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.
Sincerely,
Joel Gelman, M.D
Director, Center for Reconstructive Urology
Department of Urology
University of California, Irvine Medical Center
http://www.centerforreconstructiveurology.org
