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Avatar universal

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
47 Responses
Avatar universal
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 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.

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!
Avatar universal
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!
Avatar universal
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
Avatar universal
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
Avatar universal
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!
1 Comments
Hey! I'm approaching a urethroplasty myself due to a car accident that severely injured my pelvis which caused a stricture . It happened in August and I've had a superpubic catheter in for a while and am approaching my surgery . During this time I haven't been getting any erections and am really discouraged by it (I am also a 21 yr old man ) but have noticed some small signs of erection over time . My question is ... After surgery , will my erections eventually end up coming back ? How long ? You posted this awhile back so I'm sure by now you know what the outcome was . I need to know because before my accident I was very sexually active and it is really discouraging to think about me having any sort of ED . Thanks
Avatar universal
Good luck to your recovery.  I hope everything works out for you.
Avatar universal
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?
Avatar universal
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.
Avatar universal
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.
1 Comments
Hey gg300,

Did that numbness ever go away? I had my surgery 3 months ago and still have lost of numb areas on the scrotum. Does it get better with time?
Avatar universal
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!
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
Avatar universal
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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