[pgrovetom]

I was diagnosed in my mid 20's with a Urethral Stricture. The stricture was cut open by my Urologist with an endoscopic internal urethrotomy using an endoscope every roughly six months for about 7 years. I then had a full urthroplasty where my urethra was cut open and skin from under my arm was used to graft it over like a patch. This creates a balloon like effect with a new risk of stricture at the ends. This failed within 6 months and I returned to having the endoscopic internal urethrotomy about every 6 months for another 5+ years. I then had another full urthroplasty where the skin graft was taken from my penis and this has held for almost 15 years. Its is now failing again and I'm facing the decision of what to do again. My urologist took a look at the stricture and could see the 2 grafts and the next surgery would be more complex due to being very close to the prostate and the damage done by my 25 urethrotomies and 2 urethroplasties. I have 2 ballooned out sections adjacent one another and its closing at the deepest end near the prostate. I've now begun to look into whether there are alternatives ( lasers? Stents? improved procedures? better endoscopic approaches?) and to find a surgeon who specializes in complex strictures, preferably in the San Francisco Bay Area. I am now 55 and time is running short as I am having significant difficulty and pain urinating and having been in this situation 25+ times before and know its time to do something. Any thoughts, advice or surgeon recommendations would be appreciated.