Anyone have a prostate stricture – choices

Could be worse. I have zero flow and self-cath 5-6 times/day. Have been since Spring 2025. Since no one can guarantee full continence after any suggested procedure, I just consider it part of life now. Much better than diapers as far as I'm concerned.

Salvage radiation left me with incontinence and a urethral stricture. Depending on the severity and location of the stricture, the surgery can be dicey. My doctor told me I had a 60/40 chance of success, but a failure would make things even worse. After researching online to forgo the stricture surgery. I choose to get a Optilume balloon which dilated the urethra. My flow has never been better. A urinary clamp and one pad a day addresses the incontinence so well all thoughts of getting an AUS has been abandoned.

@lsk1000 Heard about AUS but would it not be easier to have that and have no leak at all? Keen to learn more on this issue. Thanks.

@allex50 There are several things to consider. I could be all wrong about numbers 2-5, but #1 was of primary concern.

First off, for me, if my stricture procedure failed outright because of complications or if it caused any issues over time, the AUS would have to be removed, the urethra repaired, if possible, and the AUS replaced.

For other considerations I admittedly have no first hand experience.
Second consideration, having a device implanted which can fail and need re-doing &/or will have to be replaced eventually is not appealing to me.

Third, many people report using a pad a day because, I’m guessing, it is not 100% leak-proof. 🤷‍♂️

Fourth, People have reported it can be felt while sitting on a hard surface like a bench or bike saddle which is uncomfortable. 🤷‍♂️

Fifth, to operate the AUS takes reaching down and squeezing a button inside the testicle sac which I imagine is about equal to the task of operating a clamp.

@lsk1000 Thanks for that. So AUS does accompany a stricture in some cases. I wonder how someone copes with a UTI under such an arrangement. My thinking is of course 'do I want to do anything to stay alive a bit longer' I think I'm going through the mental anguish of accepting my days are nearly up. How lucky are those who pass away in their sleep having not been through this sort of end of life experience.

@allex50
Re: “So AUS does accompany a stricture in some cases.”

To be clear, a stricture must be addressed before an AUS is implanted. That means an additional procedure before the AUS and therefore an additional thing that can go wrong, in which case the patient may end up not at square one, but at square -1. That’s the downside risk factor I chose to avoid when a clamp and a pad didn’t intrude on my life style.

Re:” Your days are nearly up.”
I’m sorry that is your state of mind. Since I do not know exactly your circumstances I an reticent to comment, the night I was diagnosed with incurable Non-Hodgkins lymphoma 20 years ago the median survival time was 3-4 years. I went outside to walk the dog and thought “so this is how I’m gonna die. I always wondered about it.”

There’s a song by David Bowie called Modern Love, and although the theme of the song is cynical, I choose to remember one lyric that goes: “Modern love gets me to the church on time”. — Modern medicine keeps me (us) alive even with our skepticism.

@lsk1000 My brother died of that disease in '96, my father of gastric cancer and my sister of colon cancer so I'm a little influenced mentally by that. I'm looking into the stricture angle as I worry that it will leave me neither radiation or prostatectomy and permanently on ADT. I have an appointment with Oncology end Sept. and just want to be part of the decision as to what next.

@allex50
While we'd all like to be the fire department's first choice when they need an extra stream...I've been on Dutasteride and flomax for a year now trying to maintain that raging torrent. What I've found works the best is pumpkin seeds. Salted or unsalted doesn't seem to make a difference. I went on vacation for 11 days without the seeds, relying on my 2 prescriptions, and by the time we got home I was starting to get a bit worried about the flow. It seemed to stop early without fully emptying the bladder, the stream was narrower and the end was in squirts with an effort. Not the usual. Pumpkin seeds in my cereal (I grind them up) for 2 days and I was back to full flow. I don 't know if that sounds familiar to anyone else but that's my story.

@allex50 Sorry about your siblings, I know first hand what that is like. I believe…. If you choose surgery and there are no issues with the margins (cancer well contained in prostate) radiation might be avoided, and therefore taking stricture off the table.