there) to completely go away. Doctors usually say it should be gone in a few weeks. But many guys say it lasts for many months – up to about 11! That’s not a horrible thing…as long as you are expecting it. You might be one of the lucky ones. Just don’t be too surprised if that pain lasts longer than the doc says it should. Best of luck!!!
Hi,
My mind has been more at ease since finding this site. Great work Ken!
My name is Vin, aged 28,from the UK and I have a 2cm stricture in my bulbar region due to a hypospadias op as a toddler. Throughout my life I always had a thin and weak stream so I’ve practically lived with it not knowing any difference and it didn’t affect me too much other than having to pee more often than most people.
However over the past couple of years it has deteriorated, after several UTI’s and blood in the urine the stricture was discovered via cystoscopy under general anaesthetic. the doctor done a dilation while i was under, after this life was great, i had great flow for a couple of weeks but then it got dramatically worse, my flow deteriorated within a matter of days and felt immense pressure in my bladder when peeing. After visiting GP back and forth I was offered a couple of treatments and was advised that another dilation maybe wont work long term as my stricture re occurred after the first dilation. The consultant suggested to do a Urethroplasty through the perineum where they will cut out the 2cm stricture and tie the urethra back together.
Im scheduled in early July 2018 for this procedure and can safely say im very very nervous, as a healthy 28 year old with a one year old and hoping for more. I have been reading some horror stories regarding this operation and was just hoping from some advice from people who have had the same procedure i will be getting (stricture cut out and urethra tied back together).
– How long did it take for yous to get back to work? (currently competing with college for a promotion due the end of July and feel if i take a lot of time off this will go against me)
– How long to get back to day to day stuff, picking up children, walking, driving etc?
– With them cutting the stricture out will this affect my penis size?
I know this procedure will massively improve my quality of life but it there seems to be alot of risk, considering Im in my prime and hoping for more children, how have you guys recovered?
Kind regards
A very worried Vin,
Hi Vin. Thanks for your kind words. I think anyone facing surgery is right to have concerns. It’s a serious business. But as someone who has been through it, let me tell you that the risks for the type of urethroplasty you are scheduled for – the same kind I had – has more than a 90% chance of permanently correcting your stricture and weak urine flow. Remember that short period of days where your stream was strong? THAT will be your permanent reality. So though I wouldn’t call it a walk in the proverbial park, as with any surgery, there will be discomfort and recovery time. For a few weeks, you’ll have to deal with a catheter and the typical post-op pain (though not the worst I’ve ever had :-), which should be well managed with post-op pain medication. If you’re like a lot of others I’ve spoken with, you’ll have some discomfort in the scrotum that will linger for longer than the “couple of weeks” the doctors often tell you about. But THAT pain is really not so much a constant hurting as it is an irritant that will fade eventually.
To address your questions specifically:
– For getting back to work – a lot depends on what you do. The biggest issue is dealing with the post-op catheter for 10-14 days. It’s not so much how you feel as how to logistically deal with that. You’ll also want/need a donut-type cushion to sit on for those 2 weeks (though the sooner you can get off that, the better). They’ll likely give you a leg bag and tubing so you can hide it all under your trousers. But physical activity needs to be pretty limited. I was lucky enough to be able to work from home, so I was able to get back to work within 4-5 days. If you have to go out into the world, you might consider public transportation or getting a ride during those 2 weeks. It isn’t easy to drive with a donut pillow and catheter. Plus, you probably shouldn’t be driving in the first 3-5 days after a surgery anyway.
– You should be able to do most day-to-day stuff with no problems at all after you get the catheter out. Prior to that time, you’ll be able to do MOST things. It will be a trial-and-error thing. Try things around the house and with someone to help you if you can. You don’t want to risk things like tugs on the catheter tube or opening up the area where they went in for the surgery. Lifting a child should probably not be attempted during this time if you can help it. Lifting puts strain on the wrong places.
– Penis size should not be affected. Mine wasn’t. And I had about 2 cm removed without a graft. If they put in a graft (usually taken from inside your cheek), the chances are even smaller that you’ll have any problem with penis size afterward.
I hope that helped. Best of luck to you!! Let us know how the surgery goes!
Ken
Many thanks for your reply. Getting advice from someone who has been through it helps alot at the minute.
Im a graphic designer for a college so hopefully they can let me work from home also.
Will keep you posted on how the surgery went .
Thanks again
Vin
Ken,
Just an update on my situation and would really appreciate some advice.
I have just found out today that my promotion interview takes place exactly 1 week after my urethroplasty. I really need this job and have been preparing for this interview for months. i’v been back and forth with HR and the date of the interview cannot be changed due to the panel only being available then.
I also dont want to postpone my surgery as i have been on the waiting list for a quite a while (few years to be exact)
Would i be crazy in thinking I could go to the interview a week after the surgery?
Kind regards
Vin
Vin – I’m tempted to say that yes, it is crazy to think you can do a job interview 1 week after urethroplasty. I was not able to sit upright in a normal chair by that point, still needing both a pillow cushion AND the ability to recline to at least 45 degrees, in my recliner chair. Beyond the discomfort of having to sit upright, I think you run a risk of putting too much pressure on the area where they did the incision (the perineum).
Keeping in mind that I am NOT a medical professional here – if it’s a matter of losing out on a job that could mean the difference in your life, I think it COULD be done. Job interviews are usually no more than 30 minutes, in my experience. If that’s true, I would make sure I had a leg-bag set-up to conceal the catheter and bag under your clothes. Then I would recommend having someone drive you to the interview (I found driving to be nigh impossible at that point). Then proceed VERY carefully when sitting, and do you best to find a comfortable position and stay there for the interview. As soon as you can afterward, get pressure off your perineum and back to rest and recovery.
Note that I am NOT recommending this. I’m only saying how you could do it if you absolutely had no choice. Best of luck!!
Sorry for the delay in getting back.
I have been back and forth with my employer and I think i’m going to go for the interview a week after surgery.
My boss has been very accommodating and told me the interview will be no longer than 15/20 minutes and that they can provide comfortable seating or I can bring my donut pillow if needs be. And after that I can go home and take as much time as I need to recover. The week after surgery will also give me good preparation time.
I tried again to get date moved but there is no chance so I will have to go and give it my best shot. I have also organised my partner to drive and collect me from the interview. Il just have to conceal the catheter in comfortable enough trousers.
Thanks for all your advice Ken!
Best of luck, Vin!
Hi Ken
Just under 3 weeks since by urethroplasty and doing great, had catheter removed yesterday and things are so far so good plus im peeing like a horse!
Is there any where specific I can post my full story and give my advice/tips on after the surgery?
Thanks again
Vin
Hi Vin. That’s fantastic! Congratulations!!
If you can write it up in an email, I can create a post for it. How does that sound?
Ken
That would be great.. what email address will i send it to?
Gonna spell out the address to help prevent bots picking it up. So replace the -at- with the normal @ symbol. Send to ken-at-livingwithacatheter.com.
