Carlos, I am the resident "expert" on chronic strictures. SRT can most definitely create additional stricture problems by itself. It's not super common, but hardly rare. My prior stricture issues from surgery, including 2 emergency dialations and 3 corrective surgeries, were only made worse with the SRT I underwent. This history was the main reason, that I had a suprapubic catheter the entire time I was undergoing SRT. The thinking was that my uro did not want me to deal with an emergency stricture situation in the middle of SRT or after, since I was prone to them.

With some guys, the sticture issues are a one or two time event, and normally a dialation or two will cure the issues. With a few of us, the stricture become chronic. I have read numbers in the 2-4% range of patients. Subicsquid and Pigeonflyer are two examples of guys here that had short term problems with strictures.

The SRT can cause some serious swelling issues during and after, especially at the bladder neck to urethra connection, which is touchy to begin with after surgery.

I hope for you, this dialation cures what woes you there, but if you suspect you are losing your flow, don't wait too long to contact your uro.

You definitely don't want it to become an emergency situation, and you don't want it to be an ER situation, as many ER's aren't properly geared to handle it without further damaging you in such a critical area.

I wish you best luck, and hopefully you won't be dealing with it again.

David in SC

David, thanks for the input.  There's no worry about letting it get away from me.  I'm almost as bad as Worried Guy (Jeff) about monitoring my flow.  A good peakl flow rate for me is about 20 ml/sec and my alarm rate is 10 ml/sec.  I do stay out of the kitchen though.

Squid,  my previous dilations were similar to yours and had that little pop as the sound entered the bladder neck.  This time was different. No pop at all and the pain level was much worse than before.  May have just been a change due to radiation.

Carlos

Self cathing can be done, on a regular basis even, but it assumes that you can safely get the tube up all the way into your bladder. There are folks with MS, that self cath all their lives. With a severe stricture, its unlikely that you could do it effectively, and without harming yourself. That would be a call between the doctor and the patient. Again, my bladder neck was so damaged, it was ruled not safe to self-cath.

If you had to self cath, it pays to have the doctor give you an ample supply of lydacaine gel, to make the initial insertion easier and less painful. If you are not circumsised, its even more difficult to self cath.

The one time I had to go to my local ER with a full bladder, pain scale 10 going on, at night, it took 3 nurses and a lot of pain to finally get the smallest size french catheter into me. They did not listen to the on-call urologist from my group on the phone in the ER, and nearly caused a disaster. My uro was furious with the staff there, and had strong words to them about it later.

David

Carlos,

Now you got me curious. How and by what method did you use to measure the flow that accurately? Some of my strictures were slow as you describe, but at other times, it was in a question of hours.

Sounds like a reasonable way to calculate that.