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Urethral dilations for possible stricture caused by catheterization? Urethral dilations for possible stricture caused by catheterization?

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Unread 07-30-2004, 02:02 PM
Urethral dilations for possible stricture caused by catheterization?

I am in desperate need of some help here, and never thought I'd be on this "road", but here I am. I had an abdominal oophorectomy almost 10 weeks ago. Since then, during the first 3 weeks I had trouble voiding on my own, so I was cathed 3 times for a total of 14 days of an indwelling foley catheter. In the last 7 weeks, I have irritative voiding symptoms, such as urinary hesitancy, frequency(but sometimes I can go for 4 hours without feeling the need to go), a splitting stream and a somewhat slower stream, but it depends on how full my bladder is. My urologist is testing me for a urethral stricture on August 9th. I will be having a uroflowmetry done and a cystoscopy to confirm what is wrong. From all I have read about urethral strictures, they are highly uncommon in women, but can occur after "uncareful" catheterization, among other things. So, if this is indeed what I am dealing with, are the dilations my only option? I live in constant fear that if it is a stricture, it will just close up and I will have immediate retention. Not a pleasant thought. Has anyone had to have the dilations for a narrowed urethra or stricture? If so, did they work, and for how long did they work? I hope someone here can help me, or shed some light on what I'm about to face, possibly. I am not looking forward to any of these tests or treatments, so if anyone has any advice, it would be most appreciated. I never had bladder troubles before this operation, not even one UTI..
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Unread 07-30-2004, 07:50 PM
Urethral dilations for possible stricture caused by catheterization?

((((Julie))))) I'm so sorry you've been having such a hard time since your Oopherectomy

I've never delt with the issues you're dealing with, but did find this web site that both discusses what Urethral Stricture is, the tests done to diagnose it and the treatment options:

Here's what they state about treatment options: http://www.urethralstricture.com/us.html

  • Dilation
    This treatment is generally performed in the office and involves stretching of the stricture using progressively larger dilators. Alternatively, the stricture can be balloon dilated. Subsequently, the management may include temporary and/or intermittent placement of a stenting urethral catheter to maintain patency.
  • Internal Urethrotomy
    This procedure, which is performed in the operating room using an endoscopic instrument (a telescope that is advanced through the penis), involves an internal incision of the stricture through the penis to "open it up". Subsequently, an indwelling catheter is placed to stent the urethra open for some period of time. Again, subsequent management may include intermittent self catheterization to maintain urethral patency. Self catheterization is a procedure where a patient inserts a catheter (tube) into his urethra periodically in an attempt to prevent stricture recurrence.
  • Urethral Stent
    This procedure involves placement of an internal metallic stent that has the appearance of a circular chain link fence. The stent is placed into the urethra endoscopically (through the penis) after the stricture is incised, and when deployed, the objective is for the stent to prevent the strictured portion of the urethra from contracting as scarring again occurs. The lining of the urethra eventually covers the stent, and the stent remains in place permanently.
  • Open Urethral Reconstruction
    The open reconstruction of urethral stricture disease may involve surgery to remove the strictured segment and create an anastomosis (re-attachment) of the 2 ends. This is called excision and primary anastomosis. This procedure is best suited for short strictures involving the bulbar urethra (see section on urethral anatomy). When this repair is not possible, tissue can be transferred to enlarge the strictured segment to a normal caliber. For example, the urethra can be repaired by enlargement of the narrow segment using penile skin. Other tissues that can be used to reconstruct the urethra when penile skin is not available include buccal mucosa (skin inside the cheek). When the above procedures are not an option, alternatives include a 2 stage repair where a split-thickness skin graft is placed along the undersurface of the penis, and later rolled into a new urethra (neo-urethra). The choice of repair is individual and influenced by the length and location of the stricture, the availability of local tissue, and other factors.
Wishing you the best of luck, and hoping that things improve for you in the near future. Please keep us posted

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