I recently got an email from a reader of this blog, who’s having stage 1 of a two-stage urethroplasty soon. He was asked some questions about the recovery from the surgery and that made me think it would be useful to write a summary of how it went for me.
- First five days after surgery: bed rest, barely allowed to move from bed. The surgeon was very keen that the graft not be disturbed. Pain from the stitches and general bruising to the penis, and from the graft site in my cheek. Some aching from bruising to my scrotum. Able to comfortably sit up in bed immediately.
- Second week: resting at home, movement very restricted. Still allowing the graft to settle in, until the surgeon could check it. Penis pain still quite bad at night but well managed with painkillers. Occasional pain during the day. Frequently using local anaesthetic gel to manage cheek pain. Able to walk normally but being deliberately careful.
- Third week: back to work. Cheek pain gone. Still needing painkillers to sleep through the night, reducing use during the day. Walking normally but not long distances. Catheters removed, having to pee quite often and urgently.
- Fourth and fifth weeks: more walking. No need for painkillers during the day and eventually not at night either. Walking quite a lot, especially during a trip to Portugal. Frequency of peeing back to normal but still often quite urgent.
- Sixth week: able to exercise again. Everything pretty much back to normal apart from having to sit down to pee.
My current status is that all the visible stitches have fallen out. There may still be some under the skin as I can feel a few lumps. I even have some sensation in the graft now, although it feels weird (in a way that’s impossible to describe).
I learned the other night that it’s a mistake to try to use a portaloo that has no lights, at night, after several beers. I didn’t want to sit down to pee (the thing was disgusting) and I managed to misalign the funnel I carry for that kind of emergency. As a result I had to walk home in slightly damp shorts.
I got a really good night’s sleep back at home, apart from the usual thing of waking up every time I rolled over to make sure the catheter tube was OK.
Back at the hospital I had a short wait until the doctor came on rounds. He said he’d told the x-ray people to make me an appointment in a couple of weeks and discharged me. I returned home with a big bag of catheter and dressing supplies and went back to work after lunch.
The district nurse at my GP surgery called me at work during the afternoon to make an appointment to have my dressing changed. We can mostly handle that ourselves but it will a useful opportunity to get more supplies and maybe some advice on the best way to deal with the catheter.
One problem is showering. No matter how hard we try we can’t find a way of arranging the dressing so that water doesn’t run along the catheter tube and soak the inside of the dressing. That means I need to change it every time I shower and I end up only showering every other day.
The bladder spasms haven’t been as bad this time around, probably because I immediately asked for medication to prevent them. One positive sign has been that I’ve actually been able to pee a little bit, even though the suprapubic catheter isn’t letting pressure build up. That suggests that the inflammation in my urethra is going down already.
I’ve now had a couple of days without the catheter and it’s going well. I get a good flow with I’m peeing, no dribbling afterwards and only a little bit of stinging pain now. In fact the pain is less than before the surgery.
There hasn’t been any bleeding since Thursday and the bladder spasms at the end of urination are now pretty much gone. The suprapubic catheter wound has closed up and seems to be healing well, although it’s still a little sensitive to pressure.
The bladder spasms came back with a vengeance on Tuesday, with quite a bit of leakage through the urethra. Even worse on Wednesday. It felt like my bladder was full when I woke up and there was very little in the night bag. The leakage also caused some pain and bleeding in my urethra.
My husband somewhat forcefully arranged an appointment for me at the urology clinic (it’s sometimes very useful being married to a doctor). I was seen within ten minutes of arriving at the hospital and the nurse flushed out the catheter and spoke to a doctor to get me a prescription for tolterodine for the spasms.
The flushing and drugs seemed to work. I had a few spasms later in the week but they were much milder and didn’t cause leakage.
My penis was looking less swollen and the bruising was almost gone. With an erection there’s a noticeable downward curve that it didn’t have before. I’m hoping that will go away once all the stitches have dissolved and the internal swelling has gone. The external stitches had all come out by the end of the week. The scar on my cheek is still irregular and noticeable but not giving me any trouble. Click here for photos.
