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

Wednesday, November 28, 2012

It's been a year!

Since the blog was started. We've had our ups, downs, and a few slides sideways, but we've succeeded in disseminating information to those in need which was not previously available without doing tons of research. To all who have participated, many thanks, and we wish you the best of health.

Per: Moderators Cesar and Tim

Monday, November 19, 2012

An answer of a Question about Urethrotomy; from one of the very best, Dr. Joel Gelman, M.D.

After receiving commentary from one of his patients who remarked that he had garnered some information from our blog-site, we were contacted by Dr. Joel Gelman, M.D., of the Center for Reconstructive Urology.  Anyone who has ever searched on the topic "urethral stricture" is well acquainted with his status as one of the WORLDS very best with regards to urethral reconstruction surgery.  I am elated that he took time from his busy schedule to contact us.

Another factor which precipitated his contacting us was our reasoning behind the deletion of the commentary by blog reader MNOQOCUA

His letter to us should serve to answer questions those who are newly diagnosed may have with regards to the most effective method(s) for addressing your situation.

I enthusiastically post this letter, with most sincere thanks!

Per: Moderator Tim

Moderator Tim,

Actually it is true that a urethrotomy usually makes the stricture worse.  Observation is associated with certain risks (bladder damage, infection, renal damage etc.).  Urethroplasty also can make a stricture worse when done by someone who is not exclusively specialized in male urethral surgery.  A very high percentage of my patients come to me after failed surgery done by doctors at Major Universities who really do not truly have real expertise in male stricture surgery.

I believe what all viewers with strictures should do is make sure their stricture is definitively diagnosed (including imaging) prior to treatment, and that they should be informed of ALL options and the risks, benefits, and expected outcome of each option (with one option being observation) before pursuing treatment.  This is what is required for informed consent.  In the case of a 3+ cm stricture, the chance of a cure with a urethrotomy is pretty much zero.  That does not mean a patient can not choose to be managed this way.  However, if that patient is not made aware that an open repair, done by someone who is an expert at doing this surgery, offers a very high probability of a cure, then he is not giving informed consent for the urethrotomy.

I would be happy to be of any help to you with your Blog.  I assume you have seen my website.  I hope to update it soon as my goal is for it to be a very helpful informational site for men with urethral strictures.  I am just so busy surgically, my time is limited.  If you have any specific suggestions for my website, I would welcome the feedback.


Joel Gelman, M.D
Director, Center for Reconstructive Urology
Department of Urology
University of California, Irvine Medical Center

Sunday, November 18, 2012

Sorry for not updating....

My apologies to everyone, as I have been in and out of the hospital (for a problem unrelated to urethral stricture disease) since mid-August, and have been unable to keep up with this site. I have loads of material to upload, however, finding the time to do it is a different story.

Please bear with me through this difficult time.

Per: Moderator Tim

Sunday, August 12, 2012

Update for the week of 12 August 2012

My local pharmacist and friend, who last year co-authored two posts about antibiotics and antibacterials, has urged me to address antibiotic resistance. It is his understanding that UTI's are becoming increasingly tolerant to treatment, some to the point of having to either utilize multiple agents, or IV infusion (first dose in hospital, then in-home administration).

This week, he will again co-author an article in cooperation with "Dr. Rob", a podiatrist, and expert on the  pathology of bacteria. He has authored several articles on the topic, some of which have been included in the Journal of Podiatry.

This will be useful information for all.

We are also considering linking with the Interstitial Cystitis Support Group, as some of our information, and theirs has the possibility of being mutually beneficial.

We're also working on uploading some items to the resources site.

Have a great week!!  BTW: Last week, we had a visitor from Iran!, welcome!!

Per: Moderator Tim

Friday, August 10, 2012

Contacting a Reconstructive Urologist in your area

We now have a (fairly) complete listing of Reconstructive Urologists in the United States, who list their sub-specialty as being "male reconstructive surgery".  The list covers all 50 states and three territories. Should you want to know the names, addresses, and contact information for specialists in, or near your location, please email us at urethralstrictures[nospam] at yahoodotcom.  We will do our very best to respond quickly and accurately to your request.

Our library also includes listings for specialists in urethral reconstruction, this list does NOT cover all 50 states; however, it does provide for regional information.