Hi Ken,
I had 2 stage urethroplasty with mouth graft. 2nd stage done on March 8 2018 . I am unique as I am an FTM – transgender . I had a metoidioplasty done with urethral lengthening done Feb 2017 to create a small phallus. The Graft failed 2 months after that surgery. Graft was made from other tissue. I don’t expect all to understand transgender stuff . Just wanted some help here. I Had perineal urethroplasty done with graft May 2017 to be able to pee and graft placed to heal over 6 months inside . I waited about 8 months to complete 2nd stage. March 8 2018 2nd stage. It is now July 2018. Since surgery I have had odd feeling in bladder like irritation. Comes and goes advised scar tissue from the suprapubic catheters . I had three over course of the failure. I also have perineal irritation now and feel as if pee gets trapped i there causing maybe irritation. Question is do some guys have the feeling of pain/ irritation in that area . I know things are different for me from other guys but it is same surgery and I cannot find anything else but your sight for help . I try to use a technique like placing a couple fingers In perineum are to help expel the urine. Some comes out sometimes. Just always achy or irritated . I also had couple UTI’s since surgery . Feels like UTI symptoms at times and I have it checked as I want no more of that . Anyway, is it not out of norm tonhave that odd feeling in that area like others . Probably nerve pain etc. Sensation is almost too good. And I run and do all my normal stuff. Symptoms seem to get worse as day progresses . In morning hardly any symptoms . I know this is unique post . And don’t expect people can relate other then the annoying pain, irritation. Like you said not over the top just annoying. Any help appreciated.
Hi Pat. the pain in the perineum area should not have anything to do with urine getting trapped. If so, that’s quite serious and you need to get it taken care of. But pain in that area is totally expected after this surgery, and it often lasts for many months in some folks. I had pain there and in the scrotum for 11 months. They do a lot of trauma in order to access the urethra – lots of cutting, pulling away of tissue and nerves, etc. So don’t be at all concerned that pain in that area is not normal or is lingering. As for the pain in the bladder – I suppose it could be left over from the times that an SPC sucks against the bladder wall. But once the catheter is removed, there should not be much pain and not for very long. So THAT you should be asking your doctor about. In fact, you should not be hesitant to ask the doctor’s office ever when going through this. Don’t stop calling/asking until you get satisfactory answers. I had to get over my reluctance to always call. I hope things get better soon!
Stream is very good though. Not an issue.. can get fan like at times but strong.
Thanks for your email Ken, I’ll get that wrote up sent to you in the next few days. Up to my eyes in work since returning this week.
Looking forward to sharing my story with everyone and recommending an urethroplasty to everyone who has a stricture.
One more question for you Ken, I have a family wedding tomorrow and considering drinking alcohol for the first time in a few months. Is there any issues with doing this , im now over 3 weeks since surgery and have got the all clear to return to normal life with surgeon saying my wound is fully healed and advised getting back into moderate exercise. I forgot to ask if drinking alcohol would be an issue?
Regards
Vin
Hi Vin. No worries. I’m on the road for the next 2 weeks anyway. As for the wedding and the alcohol,I am not aware of any direct issues at all. Remember I’m not a doctor – just my standard disclaimer. Have a good time!
Hi Ken
Should send that email off to you soon but before i do I’ve had some issues since we last spoke.
Its now just over 5 weeks since my urethroplasty and 2.5 weeks since catheter removal. Everything has been great apart from the scrotal aches (seems to get worse the more active i am) . However yesterday I noticed blood in the urine, i went to my GP and they tested urine and confirmed no infection. I had no pain or stinging anywhere and flow is still strong. GP thinks im still healing and passin some blood in urine is normal. so he sent me home and said to drink plenty of liquids however when i got home i passed more blood, alot more this time, was fresh blood and I also shot out very dark blood clots with my stream. Alarm bells started to ring and i panicked, rang GP and they referred me to the ER.
When i got to the ER, I got bloods done and provided another urine sample, same came back again: no infection. No pain anywhere else, flow is still strong. After speaking with Urologist on the ER she wreckons its possibly debris/scab etc from my stricture site and was sent home and told to keep an eye on it. Anyways more bleeding when i woke this morning, again i shot out some dark clots and some more blood.
Starting to get very worried and now waiting a call back from GP. Has anyone else had this issue or heard of it? 🙁
Kind regards
A really worried Vin
Vin, I recommend you do NOT stop asking your docs about this until you are satisfied. I found at first that I “didn’t want to bother them.” Do not feel that way! It’s your body. That said, I think the presence of the dark clots is good. It lends credence to what the one doc said about the scabs coming loose from where the surgery site healed. So it may just be OK after awhile. But I didn’t have that and I don’t think it is completely normal. So don’t let up asking your medical professionals until it stops. Best of luck! I’d be interested in hearing how it works out.
Hi Ken. Yes i made sure to ask every question before i left, i ended up in the ER again where i was referred to urology.. with further examination of the blood and clots they deemed it to be scab coming loose and some blood and debris passing from that. They were considering a cystoscopy but a surgeon said no due to my surgery being only a few weeks ago (to my relief, a cystoscopy isnt the most comfortable experience) . Luckily enough I haven’t had any blood since (3days now). After reading through 100’s of forums, blood and clots seems quite common for similar surgeries around the 4/5 week mark such as a prostatectomy, not the same surgery i know but hard to find much information on urethroplasties. Going forward i have to keep an eye on it. Will add this to my urethroplasty story and send it on soon.
Anyways since the passing of the blood and clots i feel like my stream is even more powerful and can go 3/4 hours without having to pee. Completely life changing as before i would have went every hour if not more.
Thanks again Ken!
So glad to hear that, Vin! Thanks for the follow-up and for adding to my knowledge as well as anyone else reading here!
dear ken,
i am still young 30 years old and very worried.
do you have knowledge about urethroplasty for penile stricture?
sincerely
Yes Evan. I had that. Read about it here: https://livingwithacatheter.com/my-urethroplasty-is-done/
Hope that helps.
thank you so much.
btw what do you think about optilume from urotronic?
I had not heard of the Optilume before you just mentioned it. But wow! That looks very promising. I don’t have data yet on how effective it is, but I want to learn more. Like any new procedure, it sure sounds good if it can deliver on its promise. And it may be worth trying before having a urethroplasty because it is so minimally invasive.
For everyone else reading this – you can find out more about the Optilume here – http://urotronic.com/
It is a treatment whose goal is to stop the cycle of stricture recurrence that is so common when people are treated with urethrotomy (find out more about what that is here: https://livingwithacatheter.com/dviu-treatment-for-urethral-stricture/) and find the stricture just comes back.
The only current long-term “fix” – one that would not require you to do dilations (pushing something up into your urethra to stretch it out) is still urethroplasty. But I’ll keep my eye out for data on the Optilume. Thanks for the tip!
Recentley had Urethroplasty surgery on Aug 2nd, 2018. All has gone well at the three week mark had PUG test. It showed some contained leakage. So my Urulogist wanted me to keep cathertre in for an additional week to maximize my healing. At week four cathertre removed. Now I have a great stream and majority of pain has gone away. Still some pain in the testicle/ scrotum area when sitting. I also still have a slow walking stride due to tenderness down there. All in all fingers crossed this is fixed for good. I am 38 and have dealt with this since the age of 11. As I thought having a small stream was normal. Until it just got to where I was having to push so hard that my abdomen would hurt to urinate. Not to mention it was taking so long to finish with urinating my wife thought I was taking multiple bowl movements a day. I go back to Dr. in 6 weeks for a flow test. Hoping that goes well. I have had no problem with getting an erection. So at 4 weeks I am planning on taking the full recommeneded time of 6 weeks before having sex even though, I desire to have it now at the 4 week mark, just not worth the risk!
