SCHWOIT

Some time ago I wrote about having a new hope for the cure to a medical dilemma I have suffered for many years. The issue is that my I suffer from urinary strictures. A stricture is basically a build up of scar tissue and can be caused by injury or disease. The result is a narrowing of the urinary tract,and in my case, blockage.

Now let me assure having the ability to urinate is a pleasure when you have simply not being able to pee at all. The worst experiences I have ever had was in the Shellharbour Public Hospital Emergency Department 2 years ago. I spent hours hopping from leg to leg until eventually the ED doctor had researched and sourced a temporary remedy and put in a sub-pubic catheter. This is basically stabbed in directly to the bladder. This did mean carrying a bag around with me as a companion for 2-3 months whilst arranging dilatation surgery with my urologist. The worst part of carrying a water bag was I had tickets to the inaugural Sydney Telstra 500 which had Cold Chisel tickets, I was too embarrassed to attend and so stayed at the hotel and missed one of the biggest concerts of the year.

A few days prior to surgery the catheter itself became blocked. After another visit to the ED and a few hours of hopping to and fro it was replaced. Thankfully the dilatation surgery soon followed. In this surgery the urethra is basically stretched thus allowing water flow. I did have to carry a bag for a day or two post surgery whilst the area healed, though it was a standard catheter which runs through your own piping so to speak. It is one of the weirdest feelings when those a removed, it doesn’t hurt, but feels wrong! Afterwards I spent a year with regular visits to a urologist to have the stricture dilated under a local anaesthetic.

Unfortunately another blockage occurred. This time we went to Wollongong Public Hospital Emergency Department. Again a wait involving hops from foot to foot occurred. However a nurse was able to get a standard catheter in. I had this with me for a month or two and was undergoing what is called a “trial by void”. Basically seeing if not having water flow directly pass the stricture would create a new channel non-surgically. In effect it did, however another dilatation was on the cards. That happened early in 2011 (March). Post op my urologist referred my to another urologist.

That urologist decided after reviewing my notes that the best thing would be to do an exploratory surgery to take measurements and get a first hand look at the impacted area. In particular ensuring that the area is not near the control centres that if disturbed could leave me incontinent. He also threw in a special catheter-less dilatation to get me through. The outcome is that I have a 3cm stricture that is not near a control centre. That means I am a good candidate for buccal mucosal urethroplasty.

So basically what this means is that skin from the inside of my mouth will be grafted over the top of the stricture. This will then be followed by 10 days of doing as little as possible in the hospital whilst the graft takes. After that is another 2 weeks of doing very little whilst the healing completes. Beyond that I will not be able to do anything too adventurous for 3-6 months to ensure that the good work is not undone.

The success rate is very high, there is though a threat that if enough tissue is not taken the stricture may reoccur, in which case the process is performed once more.

The challenge though is the out of pocket expense of around $3,600. This will require both Bobbie and I significant dedication to achieve our goal date of March 2012 for the surgery. Hopefully by the middle of the year my long dreaded fight with this annoyance will be a thing of the past! Then we can move on to IVF … the subject of another post me thinks.

Tags: catheter, dilatation, stricture, surgery, urethra, urinary system, urologist
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