As before, a "board certified urologist" is not necessarily a specialist in urethral surgery, for the best outcome, we must endeavor to find the very best possible surgeon within our means.

Per:  Moderator Tim

Thursday, August 9, 2012

The Ethical Decision to Delete Commentary, and the reasoning behind it...

Many of you have noticed 21 rather lengthy comments by reader "mnoqocua", most espousing the virtue of not seeking the surgical revision of urethral strictures. I left the commentary intact because it included multiple references to popular websites, and those publications were based on recognized medical and scientific principles. I also declined comment on those commentary postings which took place over a very short time period in March of this year.

For nearly six months I mistakenly thought that they provided some useful information, and were, for the most part harmless. Yesterday however, I received an email from a "novice" stricture patient who read "mnoqocua's" comments, and was considering the option of not returning to his urologist for a recommended followup urethrotomy, which the urologist believes to be necessary because of an estimated 3mm diameter x 3.4cm obstructive stricture.

To have followed the advice proposed by "mnoqocua" could have been disastrous in this case, it is for that reason that I have chosen to delete his comments in their entirety, all 21 of them.

As stated in the introduction to this site, we do not provide medical advice, we are not physicians; although we have two physicians who advise us on content, our goal is to provide information as to the options available to those suffering urethral stricture disease, PERIOD, OPTIONS - THAT'S ALL!!

I could have chosen to remove a majority of them earlier, but decided to leave them intact because I am a firm believer in allowing the opinions of all to be heard unless they are totally irrational and without reason, and these were not.

"Mnoqocua" appears to have had an axe to grind with regards to "invasive interventive urethral surgery options" because of what appears to be an alleged misjudgement of, or alleged mishandling of his situation by a urologist who was perhaps unfamiliar with urethral strictures and their management. As before, "Board Certified Urologist" does not necessarily mean that the physician is an expert in urethral surgery, or for that matter evaluation and management of strictures both complex and of lesser severity in nature.

To have advocated that persons with urethral stricture disease "leave it alone" would be dangerous; espousing that viewpoint could in-fact be disasterous for obvious reasoning. This person even contradicted my reasoning for a humorous post referencing the Fox Network's "King of the Hill", and the principal character's (Hank Hill) "Narrow Urethra".

All posts which include personal viewpoints are referred to an attorney for legal "exposure" analysis, and to a physician, for evaluation of their efficacy and basis in fact. We have that obligation to our readers, and to the urologists and publications who refer their patients and clients to this site.

As always, PLEASE continue to email your questions, and should you feel the need to offer constructive criticism, opinion, or verifiable information, please post them. If deemed to be informative, and worthy of inclusion, they will become part of this site's informative database.

From this point forward, all comments will be moderated, PERIOD. This goes against every grain of my being, however, it is sadly necessary. My apologies, and please continue to post commentary and send email with your questions....

Per: Moderator Tim

Sunday, August 5, 2012

Frontiers in Reconstructive Urology, EUROPE : Dr. Enzo Palminteri, Arezzo, Italy

A long, long time ago, before the days of Google®, when the premiere search engines were Yahoo®, Lycos®, and the Northern Light® search engine, when you would enter the words "urethral" + "stricture" into the subject field, the name "Enzo Palminteri, M.D. would appear, followed by oodles and oodles of publications authored by him.  In 1998, we had a rather lengthy three-part correspondence regarding "difficulties" that I had encountered with a permanent urethral stent; which were (then) new to the United States, but had been implanted in Europe and other countries for several years previously.

I will say that his evaluation and opinions were quite accurate.

There is an association of the world's reconstructive urologists which travels to "out of the way locales" in order to demonstrate their invaluable techniques to local urological surgeons, Dr. Palminteri participates in this association, as do the other surgeons listed within the "Frontier's in Reconstructive Urology" series.

If we ever decide to "monetize" this site, the pittance which we receive will be directly donated to assist these surgeons with their travel costs; I have been told that most of those are out of pocket.

Many of Dr. Palminteri's urethroplastic techniques were vast improvements over those traditionally performed at the time. He was among the first to warn of the problems with "permanent urethral stents", and has among the most highly skilled hands of those which perform the Johansen's procedure.

