Welcome to the Urethral Stricture Support blog. These pages are intended to assist those with questions regarding the disease, expected outcomes, resources, and emotional and informational support. AT NO TIME WILL MEDICAL ADVICE OF ANY KIND BE RENDERED. With your permission, your commentary may be included within the topics discussed within this forum. Moderators Cesar and Tim have a combined 50 years (celebrating a half-century of difficult urination) of experience in living with, dealing with, and overcoming what is broadly considered a disease with a high rate of morbidity. We have experienced every common surgical and instrumental "fix"/"repair" offered including the implantation of the Urolume Endoprosthesis. Both moderators have experience with the Urolume Endoprosthesis. To the best of our knowledge, this is the first and only such support group anywhere. Please, do not be afraid or embarrassed to ask any question with regards to your diagnosis. We encourage you to discuss any and all information offered within this blog with your Urologist. A proactive and informed patient usually receives the best care.

With your help, and well-considered posts, the information gleaned from this site should help the countless scores of males aged 18 and over who are encountering the diagnosis of "Urethral Stricture".


DISCLAIMER: We do not provide medical advice. We disseminate information relevant to urethral stricture disease. While we encourage research (and participation in research), we endorse no medication or treatment protocols. PLEASE FEEL FREE TO CONTACT US WITH SPECIFIC QUESTIONS @ urethralstrictures[no spam] at yahoo dot com

Monday, December 5, 2011

Your urologist is recommending urethrotomy PART 2

The big day is here, you have arrived at the appointed coordinates, signed-in, filled out 739 individual sheets of paper asking everything from your mother's maiden name to your preferred brand of underwear (Hanes). You'll be instructed to disrobe and change into a cotton gown (you know, the famous type where your ass hangs out), told to hop on up into a hospital bed where the nurse will again ask what type of surgery you are having (this is a good thing, a safety procedure which helps assure that you won't receive an incorrect surgery), have your vital's checked (temp, pulse, BP, pulse oximetry), and have an IV started (usually in the hand, one "prick", and it's done). You may be given an IV sedative or other pre-surgical medication at this time, also, an IV antibiotic such as gentamycin may be administered prior to your being wheeled into the surgical theater.

After your surgeon's fifth cup of coffee and a pit-stop in the bathroom, the OR staff will transfer you over to a gurney for transport to the OR. You will again be asked which procedure you are having performed (this is one time when being a smartass doesn't pay), asked to transfer onto the operating table, and placed into the lithotomy (OB/GYN) position, stirrups and all. Your choice of anesthesia will be started and this is what happens next:


  1. Your urinary meatus will be exposed and cleansed with a Povidone-iodine wipe (Betadine), and approximately 30 cc's (one fluid ounce) of a viscous topical anesthetic containing lidocaine (usually Anestacon) will be instilled into your urethra, then held in the urethra by applying a crown clamp to the base of the head of the penis (the penile corona). Depending upon your choice of anesthesia, your physician may choose to begin immediately (using the viscous anesthetic as a lubricant for the cystoscope), or wait a few minutes for it to take effect.
  2. A cystoscope with a trans-urethral injection system will be inserted into the urethra, and the surgeon will inject lidocaine (a local anesthetic) into the length of the stricture at various points using a technique called "infiltration".
  3. The cystoscope/injection system will be withdrawn, and a cutting device called a urethrotome will be attached to the cystoscope and inserted.  A safety guide filament will be threaded through the stricture, and into the bladder. This helps the surgeon position the urethrotome in a safe aspect for performing the incisions into the stricture Next, the surgeon will guide the urethrotome to the face of the stricture and a small blade towards the tip of the instrument will be deployed using a trigger mechanism to cut the stricture at locations he or she believes will provide optimum relief. The urethrotome/safety guide/cystoscope will then be withdrawn, and an appropriately sized catheter will be inserted and connected to a urinary drainage system (catheter hose and bag).  
  4. You will be instructed on the care and emptying of the catheter/drainage system/bag, and given prescriptions for an antibiotic/systemic antibacterial, a urinary analgesic (pyridium or prosed), a few days of a minor pain medication (there is usually very little pain associated with urethrotomy), and instructed to see the surgeon in three to seven days for removal of the catheter.
Youtube video showing a DVIU, or Direct Visual Internal Urethrotomy
    Per: Moderator Tim

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