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Urethral Strictures Post Catheterisation

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Posted 10/1/2011 4:24 AM (GMT 0)
I am seeking others' experiences with urethral strictures and treatment for this condition. about 12 months after daVinci prostatectomy I started to experience slow flow. A return to the urologist resulted in dilation (ouch) which was highly successful (for about two weeks)! Some time later I returned and a flow test quantified what I knew and without any further diagnosis I was offered urethrotemy. The notes to my doctor suggested if after two urethrotemies the problem came back they would recommend a urethroplasty.

My research and the "after two urethrotemies" indicate this procedure is usually not long term successful while the urethroplasty is fraught with plenty of issues and more time off work. At the moment I am managing poor flow and trying homeopathics.
Posted 10/1/2011 5:40 AM (GMT 0)
Sorry you are having this particular trouble. Until I had an Urostomy surgery last year, I was plagued with stricture problems. It involved 21 catheters, a total of about 1 1/2 years on caths, 6 different corrective day surgeries (2 being laser), plus several painful ER visits and one emerency dialation. For a small percentage of men, strictures can be a chronic situation, I unfortunately was in that group.

In my case, it began immediately after my open RP surgery. It became even worse after I had salvage radiation.

For other men, the problem can usually be resolved with a couple of attempts, I believe Subic Squid (a member here) was in that category.

If you are having bladder spasms associated with these flow problems, be sure to ask your doctor about the med Ditropan, it doesn't solve the spasms, but it really helps to deal with them.

If you would like more details, feel free to e-mal me, and we can talk about the different methods and approach more fully.

I wish you luck in this area, as I know first hand how painful this problem can be if it can't be resolved easily.

BTW, most of mine was determined to be as the result of my body constantly over-scarring when it is trying to heal. It gets the wrong signal and goes nuts with excessive scar material. My uro said he had never seen a patient that could scar the bladder neck completely closed as fast as I did. I had one laser surgery, and in length than a month later, was 100% closed shut.

I hope you have better results.

David in SC
Posted 10/1/2011 10:27 AM (GMT 0)
My stricture was discovered when they couldn't get a catheder in me in the operating room ready to operate. IThey did the dialation procedure and sent me home with a catheder for 2 weeks, very painful for first 6 days. It has now been 4 days since the catheder was removed, waiting 3 weeks to see if it stays open and is healed, then do the surgery if all looks good. My doctor says if it does start closing down that perhaps self cathedering, maybe regularly, just to open it up then take it out may be an option. Maybe its an option that would work for you..Mike
Posted 10/1/2011 11:17 AM (GMT 0)

I developed problems similar to yours about 6 months after surgery.   I had four dilation procedures about three months apart that appeared to solve my problem.  My uro offered the surgical procedure as an option but I was content with the simple dilation procedure.  I developed another flow problem after SRT and went back for a 5th dilation.  It seems to have worked so far.  I avoided surgery because of the potential for incontinence problems.  The dilation procedure is certainly uncomfortable but I don't mind doing it if I can get several years out it.

Carlos

Posted 10/1/2011 6:34 PM (GMT 0)
I went through a coupke of unsuccessful dilations and finally a urothomy, which seems to have dont the trick for me.  The uro did warn me that there are no guarantees and he wouldn't be surprised if I came back with another stricture eben one-two years later.  Everybody is different.  I wouldn't wish strictures and the resultant pain on anybody.  David seems to have suffered the worst.  His pain tended to make mine seem not so substantial.  Squid.
Posted 10/2/2011 8:05 PM (GMT 0)
Hey thanks guys. i have an urologist who is not very open and communicative although his reputation for surgical skills is high in our city. He was one of the first I believe to train in RPP with daVinci but he hasn't shared any really reliable thoughts on prognosis for any corrective procedures and is somewhat brusque in his personality.

Subic - how long since you urothomy and has the flow slowly diminished since the procedure? I have heard that they can cause more scar tissue to form.
Posted 10/3/2011 5:39 PM (GMT 0)
I had the procedure in March 2010 and have had no diminishing of flow.  The flow is not as strong as right after the initial RP, but is just fine.  I'm hoping that the scar tissue problem is one less thing for me to worry about now.  Squid.

Posted 10/3/2011 5:41 PM (GMT 0)
By the way, the procedure itself is no big deal.  Under anesthesia, a few hours of recovery, and then go home.  I think I had to have a cath for a few days to a week after.  Can't remember, so it wasn't that bad. Squid.

Posted 12/21/2011 8:16 AM (GMT 0)
URETHRAL STRICTURE CURE

Ayurvedic Medications: (take for 30 days) repeat for 15 days if necessary

1. Gokshuradi Guggal – 2 tab 3 times daily (30 min after meals with hot water)
2. Chandraprabhavati - 2 tab at bed time with hot milk

3. Banana Tree trunk SAP (10 ML) {obtained by crushing method} + Brihatyadi Kashyam (15 ML) mix with ½ Glass of Hot Water - Twice a day – early morning, and evening (empty stomach)

No Khatta, No Rice, No Cold Drinks, No Spicy food, Simple diet

Drink only warm water

Buy brihatyadi kashyam/kadha/kwath (all are the same thing) from Kottakal pharma
Posted 12/21/2011 8:17 AM (GMT 0)
URETHRAL STRICTURE CURE

Ayurvedic Medications: (take for 30 days) repeat for 15 days if necessary

1. Gokshuradi Guggal – 2 tab 3 times daily (30 min after meals with hot water)
2. Chandraprabhavati - 2 tab at bed time with hot milk

3. Banana Tree trunk SAP (10 ML) {obtained by crushing method} + Brihatyadi Kashyam (15 ML) mix with ½ Glass of Hot Water - Twice a day – early morning, and evening (empty stomach)

No Khatta, No Rice, No Cold Drinks, No Spicy food, Simple diet

Drink only warm water

Buy brihatyadi kashyam/kadha/kwath (all are the same thing) from Kottakal pharma
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