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Urethral Stricture following RT/ LDR Brachy

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User
Posted 08 Jul 2023 at 08:22

This is an update to my previous post: My HT/EBRT/LDR Brachy Experiences - Localised cancer - Prostate Cancer UK Online Community

The good news is that my psa is still undetectable 2.5 yrs after HT/ RT/ LDR Brachy.

Middling news is that the testosterone has increased slowly to 9, just above the minimal level.

The bad news is that I may have a urethra stricture resulting from the treatment. My urine flow dropped about 2 or 3 months ago from well over 12ml/sec to 5 ml/sec (my rough measurement), though it seems to have levelled out now. Also, my nocturia has now increased from 2 to 3 times/ night. There’s also some evidence of urine retention in the morning.

I’m managed to get an appointment with the consultant in a month’s time. In the meantime, I would welcome any comments/ experiences from others as to cause/ treatment/ outlook etc.

User
Posted 08 Jul 2023 at 17:23

Vince ,I formed a stricture but that was after surgery. A surgical stricture can take several attempts to sort it out. Hope yo get sorted.

Thanks Chris 

User
Posted 08 Jul 2023 at 18:31

I developed a stricture just below my prostate about 10 months after EBRT finished.  I started passing blood in my urine.  They dilated it.  That was two years ago and I've had no problems since.  The only thing I would say from my personal experience is if given the choice go for dilation under a general.  When they discovered mine with a cystoscopy they offered the choice of coming back for dilation under a GA (their recommendation) or pressing ahead then with just local anaesthetic gel.  I wanted to get it sorted so chose the latter and it turned out to be one of the most painful things I've ever gone through.  And it felt like I was pissing razor blades for days after.  That said I know other guys here have had it done under a local without any problem, so my advice is just based on my personal experience. Good luck whatever you choose.

User
Posted 08 Aug 2023 at 08:34
The length of treatment is really long or short depending on the individual. In my opinion, its effects will be slow at first, so don't worry too much about this problem. can only speak from my own experience, but I know several people who've had it done by a local without any issues. In any case, I wish you the best of luck.

geometry dash lite

User
Posted 09 Aug 2023 at 10:47

12 months after my SRT I noticed a reduction in flow, referred to urologist and after a scope was used they diagnosed a bulbar (that’s the area at the base of the penis) stricture it was about 1 cm long and my flow was reduced to less than 2ml at diagnosis. That was in 2020. I have had 3 dilatations since each time over a six month period my flow drops from >15ml to < 5ml. 

At the last session completed two months ago I was asked to consider self catheterisation as a longer term option to manage the flow. Which I now do weekly and it’s easy.

I was told by my Radio Onco (Prof) that strictures were extremely rare and that I should not be concerned (since I specifically wanted to avoid this outcome) in reality they are much more common. You have to laugh with this disease it constantly gifts things you don’t want.

Strictures fall into a number of categories. Those like mine that operate/close over a six month period. Those that last 1-3 years and some that never return after dilatation. Each group is approx 1/3rd each.

The good news. Despite my fears. Managing self catheterisation to 16 CH weekly is really, really straight forward. Also if you desire you can have surgery to fix them. I may eventually go down this route with high probability of cure. But for me I have been on the wrong side of every percentage chance on this journey so far and will happily do self catheterisation. Plus you get training on how to do it from a hot nurse. Lol

My three dilatations have been done under a local (they apply a gel) anaesthetic and the whole process is at worst and at peak only mildly uncomfortable. My first consultant doing the dilatation described my stricture as soft. If they can get a scope through to your bladder (the scope is 14 CH) then you can easily do a full dilatation to 20 CH whilst awake. I like looking at the screen and watch the camera and ask questions anyway.

 

Edited by member 09 Aug 2023 at 11:13  | Reason: Not specified

Base jumping without a parachute should be frowned at, never criticised. Fresh

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User
Posted 08 Jul 2023 at 17:23

Vince ,I formed a stricture but that was after surgery. A surgical stricture can take several attempts to sort it out. Hope yo get sorted.

Thanks Chris 

User
Posted 08 Jul 2023 at 18:31

I developed a stricture just below my prostate about 10 months after EBRT finished.  I started passing blood in my urine.  They dilated it.  That was two years ago and I've had no problems since.  The only thing I would say from my personal experience is if given the choice go for dilation under a general.  When they discovered mine with a cystoscopy they offered the choice of coming back for dilation under a GA (their recommendation) or pressing ahead then with just local anaesthetic gel.  I wanted to get it sorted so chose the latter and it turned out to be one of the most painful things I've ever gone through.  And it felt like I was pissing razor blades for days after.  That said I know other guys here have had it done under a local without any problem, so my advice is just based on my personal experience. Good luck whatever you choose.

User
Posted 08 Aug 2023 at 08:34
The length of treatment is really long or short depending on the individual. In my opinion, its effects will be slow at first, so don't worry too much about this problem. can only speak from my own experience, but I know several people who've had it done by a local without any issues. In any case, I wish you the best of luck.

geometry dash lite

User
Posted 09 Aug 2023 at 10:47

12 months after my SRT I noticed a reduction in flow, referred to urologist and after a scope was used they diagnosed a bulbar (that’s the area at the base of the penis) stricture it was about 1 cm long and my flow was reduced to less than 2ml at diagnosis. That was in 2020. I have had 3 dilatations since each time over a six month period my flow drops from >15ml to < 5ml. 

At the last session completed two months ago I was asked to consider self catheterisation as a longer term option to manage the flow. Which I now do weekly and it’s easy.

I was told by my Radio Onco (Prof) that strictures were extremely rare and that I should not be concerned (since I specifically wanted to avoid this outcome) in reality they are much more common. You have to laugh with this disease it constantly gifts things you don’t want.

Strictures fall into a number of categories. Those like mine that operate/close over a six month period. Those that last 1-3 years and some that never return after dilatation. Each group is approx 1/3rd each.

The good news. Despite my fears. Managing self catheterisation to 16 CH weekly is really, really straight forward. Also if you desire you can have surgery to fix them. I may eventually go down this route with high probability of cure. But for me I have been on the wrong side of every percentage chance on this journey so far and will happily do self catheterisation. Plus you get training on how to do it from a hot nurse. Lol

My three dilatations have been done under a local (they apply a gel) anaesthetic and the whole process is at worst and at peak only mildly uncomfortable. My first consultant doing the dilatation described my stricture as soft. If they can get a scope through to your bladder (the scope is 14 CH) then you can easily do a full dilatation to 20 CH whilst awake. I like looking at the screen and watch the camera and ask questions anyway.

 

Edited by member 09 Aug 2023 at 11:13  | Reason: Not specified

Base jumping without a parachute should be frowned at, never criticised. Fresh

User
Posted 07 Oct 2023 at 09:36

Thanks to all the comments. Hence an update, and some good news.

I had my urine flow rate checked at the hospital and this peaked at 6 ml/sec. The Oncologist felt that TURP wasn't warranted at this stage (Risks outweighing benefits). He suggested that I increase my dose of Tamsulosin to twice a day, also taking it in the morning. ( I used to take a dose in the evening).

Much to my amazement after a couple of weeks my urine flow increased to well over 10ml/sec (my basic measurement with a measuring bowl and stop watch). Nocturia has decreased back to twice a night.

I feel that the increase in flow rate is all down to the additional dosage of Tamsulosin but maybe its coincidence?  Whatever reason,  I'm obviously delighted! Just hope that things stay as they are.

Vince

User
Posted 04 Dec 2023 at 21:26
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"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

 
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