Choosing a Perineal Urethostomy over Urethroplasty?
I’m 29M and have lichen sclerosis/BXO since I was a kid.
I’ve have two strictures, one since I was a teen on my tip which is classic BXO apparently, but not insanely bad and a urethrotomy kept it fine.
The other is at the bulbar area, this came about 5 years ago and is really slowed my flow to the point I had mild kidney swelling.
After two dilations, I have been doing intermittent self-catheterization everyday for 5 years, and it works really well. It’s not flawless as it may aggravate the tissue, but it bought me time with minimal symptoms minus a flare up once a year or so.
I haven’t seen my urologist for 4 years now, and I’ve been removed from his patient list. He has always recommend I consider a urethroplasty as I’m young but would need to refer me to a reconstructive urologist. He introduced me to self-cathing to see how I take to it (fine mostly!).
I’ve looked into urethroplasties but I’m not sure if it’s what I want. If I didn’t have LS, I’d get it done as the success rate seems excellent.
But I know this is a lifelong thing that won’t truly go away. I don’t think I can justify going through it to then have it fail or simply reappear later elsewhere. I’d also have to spend time wearing SPC for at least month before and then the foley after, and have the gym graft.
I’m considering a perineal urethostomy, which is the closest to getting it resolved permanently.
I realize it’s not appealing to most young men my age. I already sit to pee and that doesn’t bother me. I’m also gay, so having kids naturally isn’t an option anyway. Ejaculating might be a little embarrassing in my taint area, but the urethoplasty and likely follow ups could also mess the area up. I know peeing in the perineum area can come with infection risks, but I figure women already deal with a similar setup.
I’m wondering about asking a urologist if they’d consider it over a urethroplasty. Am I missing something? Has anyone considered/done it?