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Recently had a Urethroplasty done..
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Recently had a Urethroplasty done..

I recently had to have Urethroplasty done. I had a catheter in for 16 days, had it removed 3 days ago. Ive noticed that when i get an erection, it hurts to have it in any other position than down. As if the catheter was still in? Also (not sure what the term is) with the erection, i can no longer flex my tip of penis? And my last question, my testicle skin has been very painfull if touched, or moved. It is even stretched out as if they used a prop to hold em up. (im sure they did have something like that) will they become less stretched out over time? And why is my skin hurting? Will this also go away? My urologist didnt seem concerned. But then again he was in a rush to get to another call. He said it was because of the cathiter and would go away over time. Ive had a catheter in the past and neither of these were side effects then. Whats up with this?
~Thanks in advance
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Avatar_m_tn
Hey! Just had a urethroplasty myself three weeks ago and I'm experiencing similar symptoms. My erections are painful no matter the position, but it's bearable. Nocturnal tumescence or erections definitely keep me awake due to the discomfort. I also can't flex the tip or glans (glands) of my penis or rather achieve a full erection, but my doctor says this is normal. The erectile pain is due to the trauma of surgery, not so much the catheter. I've also had catheters in before and never had this pain. The use of clamps and stretching during surgery, not to mention the urethroplasty itself, and accompanying bruising are likely to blame. I have dark black-purple bruises in bands around the base of my penis, kind of a stripe effect, and general bruising everywhere except the glans (glands).

The scrotal swelling, bruising, pain and tenderness is to be expected due to the surgical trauma in nearby tissue, in addition to the clamps used to keep the scrotum stationary and out of the way during surgery as you guessed. This is a very sensitive area after all. My pain is improving day by day, but it's definitely still there. I have noticed some stretched or saggy skin on the scrotum and penis, but it seems to be improving.

Hope this helps and I have a question for you -- how is your erectile length? Is the length of your erection the same as before the surgery? Mine is only about 50-60% of what it was before. I asked the doctor, but he didn't seem concerned and said it should return to normal within 6 months, but I admit I'm a bit worried. Here is my full post:

http://www.medhelp.org/posts/Urology/Penile-Shortening-After-Urethroplasty/show/1704162#post_7795168

How are you doing now otherwise?

Sorry about the stricture and the trouble you've gone through -- I wish you a speedy and full recovery!
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Avatar_m_tn
Hey! Thank you so much for the reply. It's a huge relief to know I'm not the only one. It's been about 5 weeks since the surgery and I still have pain in general and during erections. Same here, the pain with erections is more in the urethra than anywhere else.

Glad you mentioned about the weird testicle pain that gets better, then worse -- I have exactly the same thing! For example, there was a day only a week after surgery I felt no testicle pain at all, and then it returned with a vengeance ever since. Overall, the testicle pain is getting better, but I'll suddenly have a painful spot in a new area out of the blue (no pun intended) for a few days. And, just last night, I experienced a sharp shooting pain worse than any of the soreness so far, but it came and went in a flash. I wasn't even moving at the time, just laying here like always. Like you said, weird.

As far as erection length, mine *seems* like it may be improving a little, but it's still not back to normal. I'd say maybe 70-80%. Let's keep our fingers crossed, I'm hoping this is very temporary for the both of us. And, slowly but surely I'm able to flex it again somewhat -- not fully yet -- though I try to avoid it, so I trust this will return for you as well. At first, I also could not flex at all.

Yeah, please let me know what the doctor says at your followup!! I have my next checkup in five months, so if it's not back to normal by then, I will ask again and report any news back to you. Let's stay in touch either way, I'd like to know how you're improving. It's almost like we're in this together, you know, going through the same thing at the same time and it's a little easier that way.