That’s awesome, Roger! Thanks so much for posting this. Your story pretty much mirrors mine. I’m 5 years post urethroplasty and still doing well. That scrotum pain might linger for quite a long time. Apparently for some it does not, but many guys have it last up to 11 months or so to some degree. I was one of the latter.
Best of luck for the flow test and everything else going forward!
Had my Urethroplasty and buccal graft operation on the 11th of September 2018, and 8 days down the line my catheter was taken out. Im voiding very well but first 2 to 3 seconds before passing urine i have to push a bit harder for urine to come out, but after that it comes out well with no pains. Is this normal? And again after voiding, 2 minutes later there’ll be some urine drops coming out, does that mean the urethra takes time to close because im not fully healed or its because of the buccal graft?
Any chance of the stricture to come back after buccal graft operation? Or this is permanent solution? Your help will be highly appreciated.
Hi Bingo. This may all be due to the fact that you’re still healing from the surgery. And since you had a graft (I didn’t, so can’t speak directly to this), there is even more stuff that needs to heal. During this time, there is quite a bit of inflammation, which can cause most or all of the things your are mentioning. I would say to do 2 things. First, do not hesitate to ask your doctor/urology nurse(s) about this. 2nd, give it another couple of weeks and see where you are before going BACK and asking again (if things aren’t improving). But at this early stage, it could easily be the process of healing that is causing al this. Some parts of the healing will take longer than others. For lots of us, the pain in the scrotum was the last thing to go, lasting several months! So take heart. Things after this surgery seem to take much longer to heal than some doctors think.
Thanks a lot for your advice. Since you had your operation, did you ever have any problem passing urine? And how long ago did you have your operation?
Some are saying I’ll need to wait for atleast 2 months before I can even think of getting naughty with my wife, and it makes sense because I do t wana hurt myself. How long can you advice I should wait before touching my wife?
Bingo – My operation was 5 years ago. I have not had any problems passing urine since then. And as the post titles suggests, at least 4 weeks is the recommended time to wait. Hope that helps.
Im back again, had my urethroplasty and buccal operation in September 2018, now its November, Im already expiriencing bery low flow of urine, it doesn’t flow well like few weeks after removing catheter, I even had about 2 complete blockages where I couldn’t pass urine at all for about 4 hours.
Now I can pass urine but it looks like the stricture is back because i cant pee well. Went to the hospital and they couldn’t even put the catheter because it couldn’t pass to the bladder, according to the doctor he said theres a blockage and it makes it impossible for a catheter to pass.
Then I went to the hospital where i had my operation, the urologist booked me for another operation to take place this December (in about 2 weeks time) but this time he said they’ll do Scooe and Optic.
Is it normal to have another blockage just a month after having urethroplasty and buccal operation?
So sorry to hear that! No, it is not normal to have a recurrence of stricture after urethroplasty. The long-term success rate is over 90%. So it is in fact quite rare. I wonder if there was something else going on that was not typical. I wish you the best of luck with the next procedure.
I have high hopes for a new experimental technique that is hopefully going to be approved to use (at least in the US) in 2019 called OptiLume. I’ll keep the site updated on the status of that. In the meantime, you can follow the latest here: https://urotronic.com/
YI am getting a cystoscopy soon and had some questions. For those of you who had pain with strictures could you describe the pain and location. Also how long to recover from cystoscopy irritation. I have weak/split stream and recently (7 weeks ago) have had a pain at the tip of the penis. I have been to 3 urologists, have been tested for UTIs, STDs and all were negative. I am wondering if it is structure pain or something else.
Brian – my pain (before surgery) due to stricture only happened why I peed. During the process, I would get a strong ache in what felt like the muscles spasming in the “taint” area (between the scrotum and anus). I didn’t have any sharp “skin” type pain at all. And I had nothing at the tip of the penis. Hope that helps. If you have a stricture, the scoping should be able to confirm that. Good luck!
I was hoping that you had the pain in the same spot :(. I think I have 2 things going on…strictures and something else. I think my urethra is inflamed, but not from infection. I fear the cystoscopy is needed, but will make the inflammation worse!
Since the scoping will be the best way to see what is going on. I really don’t think it’s going to make things much worse. And odds are it will be the only way to make them better. Keep in mind I’m not a doctor or nurse. But I recommend going through with the scoping to figure out exactly what is going on. Best of luck!
Well the dr canceled my appointment because he will be out. Now it is the 23rd of Oct. At least I will be sedated with light general for this one. This is very frustrating….Im pretty sure I have strictures, but I do empty my bladder. I wonder if it something else either scar tissue in the urethra or surrounding the urethra.
Sorry to hear of the delay. Hang in there.
Just had the cysto today under general …light sedation. They did not find the cause of the pain, but they did find that there were no strictures! I think I read every post on your message board. I wanted to thank you for this site even though I do not have strictures. It was very helpful in preparing for it and getting good info on it.
Well that is something at least. So glad the site has helped you in some way. I hope you do find a cause though!
i have a question about catheter after urethroplasty.
what will happen if there are some leakage (by-pass) in the catheter? will it make an extravasation? and what is it effect?
Evan – there should not be any leakage around the outside of the tube. Is that what you’re saying? If so, you need to tell your doctor immediately. there is no way for me to know what that is – I’m not a doctor or nurse. But when you have a catheter in, there should not be pee coming out of you AROUND the outside of the tube. Please tell your doctor about this right away – like today if you can!
I’d be interested to know what caused this. Can you update us after your doctor takes a look?
i havent done urethroplasty yet. but when i had urethrotomy, sometimes when i tried to poop, there was some leakage around the catheter.
the nurse said it is normal and tell me to take some stool softener. but i am afraid if this happen after urethroplasty because of extravasation that might happen.
do you know anything about extravasation and its effect?
this is the article
http://healthywa.wa.gov.au/Articles/S_T/Troubleshooting-for-your-catheter
i am afraid if the bypassing happen after urethroplasty and what it can do in harming the surgical site
Hi my name is kassim I had a urethroplasty like three months ago am having a great experience as far as urine stream and flow is concerned. Though there is a little bit of a problem. Some sought of mucus/discharge comes out sometimes . It is making me uncomfortable. Also the feeling of wanting to urinate again immediately after you have just finished urinating. Three months down the line I can still feel pain during erection. Assist with you advice.
Hi Kassim. This is not what I would consider normal. It’s one of those things (odd discharge) that you should immediately ask a doctor or nurse about. I can only offer my opinion, since I am not a medical professional. In this case, my opinion is to ask your doctor immediately. I hope everything is OK.
Hello ken im indonesian men 24 yo , maybe i have stricture urethral or no idk, but i feel many symptom like everyone have stricture urethral, i come in 3 urologist in kuala lumpur and they want to do cytoscopy on me but if they got stricture urethral there they will doing dilation or urethrotomy but i dont want thats because after read all forum post about those treatment have big fail percentage. i want urethroplasty because have big success percentage. can i got urethroplasty without step to get dilation or urethrotomy ??
when i isk one of them about that but they say thats big surgery and thats cant do for all case stricture urethral .
if cytoscopy done and no one they got from there, maybe i have atonic bladder (i hope not, im to young for that 🙁 )
You are correct. I understand what they say. It has a lot to do with cost. So if it IS a stricture, and if they try a urethrotomy and a few weeks or months later, stricture returns, will they do the urethroplasty then? Once you show it is not effective, I would hope they would agree.
