Last Friday is a day I’ve been awaiting for more than 3 months – my combined antegrade and retrograde urethrogram. This was to scope out (no pun intended;)) the location and size of the stricture of the urethra that was discovered back on February 8th, 2013.
You may wonder why, when they knew what the problem was, they couldn’t just scope me in February. Well, it comes down to the fact that my stricture blocked my urethra just about completely. So the scoping they did on Feb 8th did not allow them to pinpoint the length of the stricture or the exact location. For that, they need to see above the stricture as well as below it. So for me, that meant sticking one scope down through my bladder while simultaneously sticking one up through the urethra “the normal way.” Yes guys, this is what you think.
But apparently they want to ensure that the bladder has rested for 3 months, and that the stricture has had a chance to reveal itself fully, which means not peeing the normal way for that same 3 months. Also, they have to upsize the catheter (which is the suprapubic variety stuck through my gut) a few times during that period until the insertion site was large enough to pass the scope through.
So last Friday, May 17th, was the day that everything had rested long enough. And the hole in my gut was wide enough. So they brought me into the operating room, gave me a spinal for anesthesia (it worked but I don’t think I’ll choose that method again), and did the simultaneous up and down scoping with contrast dye and X-ray.
The results were good. They discovered that the stricture was short – a centimeter or less, and the location was good. When I say “good,” it just means that I am a candidate for the lesser of the “gruesome” stricture repairs called “urethroplasty.” In general that means (guys, get ready to cringe) they start by slicing open the penis. The “lesser version” I spoke of is pretty simple once you’re laid open. They just cut out the section of urethra containing the stricture, and rejoin the remaining ends. Then they sew you back up. This is called an “end-to-end anastomosis.” The long-term success rate of this is over 90 percent.
The other urethroplasties just get more gruesome from there, involving using grafts from inside your mouth to partially or totally rebuild your urethra. This can take up to 6 months or more, in stages, depending on which version of the urethroplasty we’re talking about. So you see what I mean by the end-to-end anstomosis being the best possible version of the urethroplasties.
So I am very relieved and happy with the results of Friday’s up/down urethrogram. Now they have to schedule the surgery itself. So this thing will last at least another few months. But after 15 weeks of this, it’s sort of routine. So another few months is not that big a deal.