question about urethra

**carly** · 06-04-2006, 04:59 PM

I have one more question. I had my urethra removed when I had my bladder removed Nov. 1 When I saw my gyn. he said, only part of your urethra is gone. When I saw the nurse practioner last week, I asked her about that. She told me they take part of it, if they took the whole thing, they have to take part of your vagina. Could part of my pain be from what is left of the urethra since it was inflammed also? I am having a very hard time sitting, esp. in a car. I would do the surgery again just for the frequency, but with the pain was better.

**Kara29** · 06-05-2006, 04:34 AM

Carly,

Only your doctor can really answer this question for you because they did the surgery on you BUT, I am going to take a stab in the dark with it based on my homework.The short answer is yes. By what you described, I think what they did for you was take your urethra and just removed the bottom and tied off the top which means you could possibly still have IC Tissue in there that can cause IC symptoms such as urgency, frequency, and pain. When I did my research I made sure that I was having my entire urethra taken out. A urethrectomy is the Excision of a part or all of the urethra. They can do this is several ways. One is the way you had yours done. Mine was done quite more complex. I did not want ANY bit of that IC Urethra left in there. I will have to ask my doctor exactly what the name of the surgeries were but there were many. I do know that they used part of my interior vaginal skin to close off where the old urethra used to be. I don't have any trace of the old urethra left in.

When I go back in June I will ask what the technical terms are for what he did during the whole surgery and report back to you.

Some doctors will not do an entire urethrectomy they just tie off the end which defeats the whole purpose of having a cystectomy and urethrectomy for IC. It's harder to remove the urethra fully so most doctors dont do it. There are only 2 doctors I know of that will remove the entire thing for IC. One of them was my doctor. The question I asked the surgeon during a consultaion was something like this: Since my main problem is the urethra, would you be doing a Urethrectomy? Taking out the Urethra? Or Leaving it in and tying it off? If my urgency symptoms continue would the urethra be taken out then? The only thing I have left from the old bladder is just the urethra, I aksed my old surgeon) I am so worried that if the any part of that urethra is left in that the urgency will not go away…..

The answer was something like this: You should have a urethrectomy up to the neck of the bladder and close the neobladder junction to the urethra (your new bladder neck). Closing off the Neobladder was done with part of my interior vaginal tissue. It's just a clean way for them to close off the place where the old urethra was.

I wish I could give you more technical terms but I don't remember a lot of what happened in the surgery or after, so I will have to ask exactly what was done.

I can still have sex when I heal and I still get periods and can wear tampons, Nothing has changed in my vagina, there is possibility that I could one day even have a baby (but I have not asked that ? yet because I am not ready for the rejection) they just used a tiny bit of vaginal tissue to close of where the old urethra used to be.

Please disucss this further with the doctor that did the surgery on you.

Kara Lynn

**bunnykinb** · 06-05-2006, 08:49 AM

Sorry, but this is a dumb question. By removing the urethra, does the clitoris still remain intact?

**Kara29** · 06-05-2006, 10:14 AM

I had a Urogenital Reconstructionist do my Urethrectomy and my Clitoris was spared and the nerves around it were too. It sill works just fine

How embarrasing but I felt the question should be answered fairly. Find a surgeon that knows eactly what he/she is doing in "that area". It was a month after my latest surgery that I figured out that I still had that part of my body and it worked just like it did before the Urethrectomy.

Kara Lynn

**carly** · 06-05-2006, 12:02 PM

My understanding is that when they do a cystectomy for cancer, they take the entire urethra and lymph nodes and part of the vagina. I think they can still have sex (females, if a male has a cystectomy they take the prostate and they can't have sex for that reason.) I knew he wasn't going to take my vagina, but didn't even think about the whole urethra. This is my fault for not researching more. I will call my Dr., but think my continued pain has to do with the urethra that is left and the inflammation in the ureters. Did any of you look at your post op report and see if you had inflammation in the ureters? I know we can't live without the ureters.

**Kara29** · 06-05-2006, 01:07 PM

Carly,

Where is your pain when you are referring to inflamation in the ureters? Is it in your back? Did they reposition your ureters. Ureters are totally different from the urethra. They would be separate identities. The urethra may be causing you pain down there and the ureters may be causing you pain somewhere else like in your upper middle back called flank pain?

With your surgery you had Ileal Conduit Urinary Diversion:
A segment of the intestine directs urine through a stoma into an external collecting bag. At the bottom of this page it shows you where your kidneys are in your diversion, unless your doctor moved them for some reason. http://www.clevelandclinic.org/healt...12546&src=news

The Ureters are located near the kidneys. Here is another diagram:http://www.umm.edu/urology-info/anatomy.htm

If you were having inflmation in the ureters, I would think in my own terms that your pain would be in your back (flank area) unless your doctor moved your ureters to some other part of your body.....

Where is the "ureter inflamation" that you are worried about located? Did the Nurse show you a diagram of where your ureters were located? Or are you talking about general abdominal old IC like pain?

I guess I am confused. Are you having urethral pain and then pain somewhere else?

I am really trying to pull info for ya Carly!

I want to help in anyway I can.

Carly, can you ask the doctor if he seems worried about inflamation in those ureters. We may all have some inflmation there as a result of the sort of surgeries we had. I am just wondering what his thoughts are on it and if there is anything he can do to reduce the inflmation if he feels it is an issue.
Write down a list of all of your questions before you call him so that you know what you want to ask.

HUGS,

Kara Lynn

**zfairy** · 06-09-2006, 03:27 PM

Originally Posted by Kara29

Carly,

Where is your pain when you are referring to inflamation in the ureters? Is it in your back? Did they reposition your ureters. Ureters are totally different from the urethra. They would be separate identities. The urethra may be causing you pain down there and the ureters may be causing you pain somewhere else like in your upper middle back called flank pain?

With your surgery you had Ileal Conduit Urinary Diversion:
A segment of the intestine directs urine through a stoma into an external collecting bag. At the bottom of this page it shows you where your kidneys are in your diversion, unless your doctor moved them for some reason. http://www.clevelandclinic.org/healt...12546&src=news

The Ureters are located near the kidneys. Here is another diagram:http://www.umm.edu/urology-info/anatomy.htm

If you were having inflmation in the ureters, I would think in my own terms that your pain would be in your back (flank area) unless your doctor moved your ureters to some other part of your body.....

Where is the "ureter inflamation" that you are worried about located? Did the Nurse show you a diagram of where your ureters were located? Or are you talking about general abdominal old IC like pain?

I guess I am confused. Are you having urethral pain and then pain somewhere else?

I am really trying to pull info for ya Carly!

I want to help in anyway I can.

Carly, can you ask the doctor if he seems worried about inflamation in those ureters. We may all have some inflmation there as a result of the sort of surgeries we had. I am just wondering what his thoughts are on it and if there is anything he can do to reduce the inflmation if he feels it is an issue.
Write down a list of all of your questions before you call him so that you know what you want to ask.

HUGS,

Kara Lynn

hi, im nw to this and i can not sit or stand sometimes even lay down do to the burning , stbbing in my urethra r there any ways to ease that?

**Judith56** · 06-09-2006, 06:25 PM

zfairy, I used lidocaine gel that I got with a prescription from my uro for that sort of urethral pain that you describe. It worked well for me.
bunnykinb- my clitoris is still intact and all parts "down there" work just fine! I had my urethra removed when they took out my bladder 20 years ago.
Carly, this is a good question for your surgeon. It does take many months for everything to heal and could even take as long as a year or more to fully benefit from the surgery. I hope things get better for you! Judith