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

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