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Urology/Urethra , optical urethrotomy.

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Question
December last year i woke up and wasn't able to urinate. Taken to the ER and had multiple catheters put in but weren't able to go in through the penis all the way tot he bladder is suppose so i got transferred to another hospital and got a suprapubic catheter in place. Lasted about two weeks with it till it fell out by itself rushed to the ER they tried to put a catheter in and i guess the doctor needed another type since the one he tried didn't work he took it out and it hurt i peed by myself after with some blood and just went home. I was able to pee okay till about a week now i wake up in the morning and i can't pee right away since its my first time emptying my bladder on the day i suppose and after that when i need to pee i don't struggle and the stream seems fine. Doctor said he thinks i have a urethra stricture and wants to perform Optical Urethrotomy. I feel weird down in my penis area sometimes not a pain but a bother. Is he correct and should i trust his judgement and have this procedure taking care of? I'm scheduled for it in a week. I'm 19 years old and i want to have a healthy life and sex life and i want to be a dad i don't want this to effect my reproductive abilities. I also tried masturbating and it a sting feeling did occur when the semen came out.

Answer
Damian:

A urethral stricture is quite likely, but there is not enough information provided to allow a definitive diagnosis.  A cystoscopy (look into the bladder through the urethra) would be more definitive.  Also, an x-ray such as a retrograde urethrogram would help identify the problem.

If you are uncertain, consider a second opinion from another urologist.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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