But maybe it is NOT a stricture?
Best of luck with whatever happens!
oh wow , ur so fast answer my question ! thanks..
i hope got name doctor or hospital in austarlia,malaysia,or singapore to get best doctor for do my urethroplasty ?
i dont even want to back there, i think with they long experience not say anything about urethroplasty thats funny.
once more again thanks for fast response
It might not be a bad idea to start preparing to find a doctor who can and WILL do urethroplasty. Urethroplasty is difficult, so very few people can do it. Urethrotomy is easier and more people can do it. So that’s why they want to try it first, probably. Hope you find someone who can do urethroplasty.
Gday,have just had my catheter taken out after 3 weeks,had the inside of my cheek grafted,peeing like a champ,was just wondering when it’s good to go back to work,I’m a house painter,will be doing a bit of heavy lifting and pushing on the roller against the walls and ceilings,do you recommend going back or to leave it for a bit longer?cheers for your help Marty
Hi Martin. Congrats! A lot has to do with how you feel. But you REALLY should get your doctor’s input on this too. I think once the catheter is out and 3 weeks have passed, it should be OK as soon as you feel up to it. Hope that helps.
I have posted here before because my Dr thought I had structured, but I do not. However, my father-in-law had his prostate removed and had terrible complications involving kidneys and uterers. He had bags coming out of his back and a catheter in for 49 days! He now has really bad strictures (only a couple weeks after having the catheter removed). He had a scope where they cut some scar tissue out, but that has not worked and he is getting a dilation done next week. I have read tons on here and know that won’t work. He lives in Nashville, TN. Does anyone know a good urthral surgeon in Nashville? This man has suffered enough! Thanks for any help.
Hi
Today I’ll be going to the theatre for perinial urethrostomy, 2013 i had scope and optic, strictire came back in 2016, then i did urethroplasty, 2018 steicture can back, did another irethroplasty this time with buccal, few weeks after the operation, had urine blockage again, December 2018 they tried acope and optic which failed. Now together with doctors decided to do perinial urethrostomy which seems to be a permanent solution. The inly problem is that i’ll only pee sitted and wont be able to have kids anymore. But it wont affect my sexual like, i will still be able to have fun with my wite.
Between perineal urethrostomy and urethroplasty which one is a major operation, and whats the healing period for perenial urethrostomy.
Thanks for your comment, Bingo. I honestly had not heard of a perineal urethrostomy until you just mentioned it. I did a bit of Googling and wow! That is pretty major. to answer your question about whether a urethroplasty or urethrostomy is the more major operation, I would have to venture that they are equally “major” as far as how invasive they are. But the one with the most dramatic change in lifestyle is definitely urethrostomy.
It does sound like it will be a solution for the recurring strictures though. I wish you the best of luck on it. And please keep us updated on how it all goes!
Thanks for your advices and for making time to reply.
I went for my perenial urethrostomy operation on the 17th of January 2019, it started at 11:10am till 15:00, was discharged the following day with 2 catheters (suprapubic and the one on the hole they created), will only remove it after 3 weeks, I have no pains.
Though one of my testicle is swollen but they gave me some antibiotics to help and they said its normal because they were working just below my scrotum.
Im healing nicely and just home after 3 weeks or removal of the catheter I’ll be able to void without any difficulty.
The other thing they were suppose to do was to repair my bladder diverticulum which it doesn’t look like they did because of the amount of time the took working on this perenial urethrostomy procedure.
But I have a follow up on the 30th January so the doctor can check if im heallung ok or not. He might remore the catheter same day because he said they isually remove catheter after a week, but in my case they want to give me 3 weeks to make sure that im properly healed.
With your research, how long is the healing period after this procedure? And after how long does the catheter taken out?
I’ll update you after my follow up with the doctore.
Hi Bingo. Thanks for the update. Glad to hear things seem to have gone smoothly enough. I have not experience or much info on this particular surgery. The testicle thing CAN cause longer pain than the docs usually suggest. Many of us with perineal approaches had some pain lasting many months, which is actually pretty common. The good news on that is that is it DOES get better – just takes longer. As far as the actual creation of a new route for peeing, I can’t say. That is is uncharted territory for me. The more standard urethroplasty usually has you catheter free in 10 days to 2 weeks.
Hope that helps. And I hope you heal up quickly and have relief after all is said and done!
IHey, im 5 wks in post op (2 weeks after catheter removal), just had sex (before the 6 wk wait period). No pain but im extremely nervous after reading all this. Any advice.
I was told 4-6 weeks. So you should be fine, especially since you didn’t have any pain or other issues. I wouldn’t worry :-).
I pray and hope. Thank you. Been dealing with this for 12 yrs. I hope this is it from here on out.
So today I have what feel like soreness. No real pain. Should I be concerned? Or is that how am I suppose to feel after having sex post op? How did you feel? if you don’t mind sharing.
Felt it while urinating btw.
I also had this problem, did it turn out okay?
Holy smokes reading through all this has me absolutely terrified I messed up I had sex almost exactly 3 weeks after surgery I feel fine but the Dr told me another 6 weeks after my first 2 weeks and I didn’t make it I’m praying I didn’t mess myself up
If you don’t have any increased pain or new symptoms, you’re probably fine, though I’d follow the advice from here on out. But do not hesitate to reach out to your doctor if anything changes for the worse or you get new symptoms. And remember, I’m not a doctor or nurse.
Hi Ken,
Can I start by saying what a great job you’ve done by starting this Forum and I only wish I had
discovered this site prior to my Bulbar Urethroplasty, it would have allayed so many of my fears.
I don’t normally participate in forums or debates but inspired by you I would like to take the opportunity
to help people who have been or who are presently concerned about this particular procedure.
I am unfamiliar with the protocol regarding these forums so please accept my apologies if I have breached
any guidelines. Suffice to say like you I am not medically trained and any advice given is purely from my own personal
experience following a Bulbar Urethroplasty procedure carried out on 6th February 2019.
I am a 60 year old male living in the UK who had a 4.5 cm urethral stricture which I had lived with for 35 years and
for which I had several dilatations, which unfortunately only provided temporary relief [ 18 months maximum }. In view of this I was offered the opportunity to have the aforementioned procedure.
If anyone is out there who has any reservations about undergoing this particular procedure and /or is interested
in my experience please don’t hesitate to ask !
Jon H says
March 15, 2019 at 10:38 pm
Hi Ken,
Can I start by saying what a great job you’ve done by starting this Forum and I only wish I had
discovered this site prior to my Bulbar Urethroplasty, it would have allayed so many of my fears.
I don’t normally participate in forums or debates but inspired by you I would like to take the opportunity
to help people who have been or who are presently concerned about this particular procedure.
I am unfamiliar with the protocol regarding these forums so please accept my apologies if I have breached
any guidelines. Suffice to say like you I am not medically trained and any advice given is purely from my own personal experience following a Bulbar Urethroplasty procedure carried out on 6th February 2019.
I am a 60 year old male living in the UK who had a 4.5 cm urethral stricture which I had lived with for 35 years and
for which I had several dilatations, which unfortunately only provided temporary relief [ 18 months maximum }. In view of this I was offered the opportunity to have the aforementioned procedure.
