Summing up my recovery from two-stage urethroplasty stage 1

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.

Two-stage urethroplasty: stage 1, 12 days after surgery

I’m free of catheters!

After a short wait at the hospital the surgeon removed all the dressings and removed both catheters. There are some before and after pictures here.

So it seems like the graft is looking good, all pink and healthy. The surgeon was initially a bit concerned about infection because of the whitish stuff around the edges but there’s no irritation and she decided it’s just the usual result of having a catheter in and no washing for a week.

Now I can pee sort of normally. I have to sit down and the pee either shoots along the underside of my penis or dribbles down my scrotum but for the first time since October I can actually pee.

I also realised another unpleasant part of not being able to wash properly for almost three weeks, the head of my penis was covered in smegma. Fortunately it was quite dry and not smelly. A quick wash fixed that problem.

My next visit to the hospital (barring unforeseen developments) will be in September, to assess the graft before the second-stage surgery a month later.

Two-stage urethroplasty: stage 1, 11 days after surgery

The local anaesthetic worked for the pain in my cheek. The pain was so bad that it was feeling as if my teeth and jaw were also aching. Doses of xylocaine gel before meals, before going to bed and whenever the pain got too bad helped enormously.

Fortunately the nerve seems to have healed up a bit. I get the occasional ache but nothing so severe and I’m now only using the xylocaine before brushing my teeth.

Erections are still painful but the pain is well controlled by the slow-release painkillers. Pain during the day is now at the point where I can forget to take my paracetamol without it making a huge difference.

One current problem is the smell from the dressing. The surgeon warned me it would start to smell unpleasant but this is worse than I could have expected. I suppose it’s a combination of dried blood and exudate from the wound plus all the things that you normally wash away from your crotch and penis. The smell is best described as appalling. On the plus side it doesn’t smell like anything is rotting, so I’m not worried about it.

So, I just have to wait until tomorrow to find out how the graft is doing. It’ll be a huge olfactory relief just to get a new dressing and a bit of a wash down there.

Two-stage urethroplasty: stage 1, one week after surgery

Later today it will have been a week since my urethroplasty surgery. I’m now back home and sleeping much better, even if my activity is still very restricted (on doctor’s orders).

This time I seem to have managed to successfully communicate to the doctors that my main problem is with painful erections and now that I have some slow-release opioids I can sleep through the night without those disturbing me.

Unfortunately now my cheek is giving me trouble. It has tended to ache occasionally since the surgery but the last couple of days the level of pain has been getting much worse. It comes and goes and doesn’t really seem to be helped by any of the painkillers (paracetamol, ibuprofen or morphine).

Last night I kept getting really terrible pain if I rolled onto my left side. I could feel the weight of my wounded right cheek settling onto my teeth and it was unbearable. Morphine didn’t help, I just had to wait for the wave of pain to pass. Brushing the teeth in the right side of my mouth is impossible.

My husband (he’s a doctor) has suggested that it could be being caused by a damaged nerve in my cheek. We’re going to try local anaesthetic gel, to see if that will help at all.