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urethra stricture -following HYPOSPADIAS

My son who is 17 underwent HYPOSPADIAS surgery when he was 2 years old at the Chicago Children Hopital. He is now 17 and all of a sudden developed urethra stricture close to the tip of the penis where the initial surgery was performed. After several months our urologist performed cystocopy under full anasthesia and advised us that a. the hyspospadias surgery was perfectly done. b. the cystocopy was successful and that he might to undergo another one in about a year. (he had a cathether for about 48 hours)
About 2 weeks later my son started complaining again of burning and slow stream. The doctor decided to perform dilation under full anasthesia as my son would not let him do it in the office fearing of  pain. He had the cathether removed after a day and was advised to insert  a dilator himself twice to 3 times per week accompanied by a lydocaine gelly. In 2 weeks the same symptoms of burning and slow stream happened again accompanied this time by painful contractions of the bladder every 10 to 15 seconds!! causing him to bend and not being able to walk straight, missing school and becoming very embarassed. The doctor prescribed Detrol LA and pain killers but this has not cured the symptoms . The doctor explained that he will do another dilation-full anasthesia and would not recommend the internal incision procedure due to the Hypaspadius procedure as it can be complicated and further damage can occur. He said that after the dilation he wants my son to use a cathether daily for at least 90 days to try and hold the urethra open. My son is saying that he can't insert the cathether due to pain. Please help and advise what should we do.  

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233190 tn?1278549801
MEDICAL PROFESSIONAL
Difficult to say without evauation.

One can always obtain another opinion at a major academic medical center.  Unfortunately more dilation seems to be a mainstay of therapy.  

A more extensive surgical procedure (i.e. incision) can be considered - but as you said, the scarring can lead to a worsening of symptoms.  

Depending on the site of the sticture, a stent may be considered.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b
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