Cystoscopy and Urethral Stricture

Urethral Stricture

If you have the following symptoms, your problem may be a urethral stricture and the surgical fix via cystoscopy, is relatively simple

  • Reduced urine flow is the usual first symptom. Straining to pass urine is common but a complete blockage of urine flow is rare.
  • Spraying of urine or a double stream may occur.
  • Dribbling of urine for a while after going to the toilet to pass urine.
  • Frequency sometimes occurs (needing to pass urine more often than normal).
  • Urine infections.
  • You may have a reduced force of ejaculation.
  • Sometimes, mild pain on passing urine
urethral stricture cystoscopy

Here’s a typical case:

I have had prostate problems off and on for about 18 months.

I just had a cystoscopy and I’m glad I did. I wouldn’t get too alarmed by what you read about cystoscopies. Any type of surgical procedure carries some risks. Point being that you will read about the very few that go wrong but nothing about the vast majority that go well.

My uro positioned this procedure as the “next logical step” after failing antibiotics. There are some conditions that either cause prostate symptoms or mimic them.

As far as flexible vs. rigid, my uro told me “You’d rather be under general for a rigid and I’d rather do it in the hospital”. I did ask why the rigid. Uro said the optics are better, and if he finds something minor he can repair that he’d need a rigid scope to do it anyway. He’d rather thread a scope once than twice.

Turns out that I had a stricture at the bulbar urethra. Uro stretched it while I was under and my symptoms are much improved — no urgency at all any more. Still not 100% on other symptoms like perineal pain, but better. Uro says it may take a while for my prostate to calm down and I have to go back in another few weeks for another stretching in the office.

Pain was minimal (burning on urination for about 24 hours controlled with Pyridium, which makes you pee day-glo orange). I had Vicodin but didn’t need it. Took it easy for about 36 hours. Back to normal within 48 hours. Make sure you trust your doc. Make sure you get pain management if you need it. But if your doc is skilled, you’ll be fine.

Rigid Cystoscopy

cystoscopy

Note that you can also have a flexible cystoscopy, which is just as good at looking around but does not allow as much leeway for surgical intervention. It’s narrower than the rigid instrument and less traumatic for the urethra, but if the urologist has some expectation of needing to operate or take a biopsy, they are more likely to use a rigid instrument.

rigid cystoscopy
Rigid Cystoscope
flexible cystoscopy
Flexible Cystoscope

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