Urethroplasty

[Raj456]

Hi,
I have a urethral stricture of about 4-5 centimeter long.
Doctors suggested me a Urethroplasty where they would replace tissue from my mouth.
Since i have never had any surgery done, i am worried about the risk involved and the success rate (especially in my case as they told me my stricuture is relatively longer).
Any suggestions.
Thanks
Raj

[maseco]

Hello,

I have undergone bmg urethroplasty 3 days ago, the two stage procedure, for an anterior stricture ~ 4 cm in length. After reading all the comments here and on other sites i must say that i was a bit worried about the recovery. Surgery went well, the doctor removed a big chunk of bm from my right cheek to replace the the affected area. In the recovery room i didn't experience any real pain, not in the penis or in the mouth. The sensation was more like discomfort in the mouth but nothing to do with pain. Next morning the doctor let me go home and i will have to return after 7 days to remove the catheter. I spent the first day home mostly in bed, drinking liquids, watching tv and sleeping. Sleeping is the hardest part because of nocturnal erections and that is the only time when i experienced some kind of pain. In the second day i was feeling much better, went outside for a 1hr walk and did a bit office work. Today i'm feeling much better overall, my inner cheek is healing fast and i can drink and eat almost normally. I want to resume work and to spend some time outside. Even if i'm only three days after the 1st stage procedure, i feel very optimistic and confident about the final outcome.

[flow40]

Just wanted to share my experiences real quick.  I was first diagnosed with a stricture around 2006, but looking back have probably had it most of my life.  For the most part, it never got bad till after my first dilation.  The second time I was dilated by that uro, I was sitting on the toilet after and bleeding profusely, feeling like I was about to pass out, when someone came in and informed me they needed the room for the next patient and I needed to get out.  I never went back.  The next time I had issues, I did my research and landed on Swedish Urology Group in Seattle, specifically Dr. Kuan.  My first visit he wanted to scope me, and I was terrified after the painful experiences I'd had previously.  He finally convinced me and, to my surprise, it didn't hurt a bit.  We went through several years of management, with multiple dilations, a urethrotomy, and self-catheterization (which I was admittedly terrible about following through on... ain't nobody got time for that).  Finally, he performed a urethroplasty with a 5cm buccal graft on me.  When I woke up, my first thought was "my arm hurts!" due to how it had been positioned during surgery.  My mouth and perineum were a bit sore, but not too badly.  My only pain meds were tylenol in the hospital and ibuprofen at home, 200mg 3-4 times/day.

The worst post-op pain I had was 3 days later when I had my first post-op bowel movement... I probably should've taken some stool softener, but I didn't.  Felt like I was gonna bust a suture, but I survived.  I was sent home with a 20Fr Foley, which I had removed 13 days after surgery.  First uroflow, I hit 40ml/s, and I think things have improved since then after the remaining blood and such got flushed from my system.  So, just a couple weeks after surgery, I have great flow, no pain on voiding.  My only issues are some ongoing tenderness and swelling near the incision, and that it feels completely different to pee... mostly, I don't feel it at all.  I also seem to have slightly reduced feeling in my penis, though that may simply be from swelling around the nerves.  It's not severe, and if I had known the full outcome before hand it would not for one second have stopped me from having the procedure done.  We'll see what the long term results are, but so far I'm quite happy.

Hope this helps someone!  If you're in the Seattle area, I can strongly recommend Dr. Kuan and Swedish Urology Group.

[Charliefoxtrot74]

Thanks for posting your experience. It gives me some confidence.
I had a stricture 18 years ago that was treated once with dilation- sadly I've been getting numerous bouts of prostatitis and uti's in last couple of years and I'm now in a lot of pain- my urologists thinks the stricture has returned- if this is the case I'm going to set forth with urethraplasty - I don't see the point of any of the alternative treatments- I want it cured. Having gone 16 years with no problems I can't believe the stricture came back......I'd have another dilation if I thought it would last that long again but my fear is that it will return much quicker this time.

