Scarred Urethra

Wondering how you are doing and if you are up to visiting me this weekend. I thought your idea was great.
Balihigh

A couple of answers to the comments provided.

The stricture was repaired - at least for now but without urine flow through it, it may recur util we can get the scarring fixed

I live within 50mi of NYC (and Dr Bochner) so if he wanted to do this himself, it is within the range of what I could probably do but I do ohave a lot of confidence in the team I am with, they've done well thus far and just need to get some ideas from some of their collegues.

I was surprised when the possiblility of a conersion to a pouch was raised. We will need more info on what it entails.

Perhaps I should have chimed in sooner, but this situation is completley different from mine since I get pain and urinary symptoms from a urethral stricture, but my stricture is in the penile urethra, nowhere near the bladder sphincter, and I still have my bladder, and no significant urine flow issues.
Post surgical scarring is a tough problem when the scar causes problems. When you're working in a tight place trying to create a connection of a neo to the urethra, scar tissue in the wrong place can get in the way, and surgery always risks more scar tissue. If I recollect correctly, there was another man who had scar tissue obstructing his neo, but I can't rememeber who. This is by far the bigger problem, and should be taken care of by the top surgeon. If that issue gets resolved, then we can compare notes on any urethral stricture issues.
If you have any specific questions regarding urethral strictures and my experience, I'll be happy to answer, but you really can't judge the impact of the urethral stricture until the scar tissue obstructing the outflow from the neo is resolved.

Bochner certainly takes on the tough cases...too bad he's so far away...with scar tissue and a stricture....ouch. I may be wrong but i don't think they can do an Indiana as they've already used up much of your bowel...i've certainly heard of a reversal to the ileal conduit. Hope they can figure out how to remove that scar tissue endoscopically but i'm not sure what they can do for strictures. Warren has had a problem with that..maybe he will chime in soon.............hope all goes well..........Pat

I had my R/C a month and a half ago and as the recovery moved along, the doctor removed the foley (Yay!) but in somewhat of a surprise to me, I got very little urine through it with most still coming out through the SuperPubic tube. Well, the doctor was not alarmed but before he was able to go in for a look, I came down with an infection. Then as I healed from that (and urine through the urethra stopped), he looked with a cystoscope and found a stricture in my urethra and scheduled a procedure to work through it. THen infection took back over while we waited. Last Tuesday, he went in on a scheduled half hour procedure and got through the stricture as planned but then as he moved up the urethra, encountered scar tissue just as he got to the neobladder. His partner had been operating in the next room and as he finished came in and he took out the superpubic tube and put a cystoscope in through that hole and was also able to see the scarring from within the neo. At this point they closed things up as the planned half hour procedure was now more like two hrs.

So we are at a strategic pause while they gather data about which way to move next. The neobladder itself is great, cystogram, loopogram, CT Scan, visual inspection have all been super but it needs an outlet that works. So my doc told me he is reaching out to a number of people in the field for advice. One name he mentioned was Dr Bochner at Sloan Kettering whose name has often been mentioned on this board.

Basically, the problem is that they need to get through the scar tissue without injuring the neo or the sphincter and it has to be able to remain open, with a foley at first and then by itself.

If we can't get this done, it appears that I will have to get the neo converted to either an Indiana Pouch or an Ilieal Conduit.

Oh, and later in the week, another infection spiked up and this time, based on cultures, they switched me to Cipro. This morning was the first time I felt much like posting about it.