I’ve posted here regularly to give back — the advice and information I found here helped me work through the brachytherapy I received in 2011 and the long, long journey to a steady 0.02 nadir in recent years.
So here’s a thing: after 15 years of being basically fine, I began to experience increasingly difficult urinary symptoms last summer and fall, which caused my friends at the Princess Margaret Hospital Prostate Center to send me off to urology to see what was going on.
To make what turned out to be a long story short (a long story that included an increasing series of UTIs, and some extremely unpleasant visits to ER to deal with a full blockage that resolved poorly) they discovered that I had developed a significant and growing urethral stricture that had just about completely blocked me — symptoms somewhat masked by a flomax prescription I was given in the fall.
What to do?
The least invasive option was the standard endoscopic treatment — dilation, or DVIU (direct-vision internal urethrotomy). Basically, the urethra is dilated or the stricture cut, much like a clogged artery is opened up. Easily-tolerated day surgery — but also with a quite high recurrence rate.
The most invasive alternative is urethroplasty — surgical reconstruction of the urethra. Excellent long-term success rate with this, but a very invasive surgery.
And then there’s what I did — “Optilume” therapy. I showed up at the urology clinic, was put under, and then a thin instrument was passed into my urethra to position a drug-filled balloon next to the structure I had. The balloon was inflated, which opened the scarred section, and then a small amount of “paclitaxel” was delivered to the site. Paclitaxel is usually a chemotherapy drug, but here is was used to inhibit fibroblasts and other cells involved in scar formation, which will hopefully greatly reduce the chance that the structure reforms.
Recovery took about four weeks, mostly pretty tolerable.
I’m still sensitive to wine, coffee and the like. So I drink lots of water.
That’s it. If you develop this problem post-prostate treatment, I suggest you check out this therapy. It’s working well for me so far.
All the best,
Bt