[jackoneill]

Interestingly, K2, Acetyl-Carnitine, Lysine, C and E and I have improved a bit.  It is rare over last few days that there is any difficulty in getting flowed started, sitting or standing.  Still usually a 5-10 second pause before, but painless and no exertion.  However, I find two symptoms persist:
1) the easier it is to get the flow started, the more it goes 35-degree angle left (didn't have this before these symptoms started).  I wonder if this means that scar tissue on right side is maturing/hardening.  When it's sensitive/difficult, this is because it is trying to pee through where the scar tissue is (have felt as thought it was always more on right side).
2) Dribbling.  75-90% of the time there are 2+ drops.  This is after waiting to empty a little bit after initial flow stops...there is a combined finger in butt + kegel to get a little more pee out.  This is almost always completely painless, sometimes a little mild discomfort but I feel getting better (although this also maybe means scar tissue hardening/maturing).  But after doing this, 1-3 minutes after, always 2-4 drops.  Just a little bit, but still annoying.  I can tell when this is happening too, as soon as I pull up my pants, I know a little urine stick in penis.

I suppose, additionally the underside is not great.  Little semi-hard natural colored bump about 1/2 inch down from tip, painless.  Had this for mb 4-5 years.  Under this, about 1 inch from top, cross shaped white nerve, thinking lymphocele?  

And under that, generally red and sore - this always been fairly mediocre, partly due to bad hygiene and bad/rough masturbation habits.  Once I had symptoms 1 year ago, I started to wear boxer briefs exclusively for the first time since age 13, I had been exclusively wearing boxers.  Helped with a securing feeling, but **** always stuck to balls.  Made for difficult peeing bc scared to unstick, bad masturbation habits (often in tight boxer briefs, constricted erection and ejaculation and not changing underwear, many times daily after symptoms appeared...not good for healing in a way that would prevent scar tissue), and general redness/diaper-like irritation.  Was using desitin, seemed mildly helpful.  Since switched to Lanolin w/petroleum Jelly.  That + supplements + NON-KEGEL, CPPS-oriented PT exercises (Amy Stein) seem to be helping.  Difficult to tell which of 3 since all started around same time.

Anyway thanks for some feedback...

[jackoneill]

I'm going to keep posting here.  Don't really care if anyone else is, but it would be nice to get their input.  I started taking vitamin k2 and lysine, as well as back to acetyl carnitine after a month off.  I noticed improvement, although perhaps some deterioration today (3rd day).  My thinking with k2 was that k2 helos metabolize calcium correctly, removing it from soft tissues and ensuring it goes to bones and teeth.  Since calcium was key for scar tissue, I was hoping the k2 would help.  My underside remains sore (neg for infection/blood/protein/everything on many urinalyses).  Penile cancer obviously first concern.  Will rule out std's like herpes for underside on 10/3.  I also noticed my right testicle is quite swollen - no lump, and no pain, but it is v large, more than normal.  Or this has something to do with the fact that no orgasm for 58 days?

Anyway there are many questions above and it would be rgeat to get some input from other users.

[jackoneill]

This is very similar to my symptoms.  It can be very annoying how often posts here go unanswered, or how cursory the responses from the MD's that do bother to respond often are.

http://www.medhelp.org/posts/Mens-Health/Painful-Urination-Ejaculation-Erection-and-swollen-dorsal/show/1506900

Last few times urinating, I have to kind of flex my kegel muscles to pinch and get it started.  Afterwards flows normally.  Little post-void residual dealt with effectively by putting a finger in my rectum slightly which causes natural reflex action that painlessly, effortlessly gets rid of that residual.  But starting urination is a pain (and this feeling seems to occur even if my **** is not stuck to my balls).

I was on alpha blocker for 7+ months.  I feel like a side effect of the med (been off for 3.5 months but there are plenty of documented cases of people who feel as though the sides don't disappear even after a very long time) is that my muscles/nerves have kind of forgotten how to relax to void.  Anyone who was on flomax and could share, that would be helpful as well.  In the end I think I will just have to go Gelman and get a high-skill cystoscopy.  I wish one could get more substance from this site.