I can go on and on, referencing his publications, and his work. There will be references to his publications and his videos on our "resources" site. For now, here's a link to a Youtube® video of his performance of a urethroplasty using a buccal mucosal autograft: http://www.youtube.com/watch?v=UsbiHmxM6zs&noredirect=1

Per: Moderator Tim

Thursday, August 2, 2012

What's on the immediate horizon for this site....

To all:

I have "several irons in the fire" at the moment. Our "Urethral Stricture Resources" site is well underway (on my desktop). That will list specialists whose focus is urethral reconstruction, at last count, there were 23 in the United States.  "Dr. Joe", the prolific Wikipedia-Urology editor is working on a listing of  "general urological surgeons" in other locations who perform urethroplastic procedures with some regularity but are not considered as being specialists in this particular discipline.

Our statistics are on a constantly upward trend, and most of our email responses have been positive. This tells me that we're probably doing something correctly!

Best regards,

Moderator Tim

Saturday, July 28, 2012

Frontiers in Reconstructive Urology, Europe - COMING SOON!

Hello to all!!

Most of our information on this site has been centered on North America, Central and South America, and the United Kingdom (we wish you a successful, and most importantly,  SAFE Olympics). Many of our readers hail from Mainland Europe (especially Spain) and eastern Africa. We do have some information about urologists in central and southern Europe, and eastern Africa which we will endeavor to publish as soon as it can be verified as accurate.  We really appreciate your stopping by, and in the meantime, should you have any questions, please feel free to contact us via the email address listed at the top of the page.

UPDATE; 02 August 2012:

I am putting the finishing touches on an article about Dr. Enzo Palminteri, M.D., who has offices in Arezzo, Milan, Verona, Rome, Naples, Palermo, Repubblica Italiana (Italy for those of us who reside west of the Prime Meridian). In the opinion of most reconstructive urologists, he would be considered to be among the world's top three urethral surgeons, having pioneered many unique procedures.

I had the pleasure of corresponding with him in 1998, after encountering problems with the Urolume Endoprosthesis implanted a few years prior. I won't elaborate further, except to say that his predictions were more than accurate. 

BTW: Moderator César is going to resume his task of translating this site for our Español mirror site.

Per: Moderator Tim

Many thanks four comments regarding Hyophen®!

Thank you to all who sent info to us regarding your experiences with Hyophen® It will provide valuable insight into the results and benefits which patients have received from the medication.

Per: Moderator Tim

Tuesday, July 17, 2012

Frontiers in Reconstructive Urology, 2012 Part 2: Dr. Mang Chen, M.D. has relocated to Pittsburgh, PA

Detroit's loss is a great gain for western Pennsylvania!!

Until early June of this year, the western portions of Pennsylvania lacked the services of a specialist in reconstructive urology (this is the opinion of  Moderator Tim, and no offense is intended towards any of the fine urologists serving the western sections of Pennsylvania). As referenced in another post within this site, Dr. Chen trained under the auspices of Dr. Richard Santucci, arguably one of the world's top reconstructive urologists. Pittsburgh, you've hit a home run on this one!!!

**Remember, Dr. Chen, Moio's Bakery in Monroeville is the best, don't go to Primanti's, go to the Triangle Bar and Grill for sandwiches. Don't forget about Isaly's, and have a lemon Blendd on me!!

All the best!!!

Per: Moderator Tim

Bioengineered Urethral Tissue, quite possibly our greatest hope for a return to normal life...

A little more than a year ago, Time Magazine published an article entitled "Scientists Grow New Body Parts in the Lab".  Low and behold, the article was about a team at Wake Forest University's research into creating human urethral tissue which is grown on a tubular "scaffolding", and suitable for transplant into human males with strictures which would otherwise have probably required a partial urostomy, or Johansen's Urethroplasty to achieve urinary drainage.

The research team, led by Dr. Anthony Atala, director of the Wake Forest Institute of Regenerative Medicine created the human urethras (trust me, this was no easy process!) and transplanted them into a total of five young men, the most recent, in 2010. The longest-term recipients, all young boys have successfully retained the bioengineered tissue, which functions identically to their own (and seems to have become almost indistinguishable from their own urethral tissue), for a period of time approaching six years. Adult subjects have not taken part in this research, thus far - but I can guarantee that there will be no shortage of volunteers!!

