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Urethral strictures. Anyone familiar with them?(8 posts)

Urethral strictures. Anyone familiar with them?Shy Guy
Jan 3, 2002 10:00 AM
OK guys,

First off: this is a tough, hitting-close-to-home, medical topic. Those with weak stomachs may want to leave this post now. Sorry.

I raced years back and suffered from a urethral stricture (a narrowing--and eventual closing--of the urethra, the "pee tube" in males). After the surgery, I raced some more without recurrence. Due to my passions/interests taking me other places in my life, I took years off the bike and was perfectly fine.

Got back on a year ago, and have been riding a lot since. The stricture (or another stricture, perhaps) is back, threatening to close me up down there. I'm visiting a urologist tomorrow to "head it off at the pass," and will have the surgery again if necessary. (Ugh.)

Anyone out there experience these horribly inconvenient and uncomfortable things? My doctors (then and now) assure(d) me that it's not UNcommon in younger men, and that it can be considered a disease (Urethral Stricture Disease). Sexually transmitted diseases can bring it on (not the case with me), as can blunt trauma to the nether region (again, not the case, unless you count thousands of miles--with standing/resting in between--as blunt trauma). If you've experienced this, did you notice a tie-in to your cycling? What did your doctors say/suggest?

For what it's worth, my on-bike positioning seems right on, without any discomfort or pressure while riding. Suggestions?

Thanks a WHOLE LOT for reading and for your comments.
re: Urethral strictures. Anyone familiar with them?Roto-Router Man
Jan 3, 2002 12:38 PM
Can I be of any service to you?
Where's Dr. Goldstein when we need him?guido
Jan 3, 2002 1:08 PM
He's the guy who made it as far as a Barbara Walters interview on the probability of male impotence from riding bikes. Shortly afterwards, saddle manufacturers came out with those slotted saddles, nervous that once the word got out, they'd be sued by impotent roadies.

I bet Dr. Goldstein has heard of urethral stricture disease. He did his study in Boston, I think out of MIT.

The only time I've had crushed perineal tissue was when I've ridden hard, usually competitively, for 3 hours or more. I tend to move forward onto the nose of the saddle, in an effort to get on top of the crank, like a sprinter. This takes too much weight off the sit bones, transferring it onto the perineum. Usually don't even notice it until the ride is over and I'm pedaling home, recovering. If I feel it on the ride, all I have to do is tilt my hips back a little, putting the weight on my sit bones at the back of the saddle, which eases pressure off the perineal tissues and urethra. In other words, it's very easy to induce it or make it go away depending on how I sit.

Does this new stricture come on only after you've been riding, or have you felt it at other times when you haven't been riding for awhile? If it's the former, I'd listen to my body--in this instance, crotch--and try to position my way out of it. If it's the latter, maybe it isn't bike related.

There are several things one could do to alleviate this problem if it's caused by riding.

Tilt the saddle up in front, just a few millimeters, so that your butt naturally falls on the back of the saddle where the sit bones can take the weight, rather than sliding down onto the nose. This assumes the saddle isn't too high. Alot of racers have their saddles too high, because long pedal strokes feel good.

Raise the handlebars, and get a longer stem, so your back can stretch out and relax and you can sit properly, not hunched over on too short a reach. I had this situation when I started riding, and was continually pressing my crotch onto the nose of the saddle, trying to straighten my back, which I couldn't, because there wasn't enough room. When I increased the reach 2 cm., this problem went away.

Ergonomic problems are bio-mechanical and therefore solvable, it would seem to me. If all else fails, one of those slotted saddles might be the ticket.

I hope others weigh in on this thread. It's probably the only issue riders think about but don't discuss. Good luck.
These strictures aren't temporary, unfortunately.Shy Guy
Jan 3, 2002 2:02 PM

Thank you for all of the good points about saddle height/tilt and sit bones. Unfortuntely, though, an actual urethral stricture is something which isn't simply a temporary condition due to temporary pressure on one's urethra; they are physical and permanent narrowings. Once they start narrowing, they don't stop until the tube in question is stopped up (closed) completely. Very scary stuff. Trust me. The first time this happened (all those years ago), it happened SO GRADUALLY (over months/years?) that I had to be rushed in a cab to the emergency room because my body was unable to void itself of urine. I won't go into details about this--you'd physically feel my pain, I'm certain--but they don't stop closing until they either close up or are treated, generally by fairly simple (but unpleasant) surgery.

With post-surgery scar tissue forming, one can recur, as had happened to me once. I caught it before it closed up completely a second time, though, and was then fine after the second procedure.

For some reason (my riding the bike for miles at a time, actually, or so it seems), it's either come back to haunt me or another's formed. Tomorrow, I'll know what the urologist says I'll have to be put through.

Thanks again.
These strictures aren't temporary, unfortunately.cycleguy
Jan 3, 2002 11:07 PM
Stupid question, but with all the advances in heart surgery, valve replacement, and bypass stuff. One would think that keeping the urethral open would of been solved by now. Not to make light of, or is it lite, of you situation. But maybe a flexable flac jacket straw thingy. Guess it comes down to not enough of us guys suffer from it to make it profitable. Sucks!
These strictures aren't temporary, unfortunately.guido
Jan 4, 2002 2:23 PM
Good luck. Let us know what the urologists says.
Thank you, Guido. Plus, something for all to heed.Shy Guy
Jan 4, 2002 9:04 PM
The urologist did some tests, and I'll be going in on Monday for some in-office surgery. Since I had the operations years back, there have been major leaps in fiber-optic technology and the like, so surgery is much less "invasive" these days. (Whew!) This also means no hospital stays or any major recovery like I dealt with back then. It should take between two and fifteen minutes, he said, and I'll be out or very dazed on anesthesia throughout.

I will be looking into a cutout saddle for sure, though--not a big deal if this will help cut down on recurrence. Not too bad, overall. Just a bit scary.

Thanks so much for asking, and wish me luck.

Something To Think About: if anyone out there notices their urine flow/stream getting less forceful (or urination taking longer) over a period of time, please go for a very simple checkout at a urologist. This happens V-E-R-Y GRADUALLY (over months and months), but keep yourself in check just to be sure.

I'm not trying to scare anyone in the least, but this apparently isn't terribly uncommon, particularly in men, and prolonged pressure over time (like from a bike saddle) can affect you. If you're unsure, get it checked out. Be proactive--this is your health, and it is vital. You DON'T want to be rushed to the Emergency Room: TRUST ME. Again, I don't mean to frighten anyone; being aware is more than half the battle.

Be well.
Didn't they open for the Orbital this past tour? ;-) (nm)js5280
Jan 3, 2002 2:04 PM