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Urology (Expert Forum)
Urethra restriction
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
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Urethra restriction
by tipster, Apr 26, 2003 12:00AM
I've had a restriction at the tip of my penis since I can remember. I've often used my own implements to dialate the opening. The restriction is at the very end and goes about 1" back. The skin around the tip of my penis is thin, and when about 13 or 14 the shaft skin had healed itself over the tip of the penis, but not covering the orafice. After a systoscopy at 15 years, the urologist broke that skin connection and performed a dialation that didn't last, but the skin didn't re-heal itself to the tip, though it tried to. I belive the same process of healing-over happens at the end of the urethra - so the tip keeps trying to heal itself shut, and I keep dialating it. Urologists have advised cutting the urethra back, but I'm opposed to this. I believe that if a stent was placed in the end of the urethra the skin would be separate for long enough that it would not heal back. I'm now 46 and I belive the back up is causing me problems in my prostate, as I feel minor discomfort when sitting, an have passed "scabs" on occasion, or had blood-discoloration at the end of urinating. dialation makes this go away and eases the discomfort symptoms.
I'm not comfortable being a science experiment for a urologist since none of them can diagnose this specifically, let alone have vast experience with the operations they propose.
I would like to find experts who have dealt with this condition before. Disfigureing surgery is not an option I take lightly, and I don't think the Dr's i've seen understand the root cause - they just want to address the symptoms. I've always felt that a stent type of device would work, but they won't consider it.
Please advise.
I'm not comfortable being a science experiment for a urologist since none of them can diagnose this specifically, let alone have vast experience with the operations they propose.
I would like to find experts who have dealt with this condition before. Disfigureing surgery is not an option I take lightly, and I don't think the Dr's i've seen understand the root cause - they just want to address the symptoms. I've always felt that a stent type of device would work, but they won't consider it.
Please advise.
Doctor's Answer
by Kevin Pho, MD, Apr 30, 2003 12:00AM
, Apr 30, 2003 12:00AM
Hello - thanks for asking your question.
Urethral stents are indeed an option for strictures. However, they are not right for everyone and it depends on the type of stricture you have.
Permanent urethral stents are endoscopically placed. Stents are designed to be incorporated into the wall of the urethra and provide a patent lumen. They are most successful in short-length strictures in the bulbous urethra. Complications occur when a stent is placed distal to the bulbous urethra, causing the patient pain while sitting or during intercourse. Other complications involve migration of the stent. This procedure is contraindicated in patients with dense strictures.
Other surgical options include internal urethrotomy which involves incising the stricture transurethrally using endoscopic equipment.
Primary urethral repair is another option. This involves complete excision of the fibrotic urethral segment with reattachment.
Again, the type of surgical procedure depends on the type and location of your stricture. Your prior urologists may not have considered stent therapy because of the nature and position of your stricture.
To find a urologist near you here is the American Urological Association website:
http://www.urologyhealth.org/find_urologist/
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.
Thanks,
Kevin, M.D.
Urethral stents are indeed an option for strictures. However, they are not right for everyone and it depends on the type of stricture you have.
Permanent urethral stents are endoscopically placed. Stents are designed to be incorporated into the wall of the urethra and provide a patent lumen. They are most successful in short-length strictures in the bulbous urethra. Complications occur when a stent is placed distal to the bulbous urethra, causing the patient pain while sitting or during intercourse. Other complications involve migration of the stent. This procedure is contraindicated in patients with dense strictures.
Other surgical options include internal urethrotomy which involves incising the stricture transurethrally using endoscopic equipment.
Primary urethral repair is another option. This involves complete excision of the fibrotic urethral segment with reattachment.
Again, the type of surgical procedure depends on the type and location of your stricture. Your prior urologists may not have considered stent therapy because of the nature and position of your stricture.
To find a urologist near you here is the American Urological Association website:
http://www.urologyhealth.org/find_urologist/
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.
Thanks,
Kevin, M.D.
Member Comments
by YELLOWCAKE13, Jul 25, 2008 10:28AM
A related discussion, kidney cysts was started.
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