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Urethroplasty patient experiences/updates
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Urethroplasty patient experiences/updates

Dear All,

I've recently joined medhelp looking for some insight into patient experiences regarding their urethroplasties.  I've noticed that many on medhelp have had this procedure done and would really appreciate some feedback.  I've been diagnosed with a 1-2 cm stricture (urologist says retrograde urethrogram isn't 100% accurate in predicting lenght of stricture) in the bulbar portion.  Now i'm scheduled for a possible urethroplasty (probably anastomotic) in december and would like to learn about how patients who've had this procedure done are doing.  My questions are:

How did you feel immediately after the procedure?  Pain, discomfort

How long were you bed bound after the procedure?

How cumbersome was having the catheter placed for 2-3 weeks?

How long did it take you to return to normal life activities?

How is your urine flow NOW compared to prior to surgery AND compared to just after surgery?  Any dribbling, any other issues?

How is your sexual function NOW(e.g. penile sensitivity, ejaculation speed, retrograde/stasis of semen)?  Did anyone have any sexual dysfunction that slowly resolved?

If you've had the anastomotic urethroplasty (where the diseased portion is excised and the remaining portions joined), have you ever felt any tension in your penis during an erection?

In what area of the country did you have the procedure done? ( you don't have to answer this, I'm in the nyc area and am getting it done there)



I know i've asked a ton of questions but I'm just anxious about this procedure.  I'm sure most of you can understand the anxiety.  I've never had any procedure done before.

If you don't feel comfortable answering here, feel free to send me a private message.  I eagerly await all responses.

Thanks and God Bless!!
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Avatar_m_tn
Can you update answers to your questions so that i would benefit people like me who are planning to undergo one.
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Avatar_m_tn
I'm six weeks post my second buccal graft urethroplasty, the first one failed... and just ran across this website and thought I'd answer some of these questions from my point of view...

How did you feel immediately after the procedure?  Immediately after, something called Dilautid was absolutely heavenly.  Within about 12 hours, the pain was fairly intense, but I wouldn't have called it a "10" on the pain scale.  By 48 hours, I lost the IV and was able to be fairly comfortable with oral Vicodin only.

How long were you bed bound after the procedure?  24 hours.  Despite my objections, the doc and nurses insist I get up and walk down the hall.  

How cumbersome was having the catheter placed for 2-3 weeks?  Not as bad as you think.  Sleeping *****, only because I could either lie on my back or 'sort-of' on my side.  The lack of freedom to roll around was as bothersome as anything.  I was really intent on keeping that tube sloping down to prevent bladder spasms.

How long did it take you to return to normal life activities? It takes a while...  After my first, probably about 3-4 months.  I'm at six weeks after this second one, and just started back to work (at a desk job) this week.  Every day, I've come home and needed a nap.

How is your urine flow NOW compared to prior to surgery AND compared to just after surgery?  Any dribbling, any other issues?  Flow is good, hard to quantify, but good.  Prior to surgery, both times, I had real concerns about going into retention and needing an 'emergency' SP tube, so to say the flow is better is an understatement.  I had some dribbling after the first one, and still have some dribbling now, maybe a little more.  It's a little inconvenient, but liveable.  I asked my wife's advice on what type / size of pad she recommended.  I took her up on it, and it's not much of an issue, to be honest.  I understand that a lot of 40-ish men have some dribbling, stricture patient or not.

How is your sexual function NOW(e.g. penile sensitivity, ejaculation speed, retrograde/stasis of semen)?  Did anyone have any sexual dysfunction that slowly resolved?  After first surgery, I didn't have any change in any of these, in fact, erections while sleeping with the foley were really uncomfortable.  This time around, I think ED might be an issue.  I'm hopeful that it'll return slowly, and that if it doesn't some pharmaceutical assistance will help.  This is a risk I accepted, but I hope it's temporary.

If you've had the anastomotic urethroplasty (where the diseased portion is excised and the remaining portions joined), have you ever felt any tension in your penis during an erection?  I think my first one was augmented anastomotic, where some tissue was removed.  I never noticed any tension.

