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Urology (Expert Forum)
Uritheral Stricture
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
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.
Uritheral Stricture
by thede, Jul 14, 2004 12:00AM
My prostate cancer was cured with radiation but the side effects have been a problem. For example, I am currently dealing with both retention and incontinence problems at the same time. One Urologist performed a TURP to open up the system and considerable incontinence followed. Also a uritheral stricture has caused a daily retention problem for me. At least four dialations have been performed over the past six monthes and they help for a few weeks. Then its back to self-cathing from 1 to 4 times a day. I have also had several infections that have to be handled for my long term health benefit. My Uro now recommends a Urethrotomy where a couple of cuts will be made in the stricture to open it up (a 50/50 chance of success). He also states that in order to have a chance of success he will need to cut into the area that controls urination and this will make me even more incontinent. Further after about five months a determination will be made on the success or failure of the stricture surgery. If successful they would then implant an artifical sphincter to control the incontinence. I have two questions: Are aggressive approaches like this generall successful and are artifical sphincter's effective long term solutions?
Doctor's Answer
by Kevin Pho, MD, Jul 14, 2004 12:00AM
, Jul 14, 2004 12:00AM
Urethral strictures can be a difficult problem. The success rate would depend on the experience of the surgeon performing the procedure.
The artificial urinary sphincter is an implanted device designed to treat urinary incontinence. The most common complaint in men is incontinence following prostatic surgery (radical prostatectomy or transurethral resection). In patients with significant incontinence, the artificial sphincter is the only treatment with a reasonable chance of success.
Another consideration would be urethral reconstructive surgery. In some cases, the urethra is reconstructed by removing the scar tissue and then suturing the ends of the urethra back together. When this is not possible, the urethra may be rebuilt using buccal mucosa (the lining of the inside of the cheek) or skin flaps from the penis or scrotum. Using these techniques, the urethra can be reconstructed in most cases with a long-term success rate of 85-95%.
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.
Medical Weblog:
kevinmd_b
The artificial urinary sphincter is an implanted device designed to treat urinary incontinence. The most common complaint in men is incontinence following prostatic surgery (radical prostatectomy or transurethral resection). In patients with significant incontinence, the artificial sphincter is the only treatment with a reasonable chance of success.
Another consideration would be urethral reconstructive surgery. In some cases, the urethra is reconstructed by removing the scar tissue and then suturing the ends of the urethra back together. When this is not possible, the urethra may be rebuilt using buccal mucosa (the lining of the inside of the cheek) or skin flaps from the penis or scrotum. Using these techniques, the urethra can be reconstructed in most cases with a long-term success rate of 85-95%.
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.
Medical Weblog:
kevinmd_b