It's good you mentioned the bright side, which is where we should both be looking. ;) Yes! I'm happy your flow is stronger than ever. Mine overall is much better than ever as well! As long as I can remember, even as a kid, my flow was always pretty weak, but I just thought that was normal for me. At urinals, other guys' flows were always quicker (they'd finish before me) and louder. Geez. I guess my weak flow was a subtle symptom of the stricture all along.

Surgery, in particular penis surgery (!), is no fun at any age, let alone 18! :/ Look at it this way, at least you're taking care of it early and I'm hoping you'll be totally trouble free and back in the saddle again in no time for the rest of a very long and happy life. My stricture has been really bothering me for about 10 years now, it was misdiagnosed as a few different things over time and only the symptoms were treated. The worst was getting up 3-6+ times a night to go to the bathroom. I'd forgotten what a good night's sleep and being well rested even felt like, to say the least. I hope those days are behind both of us -- for good!
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Avatar_m_tn
I was searching the internet for topics like this because I am in the process of scheduling surgery with my doctor.  I plan to meet with the plastic surgeon next week.  I have had a stricture problem since I was a teenager.  I am now in my 40's and think it's time to do something about this problem.  As you know this has been a frustrating problem that I have dealt with for a long time.  I wanted to know how has things been for you since your last post in March?  I am really nervous, but somewhat excited to have this surgery.  Thanks for sharing your experience with this surgery.  It really gives me some hope.  Thank you.  Hope all is going well.

slrray524
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Avatar_m_tn
I was searching the internet for topics like this because I am in the process of scheduling surgery with my doctor.  I plan to meet with the plastic surgeon next week.  I have had a stricture problem since I was a teenager.  I am now in my 40's and think it's time to do something about this problem.  As you know this has been a frustrating problem that I have dealt with for a long time.  I wanted to know how has things been for you since your last post in March?  I am really nervous, but somewhat excited to have this surgery.  Thanks for sharing your experience with this surgery.  It really gives me some hope.  Thank you.  Hope all is going well.

slrray524
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Avatar_m_tn
I'm glad I found this topic online. I was in a car accident in may of this year with a result of tearing my urethra away from my bladder. I recently had this surgery and I am experiencing the exact same symptoms. My erections wake me up all the time. I had my surgery a few Weeks ago, November 19 2012. My erections aren't full yet either only 50-60%. Lol this is one of theharder things I've been dealing with. 21 years old with the fear of ED for the test if my life. The way I've damaged my pelvis in the wreck would make it challenging to get an erection let alone maintain  one.  I'm glad I'm not going through this alone. I'm glad to see the answers to a few of the questions I've had about pain and erections. Good luck guys, I wish all of you a speedy recovery!
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Avatar_m_tn
Good luck to your recovery.  I hope everything works out for you.
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Avatar_m_tn
Hi All

I went through a buccal mucosa urethroplasty operation just over 6 weeks ago and thought I'd contribute my experiences.

I was in hospital for 4 days in total and was discharged with a stented urethral catheter and a suprapubic catheter with leg bag for 3 weeks.  The scrotum was quite badly swollen for a few weeks but didn't seem overly sensitive at this point.

I went back to hospital for a pericatheter urethrogram (x-ray) which seemed to suggest that the graft was watertight and so after some flow tests etc, both catheters were removed the same day.  The urethrogram and catheter removal was an unpleasant experience but one which you just have to grit your teeth and bear.

Unfortunately, at home, I picked up an infection and so was given antibacterial drugs which seemed to clear it up.

I had similar problems with nocturnal erections which were very painful (both with and without the catheters) and would wake me up.  If I fell back to sleep within 15 mins or so, I would be right back into REM sleep and dream again, only to be woken up again with erectile pain. Despite some beta blockers prescribed by the Doc to reduce the likelihood of erections, only time has really helped with this. I still get some mild discomfort (but less frequently - perhaps once a night), but its less painful each time.