In what area of the country did you have the procedure done? ( you don't have to answer this, I'm in the nyc area and am getting it done there) I had the first one at the University of Connecticut Health Center in Farmington, CT.  The second one was at Lahey Clinic in Burlington, MA.  I highly recommend Lahey, they have a surgeon who does only lower GU tract reconstruction (Jill Buckley is her name).
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Avatar_n_tn
Dear all. There are a lot of posts for USA and I just wanted to post up some info for those people in the UK.

I underwent urethroplasy 4 weeks ago. I had a 3cm stricture so they took a 4 cm graft from the inside of my mouth. Having gone from 3ml per sec to now 24ml per sec (at least), I have absolutley no regrets whatso ever... except for not getting it done sooner. I have to have a follow up flow test at 3 months and at 12 months but the average success rate for all procedures for this particular surgeon is around 90%. It's a no brainer. My life is significantly better. I sleep better, don't wory about getting caught short for the toilet, and can drink a good amount of water without the fear of wetting the bed when asleep. If all goes well, I also won't have to worry about further treatments for a longtime.

To answer the questions above (belatedly but might be useful to others) :


How did you feel immediately after the procedure?  Pain, discomfort: RELIEVED IT WAS OVER, HIGH ON MEDS AND O2, NO PAIN IN MOUTH, VERY LITTLE PAIN BELOW. LAUGHED A LOT.

How long were you bed bound after the procedure? 2 DAYS IN HOSPITAL THEN 2 DAYS AT HOME (ALTHOUGH I DID GET UP A FEW TIMES). ON DAY 5 AFTER THE OP I WAS UP AND ABOUT AND DOING LIGHT CHORES AROUND THE HOUSE ALTHOUGH I DID FEEL WEAK

How cumbersome was having the catheter placed for 2-3 weeks? HMM. 1ST WEEK WAS TOUGH. THE END OF MY PENIS WAS VERY SENSITIVE AND THE NOCTURNAL ERECTIONS WERE... DIFFICULT. THE SUGGESTION ABOUT USING KY JELLY ON THE AREA OF CATHER BY TIP OF PENIS HELPS BUT ONLY ABOUT 50%. YOU NEED TO PULL YOUR FELLA BACK AS FAR AS POSSIBLE ALONG THE TUBE THEN APPLY THE GEL. GIVE YOURSELF PLENTY OF SLACK ON THE CATHETER TOO. BY WEEK 2 I HAD FOUND THE RIGHT PLACES TO STRAP THE LEG BAG FOR DAYTIME AND NIGHTIME USAGE AND MOVING AROUND THE HOUSE WAS FINE. SOMETIMES I EVEN FORGOT I HAD A CATHETER (!!)

How long did it take you to return to normal life activities? BY WEEK 2 I WAS FINE TO GET AROUND THE HOUSE. ONCE THE CATHETER CAME OUT I WAS STRAIGHT OUT THE FRONT DOOR AND WALKED INTO MY VILLAGE. IT'S NOW 4 WEEKS SINCE OP AND I STILL GET MILD FATIGUE FROM WALKING ABOUT BUT I'M BACK TO WORK. WILL START GOING BACK TO GYM NEXT WEEK, ALBEIT GENTLY

How is your urine flow NOW compared to prior to surgery AND compared to just after surgery?  Any dribbling, any other issues? MAGNIFICENT!!! I AM A GOD AMONGST MEN. FINGERS CROSSED THAT IT STAYS THAT WAY ALTHOUGH SPLASHBACK IN URINALS IS A PROBLEM IF I'M NOT CAREFUL (JOKE). AS FOR DRIBBLING, I THINK I'M FINE. I GOT CAUGHT OUT A COUPLE OF TIMES THE DAY AFTER THE CATHETER WAS REMOVED. I'M NOW VERY CAREFULL TO 'SQUEEZE' THE LAST DROPS OUT USING THE PERINEAL MUSCLE/PELVIC FLOOR MUSCLE THEN GIVE IT A GOOD SHAKE. SINCE THEN NO PROBS ALTHOUGH I DO SHOVE A PAPER TOWEL DOWN THERE JUST IN CASE. I INTEND TO DO LOTS OF PELVIC FLOOR EXCERCISES TO HELP MATTERS.

