Urinary Sphincterotomy

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Well for some reason my last thread here was closed. https://www.adisc.org/forum/showthread.php/106702-Urinary-Sphincterotomy?highlight=sphincterotomy
So I'm making this thread as a continuation to it.


It's been a while since I've made an update (not my fault really, my thread was closed on me for some unknown reason). Anyways, my last (seventh) surgery was on Feb 2, 2017. My urologist used a green laser on me this time instead of the usual hot knife procedure (so he could cut out more). The first five days of recovery I couldn't really feel any pain, but did have a lot of bleeding as expected. Right after that my nerves down there regenerated and the pain was pretty high. Worse still I caught a cold which made me cough a lot, which made my pain worse too. uuugh.

Well, I have been getting better obviously. The pain and bleeding both have been very, very, very, slowly getting less and less and I haven't been needing my usual oxycodone to manage it lately either! However, as of a few days ago (today is Mar 25 2017) I still had a little of both. It was mostly all manageable though, but I am still needing to sit on a perennial donut to alleviate the pressure down there.

At my last urology follow up appointment my doctor did say that oh yeah, with a green laser the pain and soreness usually last about 8 weeks (this is double what I had experienced with a hot knife). Uuugh again, why can't they tell us need to know info like this up front. Anyways, I set another follow up appointment with him in six months.

Except things have now also taken a turn for the worse. A couple days ago I started having to strain to pee again. Then on Thursday night I was no longer able to pee no matter how much I strained and pushed. I started getting more and more intense bladder urges, and their frequency kept getting closer and closer. When they got about 3-4 minutes apart I was on the floor in a ball of dizzying pain.

My first though was ok, time to go to the ER. I then immediately thought it would be 30-60 minutes before I get seen, and all they will do is put a catheter in me anyways. Duh, I still have plenty of folley catheter supplies my primary doctor gave me a couple years ago, so I decided to just try and put one in right then. (note; I've been self foley cathing for well over a decade under my PCM's guidance)

Thankfully it worked too. I had a difficult time getting it pushed past two distinct obstructions. With getting past the second, my bladder finally started to empty. No kidding, my catheter drained pee from me for 40+ seconds (albeit with a weak stream). God, no wonder my urges were that intense, it had to of been 300+ml when my bladder is barely even able to normally hold 50 now. Anyways, I was then able to put the catheter in the rest of the way and fill up the balloon. I do know my external sphincter has been blown away, and is no longer an obstruction. I do believe the first obstruction was a new stricture (which I've had two others form and block me off before). The last obstruction was obviously my internal sphincter (which obviously was not removed as my surgery intended), as when I got past it I was in my bladder and able to drain pee.

For now at least I am stabilised. Yeah, or not really. Well I called my urologist first thing on Friday. He was out of the office, and would be in surgery on Monday too. They said they would call me Monday or Tuesday morning to let me know when they can get me in for a walk in. I told them to make my appointment a cystoscopy (camera up the urethra), and asap, so we can verify what is going on with me this time. Since I've developed a sensitivity in my urethra, this catheter is yet more pain all over again. At least I still have that oxycodone to manage it though.

Oh, and to complicate things even more, I have a trip and flight coming up in late april (in about a month from now). This EXACT same thing happened to me last year too. Last time, my urologist used urethral sounding rods (medieval torture devices) on me to stretch my urethra back open. The series of rods hurt like a sob, but did work to keep me open for a little more than a month and half. Something tells me I'm in for it again, and I am not liking that though at all.
 
Yeah sounding rods are great fun , if it's a choice between the rack or rods only then do they have s use, because I suspect being ripped limb from limb would be more painfull , your urologist must be into pain as a side gig Maybe he hangs out in the dungeon between appointments, you have had zero luck with these guys helping you , I am seriously sorry , it sounds like rather than helping they are compounding the problem ? They certainly have a neck for timing ,max discomfort for your trip every time , you are definitely handling better then I would , after this much frustration , pain , & failed procedures I would be choking them .

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Brian, I'm very sorry to hear this news. Your life resembles the trials of Job!

I can't help wondering if now may be the time to give up on sphincterotomies and go for a suprapubic catheter instead.
 
It sounds like a nightmare. I'm sorry you're having to go through this. I had to cath myself for six weeks after back surgery. I got used to it but I never liked it. I wish you the best and hope there's a good outcome.
 
Well, as long as each surgery does continue to get me closer to being functionally incontinent then it's worth it to me continuing to pursue it. Now if they weren't working at all, then I'd fit the literal definition of insane.

I also got scheduled to go in for a cystoscopy this thursday. Till then I have to stay catheterized.

Funny thing is they also wanted to schedule me for a bladder scan. I asked what good that would do since I have a catheter in anyways, and am guaranteed to already be empty. Lol, I canceled that part.
 
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