If anyone is out there who has any reservations about undergoing this particular procedure and /or is interested
in my experience please don’t hesitate to ask ! Regards Jon
Thanks Jon! So is your catheter out yet?
Hi Ken,
Yes catheter removed 3 weeks after Urethroplasty Op , didn’t encounter any problems while it was in place. Experienced leakage around the catheter during bowel movement but was told this was completely normal and nothing to be concerned about.
I am now 6 weeks Post Op . I am still having discomfort around the scrotum area but it seems to be settling down. I have just in past few days contracted a UTI for which I am now taking Trimethoprim 200mg twice a day.
Like a majority of visitors to this site I was very apprehensive about the procedure, but now that I’ve come through it I have no regrets and would wholeheartedly recommend it . I am aware that I’m still in the early stages of recovery but this has been a life changing event for me.
Pre Op my voiding was very poor taking anywhere up to 3 minutes with a full bladder Post Op I am presently completely voiding in between 15 to 20 seconds, although I appreciate that this could change in the future.
I am due a Uroflowmetry in 6 weeks time and all being well I will have a second one in a Years time.
A big thank you to you and all the contributors on this Forum for sharing their personal experiences on what is a somewhat delicate and worrying time for most men ! If I can be of any help to anyone out there please don’t hesitate in contacting me !
Regards Jon
Thanks so much for the post, Jon! And I’m glad you have come through it successfully! that scrotum pain can last a long time, as many people here can attest. Longer than a lot of doctors often think. But it does go away eventually. Thanks again and best of luck moving forward!
Hi Ken,
Thanks for sharing your story. I wish I had found it sooner to get a little more insight about what I’d be going through. I had my surgery 30 days from todays date and I’ve gone through about the same thing. As of now, so glad I did this surgery, my stricture was so small they couldn’t even get the pediatric catheter through for the initial VGUG. My fiance said she could always hear grunting/straining when I was urinating as if I was taking a bowel movement.
When I was overnight at the hospital I thought I was being slick when I bought the donut pillow off Amazon and thought it would be great. Within 5 minutes of sitting on it I was like holy crap this is uncomfortable, they are currently being shipped back to Amazon haha.
So I’ve recently run into some issues that kind of concern me and thought maybe either you went through them or had some insight:
1) You mention even in another post that you had some pain in the scrotal area that hasn’t gone away. Where in the region were you getting the pain? I find mine to be in the posterior of the scrotal area (closest to scar), especially at the base closest to scar. At times I can’t tell if it is the scar/surgical site that is hurting or the scrotum itself. As a medical pessimist I always think something is wrong/botched so I’m hoping this is just scrotal discomfort and not anything wrong with the surgical site. I was getting a lot of erections within the first few days after the surgery so hopefully I didn’t do any damage to the site.
2) Once the catheter was removed, like yourself I was like “holy crap” as if I was peeing with a fire hose. I was curious if your “water pressure” decreased from the initial week. Now that a week has gone by it has definitely decreased (although not nearly what it was before the surgery).
3) I also can’t tell if my bladder is emptying all the way anymore. I’m getting a similar feeling of almost urine getting stuck in the penis and not wanting to exit following urination (similar to the bladder spasms without the quick “electrical” pains of the surgical site/bladder). Any familiarity to this?
Thank you very much in advance.
Hi Chris. Glad to hear you had a successful surgery. About the scrotum pain, it was mostly “little pins-and-needles” nerve pain and it was pretty much all over the scrotum. I don’t remember exactly where (or if) it was localized. I do remember being worried when my docs said it should be gone after 2-4 weeks. Shya! Found lots of guys reporting many months of this, lasting up to 11 months for some, which is what it was in my case.
As for the “water pressure,” yes it did go back down. But not as quickly as yours. I went a few months with that “super flow” feeling. But over time it’s gone back to normal. But not down to the level of when I had the stricture.
I don’t think I had to feeling you describe in that #3 question.
My advice, as always (because I was not shy about doing this) is to go into Urology and ask them about this stuff. They can measure your urine retention and flow to see if it’s below normal.
Best of luck moving forward!
Saw the MD today for a cystostomy. Said everything looks perfect which makes me feel a lot better. Says she usually likes no sex until 8 weeks out? Heard of anything like that, seems extremely conservative. Most of what I’ve seen ranges from 4-6 or no restrictions at all.
Good news! Thanks for the update, Chris. As you can tell from the article title, I have also been told 4-6 weeks. And since I’m not a doctor, I can’t make general of medical advice. but if YOUR doctor is saying 8 would be better, then my own advice would be the same. They are aware of your specific situation and their advice is probably best. I don’t think the risk is worth the reward in this case, having sex versus potentially ruining your repair. Best of luck regardless of what you end up doing, though!
Hi Chris,
I dont know if that would help, but once you finish urinating there will still be some urine in the penis, so you will have to use you hand to push it our from the bottom of the penis to the top and out.
i was banned from sex for 9 weeks !
Hope you feel great now 🙂
Hi Ken,
Thank you so much for putting this site together.
I had a urethrotomy in 2000 for my stricture. I did not need a dilation or at least I thought so. I thought after 19 years I best have it checked as sometimes I had a split flow. I had a cystostomy and a stretch at the same time.
Unfortunately, the stretch went very badly and the scar tissue doubled in size. This is started a period of hell and darkness as my flow went down to a dribble. I went to emergency 3 times, each time they told me they would only help when I stopped urinating altogether. I had to wait 3 months to have the Urethraplasty. I had 5cm and a graft. I am 3 weeks post surgery and 1 week without Catheter. So far so good, I am urinating like a horse, would be nice if it stays at this pressure. I am still nervous every time I go as I am worried the flow will go down.
My question is from your experience how much does it decrease. What have others experienced? My testicles are not sore but just numb. My penis still hurts sometimes I guess that’s from the catheter?
When sex does resume is there any change in ejaculation pressure? My Doctor also said to me for 8 weeks. I am in Brisbane Australia, he kept me in hospital for 3 days standard here is 5 days but let me go after 3.
Thanks again for all this information you have put together
Hi Brent. Congrats on the urethroplasty, as it is really likely to be a long-term fix as opposed to the more temporary measures. to answer your question, I am 6 years post-op and still peeing what I would call “normal” pressure. It was super-flow for the few months after the surgery. But over these 6 years, things have come back to normal – the way it always was before the stricture.
I have not had any noticeable problems with the sex question either. Hope that helps and that things work as well for you as they have for so many others.
Hi Ken,
Thanks for the reply. I don’t actually know what a normal flow is for me as I have had a stricture all my life. I guess I will find out. At the 4 weeks mark I have regained feeling in my testicles and bladder is back to normal. I have taken it really easy as I work from home and have pretty much worked from my bed. My mouth is also doing well.
Hi Ken,
Just an update I had my 8 weeks flow test which was 32, so a good result. I still have some sensory issues on my sack, but it improves all the time. I am almost at the 3 month point and all seems fine. I am still nervous every time I take a leak, from all the cases you have seen should I expect things to continue as they are or are there still major risks I should be worried about.
Again thank you for putting this site together, you are a life safer.
Dear Ken
Thanks for everything im reading here,
First of all sorry for the weak language, I did my urethroplasty 3 month ago, for the whole urethra the report says 15cm ! I actually went through procedure that I wasn’t ready for, I didn’t know it was tough! I got it done by the best reconstructive professor in the country which I have no place to say I wish I did it here or there.