My writing more will not do the subject the justice it deserves, here's a link to **"The Lancet" research paper. It is in .pdf format: http://www.mediafire.com/?3jdiyp8tlf3op3w

** © The Lancet, 2011, and respective research copyrights,

**© The Wake Forest Institute of Regenerative Medicine and Dr. Anthony Atala,

Our thanks to "Dr. Joe", our resident urologist, and an editor for WikiProject- Medicine©, whose work on updating this site, and that of Wikipedia's "reconstructive urology" pages is to be commended,

Many thanks to "Karen", of the Wake Forest Institute of Regenerative Medicine, who provided this info for all to see, and was instrumental in procuring the document for "Dr. Joe". Should you ever visit central Pennsylvania, I owe you a steak dinner!


Per: Moderator Tim

Sunday, July 15, 2012

Medication Shortages, it "ain't" getting any better, folks

A friend of mine owns a rather successful neighborhood pharmacy. Yesterday he informed me that he has over TWENTY popular medications on backorder; not the least of which is VICODIN ES. I'm told that even Wal*Mart pharmacies are having problems acquiring it.

Here's a link to the Amerisource Bergen backorder list:

That particular backorder is set to clear by 31 July 2012, pharmacies are substituting (with physician/practitioner notification) the 7.5/500 strength Hydrocodone/APAP (Lortab equivalent). From what I've heard, those supplies are stable for the time being.

A Fox News story on how medic units are having to use expired meds on advanced life support patients:

Per: Moderator Tim

Saturday, July 14, 2012

A note from Moderator Tim

Sorry for not having posted in a little more than six months, I've had problems with the Urolume Endoprosthesis which was implanted in the last century;  it was one of the first available in the United States, and has been causing angst for the last several years.

We have collected TONS of great info, and have been in contact with a physician who has a copy of the  BIOENGINEERED URETHRAL TISSUE RESEARCH STUDY  being conducted at Wake Forest University, in North Carolina. I have viewed a copy of the research report in THE LANCET, and believe it offers the best hope for those of us with complex, multiple, or strictures in excess of 4cm in length.

There's also some great news on the "Urised" front.  Hyophen®, has been approved by the FDA, it's similar in makeup to Urised, and fills the gap in the urinary analgesic scene left by the difficult avaliability of Prosed DS after the September, 2011 recall.

My thanks to those of you who have commented and written, I apologize for not replying sooner, but I had to budget my time judiciously because of the health problems caused by the stent. Please, continue to comment, and should you have a story of your "travels on the stricture express", research information, or anything pertaining to the topic deemed suitable for publication (all of this stuff is approved by an attorney and a physician prior to posting).

I am in the process of contacting the urologists who have been invaluable in the operation of this site for purposes of requesting updates as to the latest in technologies and techniques.

**A note to the the urologists who frequent this site, my apologies for not keeping in touch, suffice to say that I had a fairly substantial battle of my own to fight, and that took the majority of my time and concentration. But I'm back now, and hope to fulfill my obligation as best as possible.

Per: Moderator Tim

Wednesday, January 25, 2012

New: Urethral stricture resources site

Hello, everyone,

Sorry for falling behind with regards to updates, between foul weather, running a business, this, that, and the other thing.....  I've had to shift my priorities elsewhere, although  I have managed to keep up with email.

So here goes:

I/We am/are in the process of adding an additional resources page. Urethral Stricture Resources will, within a month, host a fairly impressive and (hopefully) one-stop shop for all of your informational needs. In order to do this, We need your help, as most of our information applies only to the United States, Canada, Mexico, and the U.K. .  Our viewers (thus far) hail from 22 countries, many, in areas with no documented urological surgeons. So please, send your (subject to verification) applicable information to:

urethral[no spam]strictures at yahoo dot com

We will have listings for surgeons who specialize in urethral problems, vendors for catheters, ostomy and incontinence supplies, manufacturers of medical devices, pharmaceutical manufacturers - (brand and generic), pharmaceutical assistance programs, and other good stuff.

Many thanks for the visits to the site, it is our hope that your questions have been answered, and that we have been of help to you.

Per: Moderators Cesar and Timothy

Thursday, January 12, 2012

Frontiers in Reconstructive Urology, 2012- Part 1, The Center for Urologic Reconstruction® , Detroit, MI, U.S.A.


