Urethral opening problem

[kaylau]

Dear all,
I m post op, srs 2 years ago. In July 2018, I got my urethral opening injury with a very tiny wound of about 2-3mm long. After that I got infection, after infection was gone, the wound is still there and does not heal. It has been about 5 months....do anyone get the same experience? I have consulted some urologist and surgeon, they all said there is no operation or medication, as it will heal itself in a few days, they said it is not DTD, cancer nor an abnormality....but it just doesn't heal.....it gives me a little bit constant pain and sometimes with blood, I have no solution so does anyone got the same...? I m just taking Chinese herbal medicine for control and it works, but just control, it does not heal....can anyone suggest some more solution?

Thanks very much.

Kay

[Dena]

If your doctor is unable or unwilling to help you with the wound, you need to look up a doctor or clinic that deals in treating wounds. Wounds that fail to heal isn't uncommon though most of the time they are the result of an injury so if you look around you should find a doctor that specializes in this area.

[Linde]

Dear all,
I m post op, srs 2 years ago. In July 2018, I got my urethral opening injury with a very tiny wound of about 2-3mm long. After that I got infection, after infection was gone, the wound is still there and does not heal. It has been about 5 months....do anyone get the same experience? I have consulted some urologist and surgeon, they all said there is no operation or medication, as it will heal itself in a few days, they said it is not DTD, cancer nor an abnormality....but it just doesn't heal.....it gives me a little bit constant pain and sometimes with blood, I have no solution so does anyone got the same...? I m just taking Chinese herbal medicine for control and it works, but just control, it does not heal....can anyone suggest some more solution?

Thanks very much.

Kay

Because your wound is located in, what we call in infection control, a normal dirty area, it is very difficult to heal it, because you could be reinfecting constantly.  The first intervention should be a strong antibiotic regime and once the infection cleared, the wound should betaken care of and be closed.  For the healing time it would be advisable to have a catheter inserted to make sure that you do not reinfect constantly.

It is of course impossible to do a long distance assessment of you problem, but you should find a physician who is experienced in treating wound infections.
Good luck and get well soon
Hugs
Linde

[kaylau]

Because your wound is located in, what we call in infection control, a normal dirty area, it is very difficult to heal it, because you could be reinfecting constantly.  The first intervention should be a strong antibiotic regime and once the infection cleared, the wound should betaken care of and be closed.  For the healing time it would be advisable to have a catheter inserted to make sure that you do not reinfect constantly.

It is of course impossible to do a long distance assessment of you problem, but you should find a physician who is experienced in treating wound infections.
Good luck and get well soon
Hugs
Linde

Thank you both. The doctor said it is not good to have catheter, but just let it clean and heal itself. It is so annoying as it inflame periodically. I guess I need to find a professor forcwound healing. Thank you very much

[warlockmaker]

Hi Kay, this is what you texted me about and sorry to hear its not healed. Its not an GRS issue anymore so go and see a gynocologist in HK. Have you called PAI and see if they can help.

[Linde]

Thank you both. The doctor said it is not good to have catheter, but just let it clean and heal itself. It is so annoying as it inflame periodically. I guess I need to find a professor forcwound healing. Thank you very much

Again, long distance diagnoses are not good.  But your wound is in an area in which it seems to get reinfected constantly, and this is the reason that it can't heal properly!  The only thing what you are creating, is a lot of pretty ad and hugely scar tissue.
Go to a doctor who knows what he is doing, either to a specialist for wound healing, or , as it was recommended already, to a capable urologist!

[Marcie237]

you could try putting SSD (silver sulfadiazine) or surgilube on it for a few day and see if any changes. Both you will probably have to re-apply after you pee, though the SSD less so.

I assume you are dilating. (?)  if not, def start till it heals and use surgilube for that.

[kaylau]

Hi Kay, this is what you texted me about and sorry to hear its not healed. Its not an GRS issue anymore so go and see a gynocologist in HK. Have you called PAI and see if they can help.

Thank you bobbie, I have contacted PAI and they said it is normal.

One urologist said it is normal again. While another said he is not familiar with transgender and asked me to see a doctor for transgender. Then I seek help from that doctor and he said it is urethral caruncle abrasion and he increases my estrogen intake level. I see the wound is changing in shape but it is still red in 2-3 days periodically. I m now suspecting that I have a bacterial biofilm in my distal urethra and periodically release bacteria that cause the wound red and arrest the healing process, biofilm is really difficult to eradicate so I m very very fraustrated...

[kaylau]

you could try putting SSD (silver sulfadiazine) or surgilube on it for a few day and see if any changes. Both you will probably have to re-apply after you pee, though the SSD less so.

I assume you are dilating. (?)  if not, def start till it heals and use surgilube for that.

Well, thanks for your advice, I will discuss with my doctor for that, thanks s lot!

[Marcie237]

Well, thanks for your advice, I will discuss with my doctor for that, thanks s lot!

.
You're welcome . Yes, def run it by your doc! I am not a MD.

[Janes Groove]

Because your wound is located in, what we call in infection control, a normal dirty area, it is very difficult to heal it, because you could be reinfecting constantly.  The first intervention should be a strong antibiotic regime and once the infection cleared, the wound should betaken care of and be closed.  For the healing time it would be advisable to have a catheter inserted to make sure that you do not reinfect constantly.

It is of course impossible to do a long distance assessment of you problem, but you should find a physician who is experienced in treating wound infections.
Good luck and get well soon
Hugs
Linde

Correct me if I'm wrong but isn't this similar to an anal fissure problem.  The urethra has sphincter muscles that are constantly flexing which is continually re-opening the wound.  This is preventing  the wound from healing properly.  The solution seems to be, as you suggested, to catheterize so the sphincters are then relaxed enough to prevent this constant flexing of the sphincter muscles.  Perhaps a prolonged catheterization is enough to relax the sphincters enough so the wound can heal.  If not catheterization + surgical closure would be indicated.