I was wondering if someone could advise me on urethral stricture disease following treatment for PC, and also what the success rates are for urethroplasty?
I was diagnosed with PC at age 50 with Gleason 7, PSA 4.7 and T2C staging. I underwent DaVinci robotic RP 4 years ago. Everything was fine for ~15 months before a biochemical recurrence was detected, my PSA went from <0.1 to 0.2 to 0.4 in 6 months. I was also having problems urinating around about this time and was passing some blood. A cystoscopy was performed, and a urethral stricture was identified. Had a Urethrotomy 15 months ago and was catheterised for a week. Immediately after this I was started on 4 months of hormonal treatment (HT). I think I got every side effect including some new ones. Almost consistently with every prostap-3 injection I would develop uveitis flare ups in my eyes which resulted in urgent trips to the hospital eye clinic. Anyone else experienced this?
The HT was followed by 4 weeks (20 sessions) of radiotherapy (RT). My PSA last August had dropped to <0.1 again, which was some good news, although the oncology nurse said this could be either due to the HT or the RT.
After the RT the stricture recurred and I was back in hospital for a urethral dilation in October last year, catheterised then for a week. I found afterwards when trying to do intermittent self-catheterisation (ISC) that there felt like there were now two strictures and ISC was becoming difficult. I was also passing blood nearly every time I was urinating. The strictures were confirmed by cystoscopy and urethrogram.
At the start of the new year I had further blood tests which indicated my kidneys were not functioning that well which the GPs believe was due to a backflush. This was followed up with an urgent call to my urologist, who after consultation arranged another urethrotomy the following day. This time the catheter has been left in for 4 weeks in an attempt to prevent the stricture recurrence. The catheter hopefully will come out next week; 3 weeks after the op however I’m still having bleeds.
Just wondering if anyone else has had a similar experience of developing urethral strictures following RP, HT and RT. I’d be interested to hear if anyone has also undergone urethroplasty, as after RT I wasn’t sure if this is an option?