Doctors Lounge - Urology Answers
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Forum Name: Urology Topics
Question: Urethral Stricture Advice
|uk_res - Wed Apr 29, 2009 5:17 pm||
Hello I had a urethral stricture which was operated on when i was 19. It was cut open and the stricture widened to allow my urine flow to improve.
I am now 30 and have had the stricture stretched twice since the above operation.
Since doing some research and also being told by the doctor previously I am aware that the scar tissue can over time cause the stricture to close up again and this will require more stretching or another operation to cut.
I looked online and it mentioned about how a coil can stop the stricture re occuring.
Today when I went back to the urologist regarding my urine stream seeming thinner and having irritable bladder symptoms (frequent urgency. feeling like bladder not emptied fully. waking up in the night needing to go etc) he mentioned about getting me back in for another exploratory minor operation and if it has narrowed again to cut away once more.
I mentioned to him about the coil i had read about and if this is a likely permenant solution. He told me that the hospital does not do it but he can refer me to a hospital that does but questioned why at my age it would be considered as normally it is cancer patients and older men who have it. He didnt seem to answer my question at all as to why a coil would not be or should be used. I got another appt with him and have delayed making a date for a operation with them yet as I have some unanswered questions and may even ask for a different doctor who can explain the options available better.
My question on here is does anyone have any information on urethral strictures that are relevant to my queries. Are there any other treatments besides simply cutting the stricture open again and me constantly having to go back and get it cut open or stretched each time it narrows for the rest of my life.
Does anyone know about the coil. Is there any other treatments that have more permenant results like laser or something? I recently discovered that its called surgical stents and not a coil for urethral stricture. I don't know if there is a big distinction.
I basically want to find the best treatment with the best and most permenant results and i am posting on here because i was very frustrated with the doctor just fobbing me off and looking at me like a crazy person for even questioning alternatives to him just dragging me in for a operation to look in and then stretch or cut if appropriate. I don't want to keep going the rest of my life waiting for the stricture to close again and then be dragged in for more operations.
Is urethroplasty a decent option. if it gives decent results i will go and see a different doctor and mention it to him. The problem i have with a urethroplasty is the description of it. It sounds like something like that would cause more problems and scarring than the original stricture?
Advice would be greatly appreciated
THank you very much.
|Dr.M.Aroon kamath - Sun Oct 11, 2009 2:14 am||
Traditionally used treatments for urethral strictures are as follows..
1) urethral dilatations
2) internal urethrotomy(optical urethrotomy) and
Urethral dilatations are not in vogue these days.The last resort traditionally had been urethroplasty.
A rather recent entrant in the management of urethral strictures is urethral stenting.
Some of the current indications sited are
-failed multiple urethroplasties,
-failed multiple internal urethrotomies and patient unfit for urethroplasty and
-patients with multiple failed internal urethrotomies and urethroplasties.
Much of the available evidence pertains to their successful use in strictures of prostatic and bulbar urethra.
Perhaps more studies are required before it is accepted as a routine procedure in the management of all urethral strictures.
I hope this information will be useful to you.
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