After my 7 hours surgery, I woke up with an extreme pain in my feet which was the cause of a mild sensory axonal polyneuropathy which causes a lot of pain, im taking heavy drugs for it till it heals. And also woke up with 2 catheters, catheter to support the new urethra which stayed from 6 weeks and the suprapubic for 7 weeks, and apparently the surgeon took skin from both sides of my mouth and a side of my tongue.
From your experience and others:
I don’t know how much it will last till I can open my mouth wide open?
Also the erection is not as before, when I have erection it goes downwards and to a side, it feels like if the urethra is holding it as if the urethra is short for the penis size while erection.
The color of the skin of the penis is more to dark skin rather than the usual color.
I feel pain at the area of the surgery.. I read that it took you 11 month.. how does it feel now for you?
Big thank you
Thanks for your comment, Emra. Wow! That sounds like you’re going through a lot! Your stricture seems to have been much longer than most. I would definitely ask your doctor about the crooked erection. I don’t know enough about that to be able to say if that would get better on its own. So for sure ask the doctor about that. I also don’t know about how long until you can open your mouth wide again. I was lucky enough that they didn’t take graft tissue from my mouth. So it’s another question for the doctor. But yes, I had pain – primarily in my scrotum – for 11 months before it went away. So it can take a pretty long time to recover from this surgery. Hopefully you can at least pee normally now, which is main point. Best of luck healing up fast!
I just had my surgery done about 12 days ago and it was a bulbar urethroplasty with a buccal graft. I think it was just over 2cm in length, but my doctor took his time with stitching me back up to make sure I would have soft scar tissue and to ensure that hopefully there would be no leaks when they take the catheter out in 2 days. I’m already pretty comfortable with minimal pain other than when I get erections and such. The swelling in the scrotal area appears to be all gone although it’s still a bit tender. I’ve been wearing a supporter as they recommended to keep everything in place and to avoid placing undue strain on the stitched areas.
Which gets to my question about once they remove the catheter, I can understand still abstaining from sex since a lot of strain is placed in that area, but if my wife were to help relieve some of the urges in other ways would that be a problem as long as we’re gentle about it?
Also, during ejaculation for me it was always kind of slow and not real forceful, now that I have the surgery done can I expect the flow from orgasms to be a bit more powerful distance-wise now that it’s not having to deal with a constricted urethra?
I’ll probably end up asking both of these questions with my doctor, but was curious since I found this article.
Hi Chris,
Sounds like you had a successful surgery. Congrats! Prefacing with “I am not a medical professional!” But I think you’d probably be OK with a gentle method like you mentioned, rather than something that will involve pressure being pushed up into that bulbar region where all the tender surgery was done. Plus you want to avoid hurting the scrotum at this point, which will probably be tender/painful for at least a few more months. but like you said, best to check with your doctor to be sure. Best of luck!
Hello Ken and first of all, thank you for this great site and all the information it does provide. It has been extremely helpful to me.
I went through a urethroplasty 3 weeks ago and have had the catheter removed about 5 days ago. So far, everything went great and the recovery has been good. I am almost pain free and have been able to get my life back. I have been following my surgeon advises of not doing any sport for 6 weeks post surgery and only sitting on donut pillow for the next 3 month (this is what they ask for in this urology department). I also have been asked to refrain from any sexual activities for 6 weeks. However, i woke up this morning after a «wet dream». Is this something that could cause any damage at all? It is very frustrating as i can not control these. I did not notice anything wrong so far but i am getting concerned. For the information, i have had a 2 cm stricture in the bulbar urethra fixed by end to end. Thanks to anybody that could comment on this.
Hi Julian. Congrats on having a successful urethroplasty! Remember I am not a medical professional. But my advice is not to worry too much about that. Every man gets erections in the middle of the night, multiple times actually. It’s just natural. And yeah, sometimes the wet dream thing happens. I don’t think that is the problem when they give advice not to have sex. I think it’s is much more about not doing the physical stress on that area during sex, and not the act of getting an erection and ejaculating. So unless you end up with more pain or get bleeding, etc. definitely see your doctor immediately. And if you have any doubts, again – check with your nurses and docs. Hope that helps. And congrats again!
Ken, thanks for your quick response. I have not experienced bleeding or any discomfort at all but I will nevertheless check with my doctor just to be on the safe side.
Thanks again
Greetings, Im based in South Africa, I just had my Urethroplasty (and they took some skin from my mouth-buccal) and some from my penis to repair my stricture. This provedure was done on the 29th of November 2019 at Steve Biko Academic Hospital in Pretoria.
Im told that its a first stage urethroplasty and will be back for 2nd stage. Now I have two catheters (suprapubic and urinary catheter), the wound between my scrotum and anus seems to be healing nicely, and the wound on my penis where they removed some skin to repair the urethra also healing slowly but nicely.
Its day 14 after my operation, anyone had this kind of operation before, kindly advice as to when did they remove your catheter and how was your urine flow afterwards?
Hello
It has been 5 weeks since my buccal graft – urethroplasty and my flow of urine has improved a lot. However I am now doing gym exercises and also having an active sex life, how can you know if the stitching is fully cured and when does the risk of the stricture reappearance die out?
Ps Thanks ken for this website you are a godsend!
One last question, i am 21 yo and am wondering when stretching would become safe?Will i ever be able to do the splits(because of the perineum area)
Have a good one Ken!
Hi John,
Congrats on what sounds like a successful surgery! As I really must make clear, I am not a medical professional (doctor or nurse) of any kind. So I can’t give you answers to these questions with any kind of authority. Your absolute best bet is to ask them to the doctor who did you surgery. Or at least to a urologist. IN GENERAL terms, after 6 weeks things should be healed up pretty well. That’s the amount of time I have been in a cast after they do surgery on my foot (done twice in the past 2 years) and they allow you to start bearing some weight on it. They take the cast off and remove the stitches after that 6 week period. So in theory, you should be good to go after that period of time. But I have NO WAY of knowing about you and your situation. So my advice is to take things slow. Try things gradually and see if you get any pain or discomfort and move toward normal activity. Hope that helps. Best of luck moving forward!
Thanks for the fast response mate!
Hope all of your extremities are feeling better.
My sister is a doc but i believe people who experienced it have a better understanding. Will call the specialist aswell, of course.
Cheers!
Ken,
Thanks for all of this information.
I am 16 days out from having urethroplasty. Entry point was through my perineum. No graft was needed. I am healing well and passed my VCUG with no leaks at 11 day post surgery. Given this, My catheter was removed at 11 days. My first post catheter urination about 2 hours later was at super flow and I was very happy.
However, since then my flow is getting worse and worse. I spoke with my doctor’s PA and she says there’s nothing to worry about citing the likely cause to simply be swelling that needs to subside. I’m not so sure and am quite worried. My biggest concern is they removed the catheter too soon and this has allowed the urethral incision to potentially close up some.
Any feedback concerning my issue would be very much appreciated.
Hi Anthony. Sounds like you have a successful surgery. Congrats! My flow didn’t stay at that same “superflow” level either. But I would say it just went back to normal. I did wonder sometimes if it meant a possible return of the stricture like you say. But that has not proven to be the case. I think you should keep monitoring the flow and if it gets to the point where you are definitely unable to empty your bladder, having to go like every hour or two, or have pain, definitely go back and keep asking your doctor(s) about this just to make sure. Good luck with the healing! I hope the flow does not get worse!
