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Dr. Y.
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 18551
Experience:  I am fellowship trained specializing in general urology and reconstructive urology.
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Its been 5 months since Ive had a meatal dilation, which a

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Its been 5 months since I've had a meatal dilation, which a urologist performed. He dilated me from 14 to 28 French. Since then, I have experienced consistent pain in the tip of the penis. I have been tested for every STD, which were all negative. I feel my sex life has suffered as a result. I am still able to perform, but it feels different at the tip and my ejaculatory velocity has diminished. In time, will these symptoms improve? If so, any idea when? Do you have any advice in the interim?
Submitted: 4 years ago.
Category: Urology
Expert:  Dr. Y. replied 4 years ago.
It sounds to me like you need to have cystoscopy to look in the urethra to see if there is a recurrent stricture or any other stricture farther in the urethra. If this recurs, you need to go to a urologist at a university hospital who specializes in urethra reconstruction as they may need to reconstruct your meatus. You should not have repeated dilations of this area as this will lead to worse scarring and further problems down the road.Hope this helps and let me know if I can clarify anything.

If you are satisfied with this answer, kindly hit the green accept button so that I may be compensated for my time. Thanks.
Customer: replied 4 years ago.
I have already had a cystoscope since the procedure and was told there were no further strictures. Will these symptons will go away and when? Will I ever feel like I did prior to the dilation? Also, does diet/drinking alcohol have any effect on my symptons?
Expert:  Dr. Y. replied 4 years ago.
Diet or drinking does not not affect this. The pain will most likely go away over time but if it doesn't then you need a repeat cystoscopy.
Customer: replied 4 years ago.

What could the cystoscopy show if there are no strictures? Was I over-dilated at 28 French? Could this be the cause of these symptoms as well?

Expert:  Dr. Y. replied 4 years ago.
You can still have a recurrence of the stricture, which can cause pain, even if the last cysto did not show a stricture. 28-30 French is what people are normally dilated to and is likely not the cause of the symptoms.
Customer: replied 4 years ago.

I never had a stricture -- according to the Doctor. He said it was congenital. I ended up at a University Doctor a few months later who determined the cause of my original symptoms was actually due to a bladder polyp. Are these symptoms I am experiencing typical of the actual procedure? Pain, discolored and swollen urethra, loss of sensation during sex, no ejaculatory discharge, etc etc.

And, if so, is it likely, and when do you think the body will resolve itself?

 

What's the likelihood that this may have been botched and not performed correctly? Any other complications you might have seen or that I may experience??

 

 

Expert:  Dr. Y. replied 4 years ago.
Well if you had a biopsy in the bladder, then this can cuse these types of symptoms, but they should not last for 5 months. If you had a polyp removed, you may need your urine checked for blood or cancer cells to see if you may this in the bladder as the cause of your symptoms. I don't know if something was done incorrectly becuase I obviously wasn't there for the procedure. If any work was done in the prostatic urethra, this can cause a diminishing of your ejaculatory volume through a phenomenon called retrograde ejaculation where some of the semen goes backwards into the bladder. Meds such as Flomax will also cause this to happen. This procedure liekly did not cause a loss in your sensation during sex and I can't explain this based on what you have told me. It is possible that this will resolve over time, but the only way to know is to wait and see.
Customer: replied 4 years ago.
How much would it cost for a phone consultation as I have more questions?
Expert:  Dr. Y. replied 4 years ago.
Sorry, but Just Answer does not allow for contact outside of this forum. I'd be glad to answer any of your questions here though.
Customer: replied 4 years ago.

Ok, I understand. I'm in pain right now and am experiencing a pins and needles sensation. I feel as though my penis has been drilled out b/c of this procedure. I just want to know when these symptoms will pass.

Expert:  Dr. Y. replied 4 years ago.
This pain may possibly be related to spasm of the bladder neck. Your urologist may wan tto try you on a medication such as Flomax to see if this will help the pain. Just know that this medication will decrease your volume of semen as it will cause retrograde ejaculation, but this will go away once the med is stopped.
Customer: replied 4 years ago.

