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Thread: Urethral stricture and dilation

  1. #1
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    Urethral stricture and dilation

    About a year back I was treated with a laser in my urethra for a urinary stricture which was caused by an untreated bladder infection. I had no problems catheterizing for some time thereafter. About a month back, it became difficult again, so I consulted with my urologist. He performed a dilation several days back.

    Now it seems somewhat MORE difficult to intermittent than it was previously. Is this due to swelling that was caused by the procedure? or did the procedure make the cathing problem worse?
    Usually i use 16s at home and 14s out of the home. I was thinking of swtiching to 14s for awhile, thinking that there might be swelling that would go down.?

    Eric Texley

  2. #2

    Swelling

    It is probably due to swelling. Many times urologists prefer to leave an indwelling catheter in for several days after a dilation for this reason. I recommend using 14 Fr. catheters for all intermittent caths, and save 16 Fr. for indwelling since you are not concerned about clogging with intermittent, and they are less traumatic.

    If you continue to have problems, call your urologist (or whoever is covering for him/her over the holidays).

    (KLD)

  3. #3
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    thanks

    You're very right about the stricture coming back. My uroglogist suggested I cath several times a week with a 16 FR and use 14s the rest of the time.

    My understanding is that by its very nature catheterization causes trauma... But right now I can't avoid it. Books I've read indicate that there are ways of making one's voiding relfex work by slapping the thighs, pulling on hairs...but I haven't had any success with this.

    It would be interesting if one could "train the reflex" like people train with supported ambulation. If that could be done it would make a real difference in the lives of many people.

    Eric Texley

  4. #4

    Strictures

    Unfortunately the nature is strictures (scar tissue) is that they do tend to reoccur, and you may need dilation periodically. Meanwhile, I always recommend the use of 14 Fr. cathters, plenty of lubricant, and consider using the hydrophilic catheters if you can get them funded (generally they are not reusable).

    Eric, training for reflex voiding like you describe was considered "the thing" back in the 1960s and early 1970s. It has very much fallen out of favor since the mide 1980s since we discovered that generally we were training the bladder to empty with high pressures, often against a tight sphincter, and this was actually causing more kidney damage than intermittent cath alone.

    (KLD)

  5. #5
    Senior Member rdf's Avatar
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    Eric or SciNurse, what exactly is the "dilation" process?
    Sounds spooky, lol, especially on that part of the anatomy.
    --
    Anyway, I believe I am developing a stricture because it's getting harder to not only put the cath in, but to pull it back out.
    --
    Can either of you enlighten me on dilation methods? I know it's been a couple years since this post, but I thought it was worth a shot.
    --
    Thanks

    -Bob

  6. #6
    Eric - The posts that were obtained from our archives addresses some of the current problems that you are having. I think that the problems are related to swelling; if you have not talked with your urologist, I would urge you to contact him. I would also encourage the use of a smaller catheter (14 FR). As I am sure that you know, repeated problems with strictures and the treatment used (whether by incision or dilation) tends to produce more scarring and a cycle of events related to urinary output.

    Bob - a dilation is performed with a local anesthesia by a dilator, which is gradually inserted into the urethra and mechanically opening the narrowed area. This procedure actually causes very tiny tearing of the urethral walls.

    There seems to be a range of medical opinions as to the best treatment of choice for persons with this problem. CRF

  7. #7
    Senior Member rdf's Avatar
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    Thanks SpinalNurse.
    I'll look into the different methods.
    --
    Just so you know, Eric posted this thread over a year ago. I should have said something about that when I posted.
    Thanks again...

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