It looks as though I still have some bruising and I have an extremely delicate spot (about the size of a 50p) under my left testicle.  The scrotal skin itself is very sensitive to the touch and gets uncomfortable if I've been walking for about 30 mins.   There is also an area  which is a little numb but I think this is shrinking.  I am surprised that the bruising and pain is still present over 6 weeks later and am not sure how long this will take to go away completely.  I take comfort from the fact that it does seem to be getting better, albeit slowly.

I have also suffered some post void dribbling (anything up to 30 mins after going) which I never had before the op.  This is becoming less of an issue with time and I am practising some pelvic floor exercises to strengthen up the muscles around the bulbar urethra which assist in the post voiding process.  I am hoping this will all but disappear in time but would like to hear if anyone else has this issue?
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Avatar_m_tn
Hey gg300!

About the post void dribbling: yes, I noticed this problem too after surgery. Even up 15-30 minutes post void, like you pointed out. As you also noted, it has improved with time, but for me has not resolved completely after almost 1 year. What I've done and what I suggest is to allow more time for voiding, essentially wait a while and allow for urination even after your bladder feels completely empty. In addition, I've become much more thorough, but gentle, in digitally voiding any urine that may remain in the urethra after primary urination... in other words, taking more time and care in "shaking it off." Likewise, I'll change my body position and move around a bit, this seems to help get the last bit out. Again, these measures have not completely eliminated the dribbling, but they do help as I no longer have cases where I basically **** myself after having just gone to the bathroom, especially awkward at the office!

About the testicular bruising, pain, tenderness, etc, even after a long time: yes! It's just about all gone for me at 11 months, but at 6-8 months it was still noticeable, depending on activity, etc.

I've posted more about it here:

http://www.medhelp.org/posts/Urology/Penile-Shortening-After-Urethroplasty/show/1704162#post_7795168

Hope this helps! Apologies for the delayed reply. Wish you a full recovery -- good luck.
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Avatar_m_tn
Hi there Lothson...and thanks for replying.  Its good to know that my experiences are not that unusual.  

I've found that twisting my waist helps to get rid of any residual dribble but its not 100% reliable so I end up putting a couple of squares of tissue down there just incase.  Its a real issue if I've been sitting whilst urinating (eg after a number 2).. Quite a lot of residual can drip out when I stand up again (sorry for being so descriptive, but that's what its like).  I am aware of the digital milking technique but I think I'll leave it another month as I'm still a little tender along the scar left from the op when I press it.

The testicular pain is really weird.  One side is absolutely fine but the other (left side) is still not right.  It IS getting better but its SO slow, this part of the recovery.  I was not warned about this, were you?  It's not agony but it can be sore and is definitely uncomfortable...it aches by the end of the day, then feels fine again in the morning.  I guess its just the fact that I've been moving around during the day in trousers etc that inflames things slightly.  Its interesting to hear that you had this for 8 months post op. You'd think that would heal quickly, like a vasectomy but obviously not.

Did you have any scrotal numbness at all?  I have a small area (about the size of a fingernail) which is numb - it seems to be quite smooth too.  I suspect this skin was stretched during the op but am wondering if I'll ever getting the feeling back - not that its a huge problem.  Its just a bit weird and, again, I wasn't warned about this.

I also ended up with a particularly persistent haemorroid over the Xmas period just to add to the fun, but thankfully this has finally cleared up.  This was probably because of all the pelvic floor exercises I did at the time and the clenching and tensing up I used to do when sitting in the car or on a hard seat...lol.
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Avatar_m_tn
Hi gg300! Thanks for the tip about twisting, much obliged. Likewise, I also experience more dribbling after seated urination. Yes, give yourself plenty of time to heal and then some and always be extra gentle.

Agreed that the testicular pain, then soreness, was more severe and longer in duration than expected or that I was warned about.

Did I experience scrotal numbness... not that I can clearly recall, to be honest, sorry. I was not warned about the possibility.

My doctors did reiterate that full healing could take up to a year or more, so perhaps that warning is meant to cover things like soreness, numbness, etc.

