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  1. #1
    Junior Member Dran's Avatar
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    Treated urethra stricture/dilation recovery

    Hey ladies and gents, I'm going to break this down so it's easier to read:

    >On 7/19/12, Thursday, I had my first cysto in 21 years of being a para.
    >The doc had to perform this in the OR because the traditional cystoscope couldn't get past a stricture (turns out there were two).
    >They dilated me to 22 Fr. and inserted a 16 Fr. foley to heal.
    >There was a decent amount of blood that I saw from the procedure, but they told me that it wasn't more than normal.
    >Doc told me to remove the foley on Monday (yesterday now).

    So should I remove the foley immediately? I wanted to give my urethra a little more time to heal since I can tell it's still "displeased." What are the consequences if I don't remove it soon besides the typical UTI stuff?

    Also, I typically use 14 Fr. catheters, but now since I've been dilated and have a 16 Fr. cath in me, should I up my size to 16 Fr.? (I self-cath around 4-6 times a day with a closed-system)... I heard it's dangerous to use caths smaller than your urethral passage.

    Should I expect to see blood for a while once I remove the foley? I'm afraid I'll have AD if I attempt to cath once I remove the foley. Also afraid of the strictures returning if I don't let it heal more with the foley inside. Any advice? Anything is much appreciated!

  2. #2
    Junior Member Dran's Avatar
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    The Removal

    Well I decided to remove it about an hour ago. I was greeted with slight bladder spasms while removing it, but thankfully no AD and only a small drop of blood. The foley catheter was white when I removed it, and had what appeared to be puss blobs on it. I suspect that it's white because that's the original color of the catheter. Thankfully I still have some bactrim though!

    I believe taking a vicodin prior to removal helped calm my body and mind, so if you're ever in this situation and have access... by all means.

    Although I've yet to receive any replies, I'll update this thread with the recovery experience as it continues so that it may help others.

  3. #3
    I've had several urethrotomies performed in order to receive Botox injections. (The stricture that I get, and which recurs, prevents the rigid cystoscope from entering my bladder. The scar tissue needs to be trimmed back for it to pass.)

    I'm always discharged with a Foley (which I hate!). My uro prefers that I leave the Foley in place for a few days but doesn't get whiney if I remove it sooner. I can't imagine any harm coming from leaving it in longer, except, as you note, the greater likelihood of UTIs, but I'm guessing you're taking antibiotics at the moment.

    There's always trace amounts of blood while it's in and maybe a drop or two (at most) upon removing it, but it's nothing I've ever stressed over. I have both 14fr. and 16fr. catheters. I don't necessarily have a preference for one over the other, but theoretically, at least, the 16fr. catheter maintains greater dilation.

  4. #4
    Junior Member Dran's Avatar
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    Thanks, I have a new term now (urethrotemies). Foley caths do suck, I hated how immobile I was, and I didn't leave my home until I removed it. Your stricture experience sounds pretty terrible, Stephen, did it start off small? Hopefully that gets better for you.

    I've had problems inserting my catheter for years now, but it would come and go. I was never able to get a 16 Fr. in, and I thought it was because my urethra was small. Turns out I had two strictures since I was a young teenager, but the urologist said they weren't bad at all. I just hope they don't come back and get worse.

    So far, so good though. I've cathed 3 times since I removed the Foley, and it's like I was given a new urethra! Absolutely no problems AT ALL with cathing, it slides right up and out with no resistance at all. AND SURPRISINGLY, I've had no leakage!!! Even when my bladder is 500cc full! I was concerned about that after being dilated to 22 Fr.

    If anyone has problems cathing themselves (e.g. needing to lean over, encountering extreme resistance the last few inches, bladder spasms, and urethral tightening), don't wait, go get yourself dilated! I can't believe I put this off for so many years..

    I guess I'll try out a few 16 Fr. caths and see how they work. I definitely wish to keep greater dilation. Stephen, exactly what catheters do you use? I was thinking about trying coudé caths, but I'd like to find one that's half latex, half silicone (so it's not so rigid).

  5. #5
    I was unaware that I had a stricture until I had scheduled a routine cystoscopy. My uro could not pass the flexible scope; however, I had no difficulties at all catheterizing myself. I would not have had the urethrotomies performed if it were not for the Botox treatments, which require cystoscopy to perform. The urethrotomy procedure itself is not a big deal and takes no more than a few minutes to complete.

    I use a variety of straight catheters. I have no specific loyalty to any one brand, but they're all hydrophilic coated. Back when my insurance wasn't limiting my medical supplies to a measly $1500/yr I was ordering Coloplast SureCaths -- it's the best closed system style that I've used. The highest quality catheter, though, is probably the LoFric because it has the most generous application of hydrophilic coating.

  6. #6
    We leave it in 1-2 weeks!
    CWO

  7. #7
    First step-Get yourself urodynamics and you can see flow under
    VCUG as it crosses . Describe if you have any issues cathing when you see doctor. DSD- you get these symptoms but if you have issues cathing--- and then false passages arise and on an on. But scarring at bladder neck area, strictures etc... We try Tamsulosin, coude catheter to help relax area and also the lidocaine gel helps but yes if you are having problems getting cath in repeatedly then sometimes there are strictures that need to be ballooned opened. Stricture at bladder neck- they do a DVIU- fancy name for direct visualization something.....
    CWO

  8. #8
    Quote Originally Posted by SCI-Nurse View Post
    First step-Get yourself urodynamics and you can see flow under
    VCUG as it crosses . Describe if you have any issues cathing when you see doctor. DSD- you get these symptoms but if you have issues cathing--- and then false passages arise and on an on. But scarring at bladder neck area, strictures etc... We try Tamsulosin, coude catheter to help relax area and also the lidocaine gel helps but yes if you are having problems getting cath in repeatedly then sometimes there are strictures that need to be ballooned opened. Stricture at bladder neck- they do a DVIU- fancy name for direct visualization something.....
    CWO
    DVIU = Direct Vision Internal Urethrotomy

    Doesn't every middle-schooler know this?

  9. #9
    Senior Member GinoL's Avatar
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    Quote Originally Posted by stephen212 View Post
    The highest quality catheter, though, is probably the LoFric because it has the most generous application of hydrophilic coating.
    X2 I have been using LoFric with coude tips for awhile now and I agree these work great because of the generous hydrophilic coating. They slide in for me with no effort. The best hydrophilic catheter I have tried so far!

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