Hello Everyone

[AnonStricture]

Hi All,

I had a urethral dilation in December last year for a urethral stricture.  Has resulted in a longer 'fat' penis (slightly bent penis) when flaccid and a noticeable 'twist' in my penis.  I have a 'swelling' in my rectum that is there 24/7 and am having ongoing treatment for pain (constant burning) and urge to go to the toilet... it is a living hell.  Initial urologist told me to 'go and get a second opinion'.

Just wondered if anyone here has a 'twist' following cystoscopy / dilation... my wife says it is much harder than previously, it doesn't hamper my ability to have sex and isn't painful when erect, I just have a constant burning in my urethra which starts in my rectum (sorry for the graphic info).

Any advice / help much appreciated.  Nice to meet you all! (virtually).

Regards

AS.

[Tychy]

Hey,

as no one answered so far, I'm dropping in.

Was it the anesthesia "increase dilators one after another" method or were you awake during the procedure?
How far in was the stricture / how deep did they dilate?
Did the doctor tell you there is some risk of uncomfortable time that will go away?
Are you generally a bit on the anxious side?

[AnonStricture]

Hi,

Thanks for the reply..

I was told 2 weeks recovery so slightly anxious that 7 months later I am still in pain.

The surgeon didn't tell me how he carried out the dilation.

Just hope this can be fixed... life is pretty unbearable now.

[Tychy]

Okay, so there are a few things to consider.

1) Urethral trauma. This should heal pretty fast, actually and is a bit unlikely, if you have no bleeding or trouble passing urine. And it should have got better after seven months. You didn't answer where the stricture was. Was it in the shaft or near the prostate?

2) Infection in the urethra or prostate. Get a urine and semen culture to be sure. No need for swabs. A serious infection would've brought you to the ER after a few days. A chronic prostate infection may linger.

3) Your reaction to post-treatment pain was clenching your anus and pelvic floor. Like "ducking" away from the pain. Do you have trouble starting the urine stream or passing stool? Do you need to push more than usual? Is the pain better when lying on your back? Is the pain better after urinating or ejaculating? Is the twist only visible when flaccid / semi, instead of only when fully erect? Do you expect it to hurt when going to the toilet? Is the swelling actually your anus muscles or a bit above and has the same consistency as, e.g., your flexed biceps?

There are reports of people getting chronic pelvic pain after a cystoscopy or dilatation. This would be your "prostatitis without bacterial infection" or chronic pelvic pain syndrome. If you can answer "yes" to many of the 3) questions, this is the likely explanation.

To be sure, get a leukocyte count (infection marker for bacterial infections from blood), get a semen and urine culture. Consider a second urologist opinion with ultrasound of the swelling.
If all end up negative, it may be a chronic "cramp" in the muscles down there:

1) be mentally aware of the muscles of your pelvic floor throughout the day. Are they tight? Support your mental image by feeling the muscles with your fingers.
2) breathe deeply in your belly. No shallow breathing throughout the day. Your pelvic floor should expand while inhaling deeply.
3) try these exercises once or twice daily Easy Stretches to Relax the Pelvis - Men - Pelvic Pain Foundation
4) reduce stress
5) don't clench the pelvic muscles during sex. They should be relaxed.
6) apply either topical diclofenac to the pelvic floor (don't let it get to the anus) or systemic ibuprofen, if the pain is unbearable. Pinch your arm hard. Is it actually worse than this or are you just more sensitive due to the constant pain. Don't abuse pain killers (I know that may be a thing for chronic pain).

I feel a bit like a quack always pushing out towards chronic pelvic problems, but they are actually a syndrome with so many different manifestations. Penile pain, chronic back pain, abdominal pain, trouble starting urinating, burning, ... you name it.

If it's actually CPPS, you don't have to worry. You'll have to work on this, like a physical rehab, but there will be improvement.

Hope that helps a bit, please report back if you know something new or the condition changes!

[Toronto34]

I agree with Tychy, from what you've written this sounds more like a hard flaccid/Chronic Pelvic Pain Syndrome, but definitely follow-up with doctors.

Things like swelling in the rectum and constant urge to pee are not Peyronies like symptoms. If you have Peyronies, the hallmark is going to be a change to your *erect penis*, usually a new curve or bend or maybe dents, lumps, hourglassing etc. Have you noticed any of these while erect?

[QuackAttack]

Anon,

I don't know if they have malpractice in the UK, but in the US we do. If a doctor botched a procedure like cystoscopy, I would slap a malpractice suit on them. I had a cystoscopy about 20 years ago and after 2-3 days of burning pee, no issues. So, clearly your doctor didn't do something correct.

[AnonStricture]

Thanks All,

I am onto my 2nd uro now who wants to do another cystoscopy.  

I definitely have "hourglassing" when flaccid and erect but not major.

I have a noticeable increased angle to the left but nothing stopping my ability to do my thing.

I have instructed lawyers already... thanks for the advice, this has been the best I've received so far.

The "pain" is a burning sensation ... the swelling is so annoying ... it's changed my life and I am very low. :-(

[Tychy]

Yeah, you definitely need another cysto for documentation. Especially if you go for a lawsuit.

Hope you will find the reason behind this!