Glad to hear that the hemorrhoid cleared... those can be a pain, and you don't need any more of those, especially not at the holidays. Definitely take it easy and I wish you continued improvement and good health!
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5829074_tn?1375038508
I am really glad to have found this thread! I had end-to-end urethroplasty about 12 days ago, and from the research I've done, expected to be fairly pain-free within a few days. But I've had a lot of scrotal and testicle pain. It wasn't until I found this thread that I felt a sense of relief about it, since it seems to be common. Plus, I learned this was caused (almost certainly) by the device used to hold the scrotum during the surgery. Anyway, I'll be posting back here as my recovery proceeds Thanks again soo much for sharing your experiences!

Ken
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Avatar_m_tn
I was told by the first specialist I saw that given the very short length of my urethral stricture, a simple urethrotomy would suffice.Now a 2nd urologist, very prominent in his field, has told me the use of a buccal mucosal implant will give far lower chances of recurrence (I am 64). I have 2 questions:
1. Has anyone had either  procedure on a very short section of their urethra - interested to hear about post-op recovery experiences, &
2. What are the after-effects on the mouth (eating, drinking, hot liquids, etc.)  of having the mucosa extracted - I have not seen any commentary on that; does any discomfort disappear within a week? Or have people experienced lingering after-effects?
Any advice welcome.
Nick
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5829074_tn?1375038508
Nick, The problem with urethrotomies is that they have a pretty low long-term success rate (somewhere between 33 and 50 percent depending on what studies you read). The general consensus among urologists these days is that urethroplasty is the gold standard for long-term success (reported at over 90%). But if your stricture is small enough, you may well not need to have a buccal graft. They don't always know for sure until they open you op and look at the urethra and stricture, but for end-to-end surgeries on small strictures, often no graft is needed. When I woke up, the first thing I did was run my tongue over my cheeks to see if they had taken tissue. They hadn't:).

Post-op experiences from several folks I've talked with and whose stories are in this thread report a pretty long period of time where there is lingering pain in the scrotum/testicles - likely due to the retraction during surgery. Almost to a man, folks said they were not warned of this. I am in that category also. If they have to take buccal tissue, I understand it is uncomfortable for a few days after surgery, but heals quite quickly.

My surgery was a great success in that my 10-week follow-up showed a very strong flow - the best in my life, actually. The doc also examined my testicles and surgical site (perineum) and said things were healing up just fine, and that my testicle pain was probably just due to the retraction and would go away eventually. But this was the 10-week point, so it has lasted quite awhile already. He recommended wearing a jock strap during the day, which I started doing over this past weekend, and I think it is working!

I hope that helps!

Ken
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Avatar_m_tn
Hi Ken,
Many thanks for your input - esp. pointing out that a decision to take buccal tissue might even be made during surgery ( but I think I'd have to pay for the guy who does that job whether he intervenes or not:~) I'm about to talk with y surgeon via FaceTime, as we are 7000 miles apart. He should have urethrogram pictures and a CD-ROM of the ultrasound exam I had here in HK.
It sounds as though your strciture was quite short, too, given that they didn;t use the buccal mucosa, so I guess  should expect a simelar length and degree of "afterburn".
I will come back on here to report my experience, sometime in Jan 14.
Best regards,
Nick
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Avatar_f_tn
Ken, i just joined here. I had a Urethroplasty on 23/09/2013 on a 1.5 cm stricture and there was a buccal mucossa. The incision is now fine, the urine flow is big and impressive but there is some pain at the end of it. My Urology Doctor said it is because of the catheter ( removed a week ago). The scrotum is still tender and itchy.
In the mouth, the stitches are not yet eaten up by the skin as i was told by the Doctor.There is less pain there but i eat using one side.

Now, kindly help. From your experience, what is the recommended time to resume sexual activity once the catheter has been removed?

