Urethral Stricture Removal

[ibook]

I'm going to be having a stricture removed from my urethra next week. The doctor will use a laser to remove it. The stricture is causing me to urinate frequently, not empty the bladder, and have a weak urine stream.

I'm concerned that the surgery will only be a temporary fix and then cause even more problems. Through numerous forums I haven't found one person that describes having a stricture removed with this procedure and being satisfied with the results. Most describe relief for a short period of time and then having to have the procedure repeated or have to dilate their urethra on an almost daily basis.  If thats the case, I'd much rather have a weak stream and pee frequently than have to use a catheter for the rest of my life. I'm worried that this might just make a bad problem worse.

Has anyone had this procedure done before? What was your experience? Any information would be greatly appreciated.

Thank you.

[axkfgj202]

ibook, you're right, and rt0rres, I agree.

Strictures usually recur after a urethrotomy, and repeating the procedure is just a temporary, palliative treatment.

Definitive treatment with urethroplasty would then be your best chance of cure. Most urologists don't do this procedure - it's a skilled specialism, so find a specialist if considering that option.

____________________

Urethral Stricture Evaluation and Surgical Management
http://www.urology.wustl.edu/PatientCare/UrethralStricture.asp

____________________

Urethral Strictures, Male
http://emedicine.medscape.com/article/450903-overview

____________________

Self-catheterization is a traumatic maneuver that most patients view with considerable disdain as a painful, time-consuming, embarrassing, difficult and unnatural practice they would gladly abandon if given the choice. False passages will develop in most cases over time, further complicating the problem. Today we can and must do better.

Urethral Stricture is Now an Open Surgical Disease
Allen Morey
Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas
0022-5347/09/1813-0953/0 Vol. 181, 953-955, March 2009
THE JOURNAL OF UROLOGY®

____________________

EDITORIAL COMMENT

... this article also casts doubt on the practice of self-catheterization to try to keep strictures open after urethrotomy. Of these patients 73% had recurrence on a self-catheterization regimen and another 18% had so much pain with catheter passage that they had to abandon it. Again, few reconstructive urologists attempt this maneuver since it always seems to fail, not to mention that it unnecessarily condemns the patient to a lifetime of painful self-catheterization, which would not be necessary after surgical cure by open urethroplasty. An excellent study by Greenwell et al suggests that self-catheterization has no value, at least for anterior strictures,1 and the current authors add doubt about its usefulness for posterior urethral distraction injuries. This suboptimal management scheme remains wildly popular, judging by the referral population seen at our clinic, despite the real doubts as to its efficacy. It is another specter in need of a stake to the heart, in my opinion.

Richard A. Santucci
Department of Urology
Wayne State University School of Medicine
Detroit, Michigan

THE JOURNAL OF UROLOGY®
Copyright © 2007 by AMERICAN UROLOGICAL ASSOCIATION
Vol. 178, 1656-1658, October 2007

____________________

[rt0rres]

I had this procedure done in 2004.  It worked great for about 9 months, after that the stricture returned.  I have had to have dilations done every 3 months after that.  The dilations hurt quite a bit.  I am talking to a Urologist at this time to have a urethral reconstruction surgery done.  It is a lenghty procedure, but it is suppose to give me a 88 percent outcome.