Thanks for your response. What is your take on how long they should leave the catheter in? They left mine in 11 days. I can’t shake the feeling it would have been a good idea to leave it in longer. I was having no issues with it. Seems like it would not hurt to leave it in another week or two just to be on the safe side.
That’s how long they left mine in. It seems to be within the standard amount of time.
Thank you and one last question.
I keep peeing out little chunks of bloody mucousy stuff. Basically like coughing up a small bloody Lougee. Did you experience this after catheter removal?
I don’t remember having that. But I have heard others here say similar things. Again, you really should ask that one to your doctor soon. Just to be on the safe side.
Ken, I have a doctors appointment this morning. My flow is getting worse and worse. It is actually slower right now than before the surgery. As mentioned earlier I pee just fine the day they took the catheter out, but it has gotten slower and slower since. I have spoken with my doctors PA over the phone and she thinks things will get better after getting worse. Have you come across any guys where this has been the case? Seems like most of what I have read is that guys typically have very good flow in the weeks and months right after the catheter is removed. And if things do slow down it is later…
Anthony – that does not sound like anyone’s story that I have heard from. It certainly wasn’t mine. It’s good you have a doctor’s appointment. Remember, I’m no medical professional. so I can’t give official advice. But I would say this is not normal. Hopefully it’s something that can be unblocked (maybe a scab/dried clot of blood?) without too much trouble. Good luck at your appointment!
hello
i am thankful for such informative web page
i am 10 days after my surgery but still got some swelling in testicles..thanks to the page that now i know its normal.
wish you allhappy life and good recovery
Glad the site was helpful. Heal up fast!
IN BETWEEN 1ST AND 2ND STAGE URETHROPLASTY Blank
Hi there, just came along this link, just wanted to share and compare…
I m currently in between 1st and 2nd stage urethroplasty with buccal mucosa, due to LS urethral penetration.
Many are the patients in my case that do proceed with closing stage 2 urethral genitalia reconstruction, but
others don t. Lols it is a tough one, as for both options there are plenty of advs vs disadvs, what 2 do…….
advs in my case: cosmetics and voiding standing up really they do not count @ all…., constant inflamed stinging burning graft skin can be reduced with the closing stage 2, and in my case is a big point, that my dermatologist confirms. Reduced risk/exposure to urinary tract infections is also a very big reason 2 proceed with 2nd stage, as by keeping urethra base to open air, is constant party time for bacteria..
disv: ED, future procedures post 2nd stage will get trickier, in my case just had a blodder neck incision. my prostate is playing around.., contraction buccal mucosa skin, nerve pain related post this kind of surgery, still dragging with me plenty post side effects 1st stage reconstructions,
Hi Carlo. Wow, that is a lot more to deal with than the standard urethroplasty! I feel for you. Thanks for posting. Hope things work out for the best!
Hi Ken
I just hadon’t an urethroplasty 4 weeks ago.
The flow is very good so far,
But my concerns are
– my erect pens is significantly smaller than pre operation
– also it is bent to the right and down, that is where the graft is
– still very painful when erect, and numb
Would these be resolved by time?
Hi Ken
I just hadon’t an urethroplasty 4 weeks ago.
The flow is very good so far,
But my concerns are
My erect pens is significantly smaller than pre operation
Also it is bent to the right and down, that is where the graft is
Still very painful when erect, and numb
Would these be resolved by time?
After only 4 weeks, I’d say yes – these things will likely get better with time. Most of us were not fully healed from urethroplasty until almost a full year. Still, I recommend talking to your urologist about these questions as soon as possible. Remember, I am not a medical pro of any kind. Hopeing things will improve soon!
Hi James
I am 5 weeks post a urethroplasty which was full length , I had grafts from inside of both cheeks .
I have the same issue as you stated regarding significantly smaller and my erection points down and bent to the side , it’s like the graft is stoping an erection .
I just wondered what your outcome was .
Many thanks
Hi Ken, I thought I just posted a question but it never got posted so I am doing it again.
I am in the process of evaluating the urethroplasty and have a question regarding SPC one month prior to the surgery vs. no SPC.
Dr. Gelman uses SPC, one month before the surgery while another urologist that I consulted with does not?
What are the reasons for it?
Thanks,
Akai
Hi Akai. Sorry about the post not coming through. I had things held for moderation for a little while due to some spam comments. But I’ve changed it back now. Anyway, the reason I was given – since my surgeon had me in an SPC for 5 months prior to surgery! – was that bladder rest needed to happen in order to allow the stricture to also have a long period of rest where there was no pressure on it. That way there wouldn’t be any inflammation or anything in that area beyond the scar tissue that initially caused the stricture. I can’t speak for your surgeon. But that was shat I was told. Hope that helps.
Thanks Ken for your kind and prompt response.
I had a RUG but it did not go well. Can’t see the stricture. Apparently it is radiation induced (HDRBT and IMRT) from my prostate cancer treatments.
The stricture is at membranous, I had an emergency DVIU in Bangkok (total blockage) in March 2019. It has been about 16 months.
I had blood in urine beginning of June and my urologist did a cystoscopy that could not go through the stricture, he listed as membranous stricture (typical of radiation induced), approximately 8fr in the narrowing part. I am still urinating OK but am afraid that a total blockage can occur again anytime.
I am seeing Dr. Gelman this coming Friday for an evaluation (RUG + VCUG).
I assume you had both done during your evaluation, was the VCUG part difficult? How long did it take?
I am very concerned on the healing issue as radiation typically damaged the tissue and the DNA of the tissue around the urethar and make healing difficult. My current urologist is confident that my stricture is short eventhough the RUG did not show it. He said that during the dye injection he could see the narrowing part then the dye just squirt up passed the narrowing part telling him that it is short. He aslo said that the fact that my DVIU lasted this long means it is not a long stricture. Not sure what to believe, he is a specialist in reconsrtuctive as well. He does not use SPC prior to the procedure.
So my question now is about the VCUG, and if you think of anything else please advise.
It is so hard to find any information on urethroplasty from fellow patients, your site may be the only one that allow us to learn but it has not been active lately.
Akai
I didn’t have the VCUG until AFTER the surgery and ultimate removal of the catheter to test how well it worked. they did an “up-down-agram” as they calle it in order to determine the location and length of the stricture. That means they went with a scope through my SPC hole and came down the urethra, while simultaneously going up the penis with another scope to come at it from the opposite direction. They gave me a spinal anesthetic for that. I didn’t really have any back pain form it, but it took like 2 hours in recovery for me to be able to move my legs. Not sure I recommend that :-P. Anyway, it sounds like Dr. Gelman will be able to give you the answers you need in a few days. Good luck at your appointment!
Hi Ken, I had a visit with Dr. Gelman yesterday. He performed both RUG and VCUG and confirmed my membranous stricture. The good news is the stricture is short, approximately about 1 to 1.5 CM. He said it should be a straight forward EPA with no grafting. The unpredictable factor is the healing process as mine is radiation induced stricture and the tissue around there has probably been damaged as well. Dr. Gelman also said that if I do not want a SPC then he still can do it. He said SPC allows him to see the surgery from the top down and if need access from the top its there for him. He said he still need to install one once the surgery is done if one does not exist.
