Surprise surgery and another infection

Last week I was logged in to my online medical records and noticed that I had an appointment booked with the surgeon who did my urethroplasty back in January. I hadn’t heard anything about it so I called the hospital and was told that it was a real appointment (not just a phone call). The letter about the appointment turned up the next day, saying they be doing uroflowmetry and with no other information.

So I drove up to the hospital on Tuesday and met the surgeon and was a bit surprised when he announced that he was going to try to do a quick urethrotomy while I was there. Preparation took a while (nobody could find the urethrotome), which was probably just as well since local anaesthetics take a while to take effect on me.

Since this current stricture was only about 3 cm in and very short he could get the rigid cystoscope in without any problems. It was interesting to watch him hacking away at the scar tissue on the screen. I didn’t feel a thing. He also had a quick look at the rest of the graft and seemed happy that it looked healthy and was wide enough to get the 20 Ch scope through.

Then I had time to grab a quick lunch before meeting a nurse to be instructed in how to do clean intermittent dilatation to keep the stricture open. I got some supplies but I’ll have to contact my local urology clinic for more, since I’ll be doing it daily to start with.

I’d managed to pee normally a couple of times at the hospital. There was a fair bit of blood but the local anaesthetic was still working, so it wasn’t painful. By the time I got home the anaesthetic had worn off. While I was actually peeing there was a burning sensation, which I expected and it was bearable, but afterwards I got rapidly increasing intense pain. This was really about the worst pain I’ve ever experienced, I nearly blacked out sitting on the toilet. The pain gradually faded away over a few minutes.

My husband brought some local anaesthetic gel and I took some strong painkillers but nothing seemed to help with the horrific pain every time I peed that afternoon. To make things worse my bladder was still irritated from the pressure due to the stricture so I was peeing quite often.

Then as the evening went on I started to feel worse and worse, achy and feverish. My temperature had got up to over 38°C, so my husband called a taxi and we went to the ER. I got seen fairly quickly, gave the same information to several different people and they took various samples. By around midnight they’d decided it was a post-operative infection and to keep me in but they couldn’t find a bed for me for several more hours and it was about half past three before I eventually got up to the ward.

The antibiotics seemed to start working pretty quick, so I was already feeling better yesterday and got to go home for the night. I went in this morning for the final dose of IV antibiotics and they’ve discharged me with antibiotic tablets.

So now I just have to see how I get on with the dilatation. It seems easy enough to do and the surgeon reckons that after a few months I should only need to do it once a week. I’m a bit concerned that that’ll be once a week forever but I could live with that.

After urethrotomy

So a week after the surgery I had the usual problems that guys seem to have with catheters but that nobody bothers to tell you about.

Being woken up during the night when erections meant that my penis simultaneously tried to pull out the catheter and scraped it over the inside of my urethra was a new experience, and one I could have happily done without. After a couple of days I learned to tape the catheter into a position that minimised the unpleasantness.

I think that night-time erections were a particular problem for me because my penis changes a lot in size between flaccid and erect. So an erection meant pulling an extra 10 cm or so of catheter over my wounded urethra. It was also a latex catheter and they seem to be stickier than the other types.

During the week with the catheter I worked from home and tried to avoid walking around too much. I never did find a position for the tubing that didn’t become uncomfortable while walking.

Having the catheter removed was very easy, although slightly delayed by a massive failure of the county’s healthcare IT system that morning. The nurse deflated the balloon and pulled it out smoothly, all I felt was a slightly odd sensation and it was done.

I went straight back to work afterwards and discovered that the catheter had left my prostate a bit tender, so I needed to use a soft cushion on my office chair.

A few days later I started feeling like I had flu or something. Several colds and flus were going around the office at the time but my husband insisted I go to the emergency room and it turned out I had a fairly severe urinary tract infection. By the time I was admitted to the urology ward, around midnight, I was sweating profusely and feeling pretty grim.

They kept me in the hospital for three days while the antibiotics started to take effect. When I was discharged I had a meeting with the doctor who’d done the urethrotomy. I was a bit concerned that I hadn’t had any night-time erections for a few days (which was probably just due to being really ill) but he just casually said that it could be a complication of the surgery and made a weird comment about the next step being anastomosis and that that would likely cause shortening of the penis. It was an odd thing to say both because anastomosis isn’t at all a suitable surgery for strictures in the penile urethra and because it had nothing to do with the question I’d asked.

After a week of recovery I could concentrate for long enough to go back to work, although the infection had settled in my prostate and needed another couple of weeks of antibiotics to be completely rid of it.