The pain of night-time erections gradually got better during the week, taking some slow-release ibuprofen along with paracetamol before going to bed helped.
The bladder spasms were better once I was rid of the urethral catheter. I started working from home although I was very tired due to poor sleep and avoiding caffeine. I slowly started drinking coffee again as the week went on.
When I was pooping I kept getting some very odd sensations in my prostate, maybe because it was still sensitive from the catheter. On one occasion I had what I’m pretty sure was a prostate orgasm, which was very intense.
I started off going to the nurse at my GP surgery to get the suprapubic catheter dressings changed every few days. I usually got wet when I showered but the wound didn’t seem to be seeping at all. The nurse changed my leg bag on Monday and I got supplies so that I could do that and replace the suprapubic catheter dressings myself.
For a couple of days I was getting pretty severe pain on the left side of my jaw and apparently grinding my teeth during the night. That went away by itself, probably just a side-effect of my mouth being wedged open during the surgery. Otherwise the wound in my cheek was healing up pretty nicely, still a little bit irregular and sensitive but not causing any problems.
After a very disturbed night due to erections I got up and pooped again. This time it was preceded by really bad bladder spasms and a few centilitres of urine squeezed past the catheter.
Took the bus up to the hospital in time for morning rounds. A more senior urologist was doing rounds and he’d been informed about the trouble with the suprapubic catheter. I had to wait for someone to put in a new one, which would be done on the ward with local anaesthetic.
The treatment room in the urology ward seems to mostly be used as a storeroom, with nurses coming and going all the time to collect supplies and pick up labels from the printer. An operating light had a sign saying that it was faulty and had been reported in March.
A young doctor and a male nurse were going to be replacing the suprapubic catheter. After a bit of a clean the nurse started squirting saline into my bladder, stopping when it got uncomfortable. At the same time the doctor was injecting the local anaesthetic, with a fearsomely long needle. The first batch wasn’t quite enough and I was glad that he believed me when I told him I usually need more.
Once the anaesthetic had taken effect the doctor took the huge thick needle (it looked like a skewer) and started poking it through my belly, causing all sorts of odd sensations. That didn’t work, so he pulled it out and tried again. The second attempt failed, liquid would come out of the needle but when he inserted the catheter nothing came out through it.
The third attempt was also unsuccessful so the doctor scuttled off to consult a more senior colleague. It seems the advice was for more water, to make my bladder easier to find. The fourth and fifth attempts were incredibly uncomfortable as I felt like I desperately needed to pee. I ended up panting and feeling panicky. As they still hadn’t succeeded they let the saline out while the doctor went to fetch his colleague.
The senior doctor seemed to be in a charming mood and he fairly quickly and efficiently got the catheter in and then spent a while stitching it firmly to my belly.
I got dressed and went along to the day room for lunch, feeling a bit shaky. Then I had to hang around all afternoon waiting to be discharged. A nurse came to remove the urethral catheter and left me a supply of night bags but no drugs nor any discharge information.
Eventually another nurse gave me my drugs to take home. My husband insisted that I needed to see a doctor before I left and finally the young one who’d had all the trouble with the suprapubic catheter turned up and discharged me.
Had a less horrible night, still woken by painful erections but managed to at least get a few solid hours of sleep.
The catheter night bag was really full and difficult to empty. When I cut the corner off a jet of urine sprayed the area around the toilet, so I had to wipe it up and mop the bathroom.
I managed to poop for the first time in four days and without any spasms. I’d avoided caffeine during the day, so maybe that helped.
I had a horrible night with a persistent semi-erection from about 04:00, usually becoming fully erect with about 15 minutes of me dozing off.
The dressing on my penis was in need of replacement but we didn’t have the supplies to do it. While everything is more visible I could see that my penis is looking quite twisted but that was apparently due to internal bleeding and swelling and will resolve itself. Click here for photos.
I risked some coffee at lunch but then had some horrible bladder spasms in the afternoon. I’m not sure if the two things are related.