Can you give me an explanation of meatal dilation? I just feel like I lost a large portion of volume from the inside of the penis.

Expert:  Dr. Y. replied 4 years ago.
Meatal dilation is done with metal rods called sounds that are inserted the end of the penis to open up the urine channel or break up scar tissue. This procedure has nothing to do with the rest of the penis and does not remove anyhting from the penis.
Customer: replied 4 years ago.

What are the side effects as a result of this procedure?

Expert:  Dr. Y. replied 4 years ago.
You can have bleeding, recurrence of the scar tissue or stenosis, or pain from the dilation procedure itself. The pain typically goes away after a few weeks.

Edited by Dr. Y on 6/7/2010 at 2:19 AM EST
Customer: replied 4 years ago.
In your medical opinion, do you think some of what I am experiencing could be psychological instead of physical?
Expert:  Dr. Y. replied 4 years ago.
There very well could be a psychologic component to this pain. However, I cannot say this for sure without being able to examine you. Your urologist would be the best judge of this.
Customer: replied 4 years ago.

Is complete loss of libido a likely side effect of the procedure? If so will it return, if so, how long??

Expert:  Dr. Y. replied 4 years ago.
No, loss of libido is not related to this procedure. If you have this problem, then your urologist needs to check your testosterone level a low level may be the problem.
Customer: replied 4 years ago.

what are the most severe complications you've seen or studied as a result of the procedure Dr Y?

 

Expert:  Dr. Y. replied 4 years ago.
The most severe complication after meatal dilation that can occur is obliteration of the meatus from recurrent scar tissue. I have also had a patient complain of pain in the tip of the penis, but this was becuase he had to perform meatal dilation daily to keep his meatus open. Other than this, the other possible complications include bleeding and infection. There is not much else that can go wrong after meatal dilation.
Customer: replied 4 years ago.

So i gather that you consider bthis procedure normal and routine, in no way life-altering as it feels?

Expert:  Dr. Y. replied 4 years ago.
The procedure that you had is very routine. The symptoms you describe do not sound like threatening in any way.
Customer: replied 4 years ago.
no, no- life-altering, so the differences I've experienced before and after the procedure- change in sexual function, drive, continued pain, propensity to develop scar tissue, need for self dilation now at some point, etc??
Expert:  Dr. Y. replied 4 years ago.
This procedure will not cause change in sexual function or drive. You can have recurrence of the scar tissue and may need repeated dilation due to the disease process itself.
Customer: replied 4 years ago.
But I never had the disease, there were no strictures, Dr said he did this because it was congenital, and the irrative voiding symptoms were eventually attributed to a bladder polyp. Tough to accept now because I truly never had a penis problem. My question is, with the understanding that there were never strictures, am I to expect them now that I had the procedure? Could the procedure itself now cause current and future complications??
Expert:  Dr. Y. replied 4 years ago.
It is unlikely that the meatal dilation procedure will cause strictures. However, the fact that you had a polyp removed with a scope can predispose you to getting a stricture, but this may or may not happen to anyone who has that type of resection procedure.
Customer: replied 4 years ago.
As for ejaculatory velocity, severely diminished- I'm told that the urethra is like a "straw" and when the penis is dilated, the end is split, like splitting the end of a straw, thereby decreasing the ability to spray, causing it to dribble out. Is this an accurate analogy? Have you heard this complaint from other dilated patients??
Expert:  Dr. Y. replied 4 years ago.
This is an accurate analogy and I have heard it before from patients who have been dilated. The dilating of the urethra can diminish ejaculatory velocity.

Please hit the green accept button so that I can be compensated for my time spent with you so that I can continue to answer questions. Thanks.
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 18551
Experience: I am fellowship trained specializing in general urology and reconstructive urology.
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