May this year be more healthy, productive, peaceful and fulfilling than the last, and in that context, let's begin 2012 with the encouraging news that we are now (mutually) linked with RECONSTRUCTIVE UROLOGY , the website for dissemination of research and information by Doctors Richard Santucci, M.D., and Mang Chen, M.D. . We hope that which follows does their work for the advancement of knowledge, understanding, and utilization of novel surgical techniques in the field of reconstructive surgery of the lower urinary tract justice. Their site features in-depth information, resources, and HD video(s) on a myriad of topics with regards to reconstructive procedures of the lower urinary tract including the bladder, urethra,  and external genitalia.

It is work such as theirs which provides hope that we can once again resume a normal life, free of the discomfort and constant concern which often accompanies the diagnosis of urethral stricture disease.

A little biographical info:  These gentleman have been at the forefront of research into treatments for urethral stricture disease for (probably) longer than anyone in the United States. I (Moderator:Tim) remember reading references to the work(s) of Dr. Santucci during the latter days of CompuServe, Prodigy, and shortly before AOL began littering every (snail) mailbox on earth with floppy's and CD's. 

Dr. Santucci's improvements in the techniques for the harvesting, preparation, and positioning of buccal  mucosal onlay autograft material during urethroplastic procedures are included within the standard curriculum of many urology residency programs in the United States, and elsewhere. His group was the first to issue reports with regards to statistics of complications and recurrence following various urethral procedures, and were really the first to shed light on the fact that a more specialized field of reconstructive urethral urology was necessary. Dr. Santucci also travels abroad, often to under-served regions of the world, sharing his techniques and training local surgeons in advances in reconstructive urology.

We were tempted to write that Dr. Chen could very well be considered the "Robin" character to Dr. Santucci's "Batman", however, that would be unfair, as our research has shown that Dr. Chen is considered to be the "patron saint" of those in need of substantial reconstruction of the lower urinary tract. His work in advances in techniques in "reconstructive trauma urology" (for lack of a better term) are utilized in trauma centers and major hospitals throughout North America.

This may well be reaching for the stars, but our greatest hope for this working relationship would be the possibility that someone substantially benefits from information and/or resources provided through our mutual cooperation.

The Center for Urologic Reconstruction® at Detroit Receiving Hospital 

Reconstructive Urology

Per: Moderators: Cesar and Timothy

Tuesday, January 10, 2012

The advantages of in-home uroflowmetry, AN UPDATE - Part 1

The original post:
In the mid-1980's, my urologist urged me to use a device for uroflowmetry which looked like a small rectangular plastic fish-tank prior to commencing each office visit. The urine flowed through small "trap doors" which activated at four stages. The urine measured at each stage was compared to a chart that provided a mean-value which was charted for comparison to a base-line obtained soon after each urethral surgery. Eventually, I was prompted to purchase one of these now-extinct "manual urine flow gauges" (which lasted ten years) to track thrice-weekly measurements which really did help by forcing me to go for a dilitation/urethrotomy, or whatever - while the stricture was in a more open state, allowing for a "kinder instrumentation" or easier urethrotomy.

Ask your urologist if he or she feels this type of tracking would be beneficial in your case, there is a device *which is FDA approved, and made in the U.K. known as the Uflow urine meter which is not easily available in North America. With shipping, the cost is around $23.00 U.S.  A base-line (in-office) uroflowmetric study will have to be done for comparison to your initial results.  The savings in discomfort should be well worth the investment!

*a brief update: While researching for this post, I read documentation stating that the device was FDA (USA) approved. That information was apparently inaccurate, and that documentation has been withdrawn from publication. I have edited the original post to reflect this change. Today, 13 January 2012, I will make an effort to contact the manufacturer of the Uflow urine meter, Medical Devices Technology International, and report my findings as soon a possible. I can tell you that from what I have read, they seem to be very reputable and quality conscious (my opinion). I am told that the device may not require FDA approval.

Status: Will report

* another update 14 January 2012: we have been in contact with MDTI, and they provided a phone number to their product information and engineering department with statement that the gentleman there will answer our questions to the best of his ability.  I will procure a VOIP phone on Monday, and proceed with a "thoughtful interrogation. They replied to the email request within an hour of its receipt, that's pretty good in my book!

Status: Will report after our conversation. If possible, I will also inquire into direct sourcing from within the U.S. , and make the case that there's probably a market here for the Uflow Urine Meter.

Per:Moderator Tim