How is your sexual function NOW(e.g. penile sensitivity, ejaculation speed, retrograde/stasis of semen)?  Did anyone have any sexual dysfunction that slowly resolved? ERECETION, CHECK. SENSITIVITY, CHECK. SEMEN...WTF!!! DO NOT, WHATEVER YOU DO HAVE SEX OR MASTERBATE FOR AT LEAST 4 WEEKS AFTER THE CATHETER IS REMOVED. I TOOK MY FELLA FOR A TEST DRIVE 2 DAYS AFTER REMOVAL AND MY SEMEN HAD SO MUCH BLOOD IN IT TAHT IT LOOKED LIKE TOMATO KETCHUP. THE SURGEON SAID IT'S TO BE EXPECTED AND TO LEAVE IT ALONE!

If you've had the anastomotic urethroplasty (where the diseased portion is excised and the remaining portions joined), have you ever felt any tension in your penis during an erection?
HAD A GRAFT SO NO EXCISION. ERECTIONS DO FEEL TIGHT THOUGH ALTHOUGH I'M TOLD THAT WILL EASE UP.


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Avatar_n_tn
> How did you feel immediately after the procedure?  Pain, discomfort

I had urethroplasty using buccal mucosal grafts, taken from both sides of my mouth to treat two strictures (an acquired stricture from previous urethrotomy attempts, and the original stricture that had never given me any trouble before the first urethrotomy).

Mouth quite painful for a while; I put food in the blender and didn't really eat solid food for a couple of weeks.

Perineum moderately painful. I would move carefully. I wouldn't want to go right back to work and sit in an office chair all day.

> How long were you bed bound after the procedure?

1 day in hospital, went home next day.

> How cumbersome was having the catheter placed for 2-3 weeks?

It's an inconvenience. Doesn't stop me sleeping or walking. I didn't go to work during that period.

But this was not the first time for me, because I had to go through all that before after the original urethrotomy.

> How long did it take you to return to normal life activities?

Don't remember exactly now; my urethroplasty was five years ago. I phased back into work after maybe four weeks. Possibly could have shortened the time if I was under demands from employer, but lucky for me I had it easy.

> How is your urine flow NOW compared to prior to surgery AND
> compared to just after surgery?  Any dribbling, any other issues?

Urine flow is has been good ever since (five years). I'm very pleased with the result, and would've had urethroplasty before if I'd known about it.

Dribbling other issues: I acquired them from the original urethrotomies years before. Urethroplasty can't fix that, I'm afraid.

> How is your sexual function NOW(e.g. penile sensitivity, ejaculation
> speed, retrograde/stasis of semen)?  Did anyone have any sexual
> dysfunction that slowly resolved?

The original _urethrotomy_ destroyed my sexual function.
Spontaneous erections stopped altogether.
Stimulated erections are weak, transient, unreliable.
Ejaculation speed is zero - I can come, but the semen remains sequestered in the urethra.
Penile sensitivity is severely reduced.
Orgasm sensation: lost 95% or so.

After that, I really didn't have to worry about the risks from urethroplasty. Morning erections have actually improved a bit; no effect otherwise.
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Avatar_f_tn
Gentleman, I'm 36 yrs old.  9 weeks post-op.  Flow is great!  Erections...still getting used too.  Intercourse... i tried it tonight and could not ejaculate - WTH!  I've read some other posts and they have helped.  BOTTOM LINE:  I'd do this again.  I've been dealing with strictures for 20 years now.  I guess i just need to give it some more time.  Good luck to you all.  
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Avatar_m_tn
I've just had the op for a bulbar urethral stricture.  Got an abdominal (sp) catheter draining the bladder and a urethral catheter which is blocked off and supports the buccal mucosa graft.  

I'm fine with the management of the abdmonial catheter that drains but am unclear, even after medical advice, whether its worth changing the stopper on the urethral catheter?  This would release any pooled urine but could increase the risk of infection.

I can see that either option poses a risk but would be interested in your views.
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Avatar_m_tn
Got a conclusive answer to my question from a senior urology doctor - the spiggot should not be removed and the urine will not be a problem for such a short period of time.

