Anyone dealing with Prostatic Strictures after Radiation therapy?

Thanks Bob for the encouragement! Yes, the test is a Cystoscopy. It’s a shame, aside from this burning sensation I feel healed from the rest of the surgery. Actually I feel I have more energy after the surgery than I did before. I’m praying the Urologist can help me resolve this issue. Have a blessed day!

Hi, I also had RP, no radiation. It will be 2 years Oct. 1 2023
I started experiencing the burning urethral pain 1 month after surgery. It was mis diagnosed for a year.
Long story shorter more recently and 2 cystoscopies 7 months apart, I have injury to my urethra possibly due to the catheter at surgery. My treatment regimen for now is 10 weeks of intermittent intra urethral clobetasol which is a steroid ointment. The doctors are hoping it will relieve the inflamation and pain.
If this doesn’t work there are other options to explore for the scarring also known as strictures. Urethroplasty being the last effort for serious strictures that prevent one from emptying the bladder.
I don’t know yet if I’m going there because I can still pee and my PVR testing is still quite good. PVR is post void residual, how much is left in the bladder after relieving yourself. Also I am scheduled in October 2023 for a urethragram which my urologist says will give him an even more detailed look at the urethra. I’m not sure if this helps you but your description of the pain sounds like what I have. I also have healed nicely from my surgery in every other way. I wish for you the best possible outcome,
Brice

Hi Brice,
Thanks for sharing your story. Having been catheterized many times I wonder if that could also be the source of my urethra pain. It has not quite been a month since my last Urethroplasty with a TUIP. (Transurethral Incision of the Prostate) so I will give it some more time to heal. My PVR has been good but my urgency to urinate not so much. Incontinence seems to get worse with every invasive procedure. My doctor says the urgency can be handled with 20 botox shots into the bladder but I am hesitant to do more invasive procedures. I have gone into Urinary retention twice and it is not something you want to go through. Interesting they are using clobetosal in your urethra. I use it to treat psoriasis. Very strong steroid but I have been told to use it sparingly as it can thin the skin over time. Granted this is for external use but I wonder about long term use in the urethra. Have you noticed any pain relief with the clobetosal? BTW do they give you anything for pain for the cystoscopy? I have had quite a few but only lidocaine is used. Sometimes they are not bad at all but sometimes very uncomfortable. In my case I think it might be when they have to navigate the instrument past my strictures. Best to you Brice and hope your urethra heals up nicely and you are able to move on post RP.
Bob

Thanks Brice & Bob,
Unfortunately, what I seem to be dealing with (stricture?) is uncomfortable most of the time. Standing too long or sitting on anything hard creates a burning pain. A feeling of needing to urinate all the time, only I have very little urine. My stream is split as well. I go in today to have my flow measured. As much as I don’t want to have an invasive treatment, I don’t have much of a choice. Cannot go on living this way. Best of luck to both of you!

Hey Bob,
I appreciate your input too. I have been given lidocaine on both cystoscopies. One was horrible and painful the other was bad but not as bad. I have a lot of irritation and soreness there all the time so they tell me most patients tolerate this scope easily. I don’t fit that profile. It could be the scope operator factor. The clobetasol treatments are helping a little I think but I was expecting or hoping by now I would be saying “wow big difference “ but no not there yet. I’m half way through 10 weeks of treatments titrations down to the last 4 weeks once every 4 days. Currently I’m every 3 days. I started treatments every day for 1 week , every other day for 2 weeks. Mayo urologist suspected Lichen Sclerosus but no biopsy to prove it means treatments with clobetasol is diagnostic. Also my urologist at home here thinks probably not LS, however says finish 10 week course because the steroid should quiet inflamation anyway.
I have no prostate, had prostatectomy and I’ve read that scope navigation through the prostatic urethra can be difficult.
Again wishing you the best and prayers for a positive outcome.
Brice

Hi Myersja,
I cannot say I was uncomfortable with the strictures as I could not feel them but did, and still have the burning pain you refer to when I urinate. No pain unless urinating. The stricture removal does definitely help with urination but has not helped me with urgency or incontinence. No joke, I believe I urinate 24 times a day which has it's own challenges as in going to a movie or dinner or anything not at home. I am good as long as there is a restroom nearby. I may have to try the botox treatment in the bladder but even that is not a permanent fix. I wonder if anyone reading this string of messages has had the botox treatments of the bladder to reduce urgency and if so what has your experience been?
Bob

Hi Brice, I was wondering how you are doing? I believe I was injured by the catheter also. I am 2 years post surgery and I continue to have penis pain. My catheter popped out on its own 4 days after surgery. I'm not sure I can undergo anything intra urethral. Any insight/advice you can provide would be appreciated.

Thanks and I hope you are well.

Hi, my most recent visit with my new urologist resulted in a postponement of the urethragram because I was about 50% better by 9/19. Now the soreness is creeping back so he told me to do ibuprofen 3 times daily for a week and see if that helps then possibly revisit the urethragram so ..
Still working towards a solution but not there yet.
How about you?
Any news to report?
Thanks

Still dealing with pain. I prefer not to take meds but perhaps I'll try the ibuprofen.

Thanks for your help.

I am taking 400 mg ibuprofen 3 times a day with food for a one week duration. Ibuprofen is an inflamatory drug.
It can cause constipation so I take Metamucil every day around 5 pm. 2 heaping teaspoons in 10 oz. Of water. Also I have been using virgin olive oil topically for a long time applied into the meatus. I always feel better first thing in the morning and typically as my day wears on the pain and discomfort increases. After 10 weeks intra urethral clobetasol ( steroid) treatment regimen I had considerable relief but as I said earlier it was not curative and the discomfort , soreness and redness is returning. I’m not sure if a urethragram will show anything other than stricture/ scar tissue but I am able to void my bladder completely so whatever stricture is present is not so bad that it prevents flow.
I will need to discuss this with the doc next visit which is not until April. Possibly sooner through the patient portal but not as good communication as in person of course. I have already had 2 cystoscopies over the last year both showing scar tissue so I have been told that scar tissue can cause pain. I’m still a bit puzzled though.