Island, here is the discouraging study on urethroplasty after radiation therapies.
This is what set me into the panic mode.
Long term success rate is low plus healing complications.
It makes mine hurt just reading about
it. I did not know that there is more than one kind of urethroplasty.
My take away from studying that study (as well as other readings I've done)….is that the length of the stricture is everything. From the study you're looking at, it seems If the stricture is around 3 cm or less... The success rate at 4 years is 90% in one study. The success rate at 4 years in the other study was 70%. "Time to recurrence" does not apply to the success stories. (Only to the failures). "Time to recurrence" only applies to the 10% of failures in the one study and to the 30% of failures in the larger study.
That's how I'm reading it. (but, I'm no expert at reading studies).
The failure rates I believe you may be referring to applies to longer strictures (6 cm) using graph flap as opposed to EPA's. Maybe read it again after reading how I'm interpreting it. At the end of the day, only a some testing and a good doc can determine.....
open surgery is planned, the careful evaluation of the actual stricture, patient counseling and patient selection are basic requirements for a successful treatment. The surgeon should be experienced with all the techniques of
open stricture surgery. Even in experienced hands, success rates decrease with the extent of tissue damage and stricture length. For short strictures EPA should be the first choice, as onlay techniques are required for longer strictures."
Man...I"ll tell ya what akai. I don't envy ya buddy. There is nothing fun about
strictures.....period. The incontinence issue, while not at all trying to minimize it (it's never minimal when you're the one facing this stuff)….I think your doctor should have a pretty good handle on what to expect there. It may not be a given. And there's different levels of incontinence. To my mind....we may not be talking about
zero control. But, that (as well as all of this) is why we talk to doctors.
If I ever do SRT....I"ll be in pretty much the same place as you are right now. (Unless I went ahead and had a urethroplasty in anticipation of SRT....which....in my mind anyway....seems ludicrous).