Stricture

Since I finished my SRT my urine stream has progressively gotten weaker. I just completed 10 days of antibiotics for a UTI but the burning and weak stream persist. I've been referred back to the URO to see if I have a stricture. My understanding is that means there could be a build up of scar tissue in the urethra so they need to dilate it. The nurse said it is a fairly quick procedure. Has anyone else had this done?

Post Edited (P34) : 11/18/2018 7:49:11 AM (GMT-7)

P34 said...
Well, I go in Dec. 4th so I'll let everyone know what's involved.

Good luck P3.

There may have been some scarring from your RP. There can be some stricture from the operation without a man knowing it. (They have to get down to a certain diameter before they begin to cause symptoms). We’ll compare notes after....so let us know how it goes.

(Mine just required one procedure and it has stayed open since. But mine was a different procedure from what your getting).

From what I understand....scar tissue and radiation aren’t always good bed fellows..

But hey...a man’s gotta urinate. At least that’s what they tell me.

Be cool man.

And good luck to ya P34

David

P34 I have had the dilation 4-5 times over the 20+ years since I was diagnosed with a neurogenic bladder. I recently did it prior to radiation which I believe has helped quite a bit. However doing it after radiation too early may make the procedure a little more delicate. I have always been awake with a topical anesthetic which I would recommend for the procedure. It involves very little pain and you can let the UR know if there is any. A number of different sized metal tubes are used to stretch the bladder neck open. It doesn't take very long. Another word of caution do not allow any cutting of the bladder neck. These operations have a very low success rate. If you need to use an intermediate catheter later take it from me it isn't all that bad and it gets the job done.

69 yrs., marathon runner, 39 of 44 3D-CRT/IMRT Radiation delivered via 3D-CRT in 1.8 Gy minimum dose fractions to a total of 79.2 Gy., 10.5.18. PSA .012, 8.12.18, 1.42 June 18, 2018 (Lupron 5.21.18 & 8.15.18), 12.7 May 2018, 13.7 Jan. 2018, 2.1 May 2012. SpaceOar 9.6.18, testosterone <.7, 8.15.18, Tot Mayo 19 ng .17 testosterone Free 6.18.18, Gleason 3+4=7 involving 15% of the right apex and 15% of the right mid, 3+3=6 prostate cancer involving 5% of the left base. Pathology interpretations by John Hopkins, UNM Cancer, and SF Path 3+4=7 or 4+3=7 MD Anderson Proton Center w/o %. T3 MRI w/ contrast 1.8 lesion left side 5P, Neg. Bone Scan. Prolaris test 3.5 consistent with intermediate and a PTEN test negative. Father PC age 78 RT & ADT now 94 yrs. Neurogenic bladder due to lumbar disk disease and recurrent bladder neck contracture with urinary retention man. 20 years doing catheterizations. TURP & scaring 2003, Finasteride 5 milligrams daily since 2002.

I had it done just recently and it worked out very well for me. I also had it done with only the local and while it wasn't a walk in the park, it wasn't that bad comfort wise. Did have to walk with Foley for the weekend & was asked to self cath. once a day for a spell and should be able to taper off of that. Like Santa said, it really isn't tough to do.
Odd thing for me is, my urinary blockage was completely due to the stricture, but they found this PCa looking for the cause of the blockage. I'd bet the actual cause of the stricture was from my colon resection this past march.
I may be blessed or cursed, but I now pee like a horse on drugs.

Thanks guys. It was my RO that said it could be stricture and he referred me to the URO. He never said anything about it being a rt se. After looking at my appointment it says I'm booked for a cystoscopy? So I guess they're just looking for now. Based on your inputs I would prefer the prescription avenue if its doable. I'll let you know what happens.

I had a manual dilation done in hospital for a stricture that developed following scarring from a catheter after my prostate was removed. For me it was extremely painful as in involuntary screaming as in each time the wire or whatever was inserted. My blockage was 99% and in the head of the penis (navicular fossa). location, amount of blockage and the fact that no local pain killer or pain blocker were given (I was told it was not possible) made it a very painful experience. I will never, never do this again - general anaesthesia next time.

I think what pain you experience depends on the site of the blockage and how blocked it is.

After this first manual dilation in hospital, I self-dilated for a few months. That was a little painful, but not too bad. Just be careful, if you have to self-dilate make sure the device has a little ball on the tip. The one they gave me initially didn't have this and it was painful to use. The ones with a little ball (rather than a sharp tip) will push through scarring much better.

For me this manual dilation didn't work as the scarring continued. From dilating once a week to every 2nd day and still a losing battle. I then had a urethroplasty operation to repair the site. At the moment I'm in the healing process from that.

Post Edited (jasperx10) : 11/22/2018 10:41:23 PM (GMT-7)

Thanks P34. The cystoscopy will be very informative in seeing what's going on. I'm not familiar with this procedure but it shouldn't be painful for you as I assume here it's "looking" thru the camera only, rather than cutting or pushing through a blockage ?? There are probably so many variations of this procedure.

If you want to keep track of your urine flow rates at home (your urologist should be testing this in-office as well), you can download a timer app onto your phone and measure the amt of urine you pass in that time. It can be surprisingly fairly accurate and at least gives you an idea if things are getting better, worse or remaining the same.

Inflammation can reduce flow rate too, so a chance it is this rather a stricture and why they're using a cystocopy. If they were certain it was a stricture I *think* they'd probably just inject some dye into the urethra and scan that to follow the path and see where the blockage is. I'm only guessing, though. I only mention the inflammation as after my urethroplasty my flow rate suddenly doubled after about 1-2 months. My urologist figures it's due to settling of inflammation around the repair site.

Good luck with the procedure on the 4th.

Post Edited (jasperx10) : 11/23/2018 4:51:42 PM (GMT-7)

Went to the URO today and he ran a camera up my penis, yippie. He let me watch and we both saw significant scar tissue. He said he usually can push the camera through but the opening was so small it wouldn't go. After seeing this I'm surprised I can pee at all. Anyway, I'm going in for a outpatient procedure Monday. He said I will be under anesthesia so hopefully this will take care of it. He said I could be incontinent for a few days and it could cause more scarring. Sounds like what Fiddlecanoe may have gone through. At least I'm getting it done before years end so my out pocket maximum has already been met.
Update: Found out I'm going in for a bladder dilation. Its supposed to be a 15 minute job.

Post Edited (P34) : 12/5/2018 4:36:32 PM (GMT-7)

Glad they found the problem @P34 and you're getting it looked after. Always hard to tell if the scarring comes back. Doc probably told you that "in case". I had a relative who had a dilation a year ago and no issues at all, whereas my scarring kept coming back - so a very individual thing I guess. Bet you're looking forward to the procedure to seeing the improvement after.

Let's hope it one and done.

Keep us updated.

Andrew

Good news - whatever they did worked.