Thanks,

Bernard
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5829074_tn?1375038508
Bernard,

I had heard something like 6-8 weeks before resuming sexual activity. But since I'm still having pain 14 weeks later, and have an inguinal hernia to boot (surgery in 2 days for that), I'm still not back in the game, as it were.

Are you still having the scrotal pain?

Ken
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Avatar_m_tn
Hi Bernard,

I am scheduled to have BMG urethroplasty on December 10th, I to have a short proximal bulbar stricture (2 cm or less) and was advised that this was the better option even though my stricture is short because of the lower risk of sexual complications (doc says it runs near zero). Was this the same argument that your doctor used to support the use of a buccal mucosa graft? Did he place the graft ventral, doral or lateraly? Is pain still an issue today?

Hope to hear back from you.

Regards,

Daniel
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Avatar_f_tn
Thanks Ken. I still feel scrotal pain though mild now. It comes with some teasing pain near the site especially when i am driving or sit a bit long in office. The healing seems to be steady but i am still under treatment for a UTI detected after the the catheter removal.

Regards,

Bernard
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Avatar_f_tn
Hi,
Pain is no longer a big issue today. Yeah, that was the argument. Due to the erectile pain i experienced with a catheter on, i had fear of erections even after the removal of the catheter. I thought it would still be painful even during coitus. I am waiting for the uti to clear and then i see how it shall be when i have to fulfill my manly roles.

Otherwise, i wish you all the best and hope to read your comment after the op.

Regards,

Bernard.
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Avatar_m_tn
Thanks Bernard for the good wishes, counting down the days to the BIG day!! I am one of those people that wishes to avoid surgery and medicine at all costs unless it is absolutely necessary.  However, now its time to take this in and let the river flow.

Just curious, how is your cheek doing 8 weeks post surgery? Did you get treated in Detroit by any chance? I hope you have your UTI under control now.

Warm regards,

Dan
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Avatar_m_tn
Hi

Nice to find some guys recently or currently dealing with urethroplasty.  I had a buccal mucosa urethroplasty 20 days ago.  I spent 3 days in hospital then 3hr ride home.  In addition to urethra repair, I had a vasectomy at the same time.  I am almost 3 weeks post-op and still have scrotal pain.  It is a dull ache with stabbing pains while walking.  The incision site has healed on the outside, but feels like I am tearing myself apart during the process of standing up or laying down.  

I started looking up pain following vasectomy and pain following urethroplasty today to see if it is normal to feel it 3 weeks into recovery.  Sounds like I am not alone and have some more weeks of pain to look forward to.  

I have a post-op visit with the urologist in 17 days.  He wanted the Foley in for 5 weeks for healing.  I have not had  a catheter for this long before and I am counting down the days to have it removed.  

My mouth is healing.  Still feels stiff on that side of mouth and numb at my lip.  The elasticity seems to be getting better but will probably take quite a bit of time to get to normal, if it will get to normal.  Meanwhile, I chew food on left side of mouth.  

I have prayed that the stricture problem is resolved for good and the surgery was a complete success.  I really don't want to do anything like this again.  

Continued successful recovery for you guys
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Avatar_m_tn
Hello
I'm in my seventh week after urethroplasty, and my scrotom area inches all day.any suggestions what I should do
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Avatar_m_tn
Hello
I'm in my seventh week after urethroplasty, and my scrotom area inches all day.any suggestions what I should do
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5829074_tn?1375038508
I'm assuming you meant "itches" all day? If so, then I'd say it's probably a good sign. Itching is often a sign of healing. But different folks may feel different things down there due to all the tissue damaged cut and cauterized, etc. I still have lingering pain 10 months after surgery though now it's much less than before. I was told by my doctor that it could take up to a year for that to go away. I think it's just the nerves in there doing weird stuff. I've been THOROUGHLY examined down there by serval doctors just within the past 3 weeks. All of them say that there is nothing abnormal. So it's just the nerves I guess. Weird stuff. Hang in there, though. It does get better.

Ken
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