Skin Graft Turning White(?!)

[