Another issue that I am facing is that when I had my gallbladder taken out, I developed keloid at one of the incisions. Dr. Gelman is not familiar with the keloid issue. It would be a major issue if keloid developed at the perineum. I am hoping to see a dermatologist for more information. From what I read, there is no way to prevent it or permanently treat it once it grows, its like trading one problem for another permanent problem.
I have not made a final decision, pending more information on keloid issue.
I am urinating OK without problem. Were you having problem urinating when the whole process started?
Thanks,
Akai
Thanks for the update, Akai. I absolutely had trouble peeing before it all started! It was painful to pee and it took me like 5 minutes to come close to emptying my bladder. The day I woke up and could not pee AT ALL was the day I went to the ER and got the diagnosis (after a very painful session of ER nurses trying to force a standard catheter up my penis!). They put in an SPC and boy am I grateful for that! If I had the choice of having a suprapubic catheter or standard urethral one, I’d chose the SPC every time. It made life much more convenient not to have a huge tube up my urethra!
Anyway, best of luck to you no matter what you decide!
Hi everyone i need help i have stricture on bulbar urethra less than 2cm more than 10 years i did twice urothrotomy faiuled i planned for urothroplasty recently im afried about my life after surgery whars opinion i go throught it or continue my life suffering better !?! My age 28
If i did it and success how many years i will be ok 5 years or life long
Hi Mohanad. Success rate for urethroplasty is 90%-95% for long-term (forever) fix! I had mine done in 2013 and still peeing normal! Hope that helps
Hi Mohanad, I had a stricture for 49 years, and had 6 urethrotomies; All of them failed. Had “end to end” urethroplasty in June 2015 (2.5 cm in bulbar). Still peeing normal 5 years and 3 months later. So there’s two of us past 5 years and still going strong.
Thanks for posting that, Ned!
Urehtroplasty usually lasts the rest of your life.
Yes, urethrotomies are only 50/50 in chance for success. But urethroplasties are 90%+ for long-term success. It’s really the only way to be confident of a permanent fix.
Thx all my op done 24/9
Im 6 day with out cath
Im passing well i never pass urine like this before thx god
Still testcular pain going on
Im siting standing no problem but im not sure inside my urethra healed or still i hae lottle pain on top of my peins its normal
When i can go back to work im staff nurse working in emergncy
Thanks for the post, Mohanad! Congrats on what sounds like a successful surgery. It sounds like things are pretty normal, even the testicle pain. that lasted for many months for me but went away after about 11 months. Going back to work is something you should talk to your doctor about. But usually I think they say at least 2-4 weeks after your surgery. It alls depends on how you are recovering. And your doctor will have that information best, usually. Best of luck!
Most welcome
Thnank you also
One more qustion my doc prescribed for me alpha blockers silidosin 8 mg daily for 30 days should i continue take it !? Or only 30 day.
I am unqualified to answer that, Mohanad. This is definitely something you should ask your urologist.
Thank you for fast replay i asked him today he told me to continue for 2 more month im suppried cuze no one mention here or else where that they took any alpha blocker i search in google it seems like this medicine help to relax bladder muscle and urethra muscle to get time to urethra to heal and graft to completely attached that what i think so
Update
I did my urothroplasty with BMG graft on 24/9/2020
Im healing will
They talk 6*3 cm graft from my inside my mouth wich really paining more than surgery it self
Im in foleys for 3 weeks
Thing only i have in between some blood leak around my cathter my surgen told me its normal nothing to worry about
Im still in between giting testicualr pain and swelling which sound like normal for each one
Till now i did not get erction only little bit !?
I hope if some one get blood around catheter to reassure me
Thank kan this side help me alot and i decide to do surgery after i read all story her
5 weeks post op
I have some pain inside my uretha i spoke with surgon told me normal i think pain associated with testcular pain any one had same pain
And usually my pain relived while im walking or sitting some incontinus urine i will pass
About stream firt to second stream is weak then gradually increase till i empty my bladder then deacresed till I dripping and i will feel i need to squeeze my urethra to complete empty from urine i will not feel pain its like discomfort thats i want to do any thing to empty the urethra its normal
How much i will take to completely healed im still off work With all this symptom im afried to go back work cuze i have bad experiences with scope before i explain to my surgan he told me all normal will take time any one had same symptoms
My op was with bmg 6 cm
Thx
I had surgery 11/2/20…. Now let me start by saying I was extremely nervous for this surgery as I’m 21 and never thought something like this would happen to me. I thought it was going to be extremely painful recovery, but to my surprise I’m a week in post op and have no pain and the swelling in my scrotom has gone down a lot i still have limited feeling. The most painful thing I’ve found after surgery is bowl movements. I’m not sure if that normal or not.
I’m hopping that on the 24th I’m able to get my catheter removed as i read some people don’t get it removed due to leakage. Now I’m wondering since I’m doing so well in recovery if that means i should only wait the 6 weeks to resume sexual activities. Also am i too premature on my recovery???? Least to say that i think I’m doing well will keep updated.
Hi Z. Sorry for the delay in replying. Everyone is different and I don’t believe there is any reason to be worried that your are “recovering fast.” I did not have painful bowel movements, as I recall. But I do remember a constant feeling of pressure “up there.” As it eventually turned out, it was severe hemorrhoids! Also, opiate pain medication can cause painful bowel movements as well. My advice would be to wait until after your catheter is removed and your are tested to make sure everything works (no leaks, etc.). As for the sex, I think you need to ask your doctor about that. You don’t want to risk messing up all that work just for that :-P. Hope that helps!
Hope you will recover soon
About bowel movement its normal to have some change long anasthisi will cause paralysis temporary to the bowel movment it will take several week to go back to normal movements thats completely normal important thing to eat more fruits and vegetables and fibers to promote bowel movement and avoid oily fool fatty food , drink much water as you can it will help
What type your operation did they use any graft ??
10 weeks post BMG bulbar urethroplasty the flow still strong
But i have still pain in shaft of my penis and irritation
Testicuar pain and tender little
Some discomfort on urethra itself
I do not know if this feeling normal any one did urethroplasty can update me how feeling after 10 weeks
Still i dont get erection at all before operation zero problem in erection
Thanks for all of these posts. Dec 1st 2020 was my surgery. It was supposed to be a 4 hour prosidure for a 4cm scarring. Turned out to be 11cm and 6plus hours. The whole left side of my cheek was used to repair. I was supposed to get my cath out on the 21st but got covid so they could not see me. I also had the same issue where I didn’t know what to expect and all kinds of things were freaking me out. Calling and talking to nurses was not the best but they did help as much as they could. I did finally get the cath out yesterday 12-30. First 2 weeks were not bad but the 2nd 2 weeks were miserable. Blood clots lots of white puss (not infection I found out later) and unbearable bladder spasms even with medication. So far only a little burning during urination but scared to have sex. Will update on that later. Happy to answer any questions anyone might have to help.
Holy crap! That’s a lot! I can’t imagine going through all that and with COVID. I’m glad to hear you’re on the other side of it. I would definitely recommend holding off on sex for that 4-6 weeks. Best of luck with the healing!
I have urethroplasty(BMG) done on 26th May 2021 .I am still on catheter. My problem is that every night I have a erection.
Will it effect my chance of recovery and it’s success rate.
Thanks