Hi. I am a 34-year-old male in the US and stumbled upon this site as I was looking for some information regarding the effect of having erections with a catheter inserted after having a buccal mucosa skin graft urethroplasty. I found the site and stories so interesting that I thought that I would share my story.
I was diagnosed with a urethral stricture about 17 years ago. I will not get into too great of detail but I underwent some dialations early on and then had a laser incision done on the stricture to try and remedy things which was unsuccessful. This laser incision was done years ago not long after the initial diagnosis and following that it was a series of dialations. I moved around a lot and saw a lot of urologists. We tlaked about stents. We talked about open surgeries. I probably was dialated five or six times a year. Had times that things totally closed up and had to have catheters inserted. Ugh.
Finally my urologist put me in contact with another urologist that had done some urethroplasties. This doctor said that we should have done the urethroplasty years ago. We bit the bullet. Anyway, we made the appointment and we did it. I am currently laying on the couch in recovery. Here's how things went so far.
I had the urethroplasty done on January 3rd. The doctor explained that they would make an incision between my penis and anus and then first try and cut the stricture and tie the ends together if it were possible and if not then they would move to the idea of removing the stricture and reconstructing the urethra using skin from inside my mouth. This is called a buccal mucosa graft. As a preparation the doctor gave me some "Swish and Spit" to use before and after to help keep my mouth clean. When I woke up in recovery after the anesthesia wore off I knew which option had been used. They had taken skin from inside my cheek. Coming out of anesthesia I felt like I needed to vomit a few times. Once that wore off I was just really cold and sleepy. I stayed over for one night in the hospital. There was some dull pain where the incision was but the worst pain was the inside of my mouth. It is hard to believe how painful that area can be and how slowly it will heal.
Anyway, I left the hospital and returned home. I was given prescriptions for four medications. 1. Vicodin - Very helpful in mouth and incision (mainly mouth) pain relief (took lots of this) 2. Stool softener (took a little of this) 3. Bladder spasm calmer (never needed this) 4. Antibiotic to be taken 2 days prior to follow-up visit. I still had the "Swish and Spit" which burned but helped my mouth heal. For the first day or so I was in a haze at home. It was a combination of the anesthesia and the vicodin that I was taking. During the next week the mouth pain was awful. All other pain was minimal. I have been surprised at how little the incision has been painful. Many speak of issues related to dealing with a catheter. Maybe it's my past experience (I've had many) but the catheter bothers me little. The worst part is when I get erections with the catheter in place. I've wondered what affect those have on the skin graft.
After two weeks or so there is very little pain anywhere. My mouth pain is very minimal. I can feel the smooth healing skin in my mouth with my tongue. The incision gives me little trouble. There is still a bit of scrotum swelling. I should mention that, as others have mentioned, the scrotum will be enormous after the surgery but over time the swelling will subside.
I have nine days left of the catheter being in. I will start the antibiotics two days before. When I go for the follow-up they will remove the catheter and do some X-rays similar to the ones that they did prior to the surgery to take a look at the location of the stricture. It's amazing in the pre-operative x-rays how narrow that opening really can get with a stricture.
One thing that should be mentioned is the importance of keeping the incision area as clean as possible given that it is so near to the anus and that bowel movements could introduce some adverse conditions. Bowel movements with catheters in place are interesting in the first place. You may anticipate some anal swelling.
It will be then that we will get the first inkling of the success or failure of the long-awaited surgery. I feel very confident that things went well. I guess we'll see.
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