I hear that I've to get a pericatheter urethrogram in a couple of weeks - having Googled this it appears that an additional small bore catheter is inserted a few cms into the penis and dye injected under pressure to check for leaks - yikes, another catheter?  Is there any more room in there?  If no leaks, then they will remove the urethral and sp catheters.

Has anybody undergone this procedure and if so what was your experience like?
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Hello Flowing Freely,

I just recently had urethroplasty on 11/28/12.  I have been dealing with strictures for well over 25 years.  This has been a very frustrating problem to deal with.  I had a piece of tissue from the inside of my mouth used to help fix the stricture.  I really didn't have too much pain down below.  I have had more discomfort inside my mouth.  It is getting better every single day.  It's a little uncomfortable wearing this cathedar for 3 weeks. I can't wait for it to come off. I pray everyday that my surgery is going to be successful. In a couple of days I am going back to get the dye test to see if my surgery is healing.  Can you let me know how you have been doing since your surgery back in 2011?

Is your flow still normal?

Any post problems since your cathedar has been removed?

I have tried to contact via email several other patients with similar issues.  Nobody has responded back with updates.  Anything you can do to share your updates with me would be greatly appreciated.  Thank you.
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Hello Timtalton,

I just recently had urethroplasty on 11/28/12.  I have been dealing with strictures for well over 25 years.  This has been a very frustrating problem to deal with.  I had a piece of tissue from the inside of my mouth used to help fix the stricture.  I really didn't have too much pain down below.  I have had more discomfort inside my mouth.  It is getting better every single day.  It's a little uncomfortable wearing this cathedar for 3 weeks. I can't wait for it to come off. I pray everyday that my surgery is going to be successful. In a couple of days I am going back to get the dye test to see if my surgery is healing.  Can you let me know how you have been doing since your surgery back in 2010?

Is your flow still normal?

Any post problems since your cathedar has been removed?

I have tried to contact via email several other patients with similar issues.  Nobody has responded back with updates.  Anything you can do to share your updates with me would be greatly appreciated.  Thank you.
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Hey slrray254! I myself had a urethroplasty done back in January of 2012. So far the surgery has been a complete success for me. However, this surgery does come with some possible side effects. After my surgery my penis has shortened, along with not being able to use my penile muscle during an errection. Now nearly a year later I am just barely able to use these muscles. My Urologist had told me the muscle could possibly be permanentlt damaged. So this surgert does come with a pretty long recovery time frame.

My flow after getting the cathedar removed after the 3 weeks was extremely strong. It eventually faded out to becomming a "normal" flow once again.

Not going to lie, I was a bit scared to urinate for the first time after the cathedar was removed. But it all went smoothly, and no problems had/have occured since it was removed.

My best wishes for a quick a speed recovery go out to you.
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Avatar_m_tn
I am a 26 year old who had a bulbar urethroplasty in December 2012. Everything is working fine: erections, urine flow and it healed really good. I did not have a graft inserted though. Only a short stretch (1cm) was removed. The only problem I'm having is that I cannot ejaculate. I am really worried as I don't have any kids yet and would like to start soon. Should I be worried or is this normal for this type of procedure? Thanks
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Hi gg300, it is three and a half months since your procedure almost, and I am going under for the same thing in three weeks. Is that smaller catheter they injected the dye in your urethral graft painful going in, or was that an anesthetized  procedure as well?

Also, now that its been a few months, if ya don't mind my curiosity, are you able to achieve a semi-normal erection? More curious, do you have retrograde or normal ejaculation? I am worried about the possibility I'll continue to send them retrograde, as I do now, even after I have the graft. Please let me know.
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Avatar_f_tn
*I meant 2.5mo, but at any rate, I'd still appreciate info. Thx.
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Hi.  Best of luck with your op.

The small bore catheter for the urethrogram isn't too bad - they numbed the area with a swab.  Its uncomfortable but not painful.  To prevent the dye running back out they put a clamp on the outside of the penis - again this is uncomfortable but not too painful.  Its not a long procedure and its good to know that everything is watertight.  Afterwords, I got both the urethral and suprapubic catheters removed.

As for the erections, dysfunction was never a problem for me.  Infact, I got them regularly which caused me a lot of discomfort for about a month.  They are painless now and I am now fully functioning again in that respect.  

I never had any problem with back flow upon ejaculation, either before or after the procedure.  I would think that the op will sort this out for you but I'm no doctor so worth double checking.

Hope this helps. Again, best of luck.  Hope all goes well.
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Hi uroretronow,

I had my op in June 2011, so far, everything is functioning mostly normal after the operation.

2 key differences though, I tend to dribble a little after peeing and as such, i avoid light colored underwear, also if I ejaculate too frequently in a short span of time, the subsequent ones tend to hurt (once every 2 days seems to be the most before it starts to hurt, and i would have to abstain for a few days to recover)

Other than that, everything seems to function pretty well, I do have some retrograde ejaculation, but it is minor. I've notice that I release less semen compared to before the op, but it is not by much, and I doubt it affects my fertility.
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I under went a urethoplasty buccal muccosa in aug 2012 first stage in uk. Was told id have second within 6minths hiwever due to me going on holiday i never yet had my second stage. In march this year after intercourse with my girlfriend i bled and went into retention again and my probs have comeback. In last 3months i have had number of episodes of uncontrollabe bleedin and now my surgeon has fitted me with a SPC pos long term and told me i unable to have my second stage till i been clear of bleeding for atleast 4months.  Although i am a minority of where it has failed and ashamed of what i look like i dont wish i never had it. Although my girlfriend is supportive she wont sleep with me till i sorted as she feels guilty for the bleeding. However saying that today is fathers day and i have just found out by text this morning my girlfriend sent me saying HAPPY FATHERS DAY. Well i never in my life thought id ever hear those words cos of previous cancer cells but today is happiest day off my life and i thanking the urethoplasty for it. So all you people out there no matter what you face it is worth the risk. I hope one day i can make my girlfriend happy like she has me
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Avatar_m_tn
This is such a helpful thread, many thanks. I'm 44. I had a urethrotomy eight years ago and just underwent my first dilatation, which looks like will be a $9k failure. My urine flow is better but there is still spraying and the high frequency of urination -- my biggest problem -- hasn't reduced. I'm wondering if I should go right into another urethrotomy or just do urethroplasty. The stricture is apparently 2mm, which I guess qualifies as small. I'm not sure of location. Some questions for anyone who can help:

1.) How many urethrotomies did people have before they did a urethroplasty? What was the diminishing return with each successive one? When did you throw in the towel and just do the full surgery? What do you recommend? My health is good.

2.) Did successive urethrotomies create complications? I've read that scaring can be an issue but am inclined to keep doing the procedure as long as possible provided it buys me a decent chunk of time.

3.) Any recommendations or advice with self-cathaterization? I'm now signed on to do this process weekly for the rest of my life presuming I don't opt for urethroplasty.

I really appreciate everyone posting here. This is not an easy subject to broach with people, obviously, and doctors can talk about this faster than what my brain can absorb.

  
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Hi i had sex to early after my urethraplasty i had sex the day after i got my superpubic catheter out and i cant get erections and my penis also is very sensitive at all anymore. The reason i had sex so early is because i was really high on painkillers and misunderstood what my nurse said and it was 4 months ago this happened and i thought it was something that would get better but it hasnt (ive been masturbating once a day hoping it would get better.) Im not really sure what to do if i wait will it get back to normal and i will get erections???
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Avatar_f_tn
Hey guys.. Seriously need your inputs for my queries. Im 27 yrs old. I had anastomatic Uro plasty 2 months before. After 5 weeks of surgery I tried mastrubation..and got normal erecton..but my erected size reduced by 1 inch..n ejaculation force got reduced..
So I did mastrbn 3 to4 times hardly in tht month becoz I m waiting fr complete recovery..

Now it's worrying me a lot tht m facing ED now, no morning erections, m facing very hard time in getting erection.
Need yo guys experiences on ED.. Whether u faced this, if yes..its got better by time ..n how long it took to get normal sex life..
Thanks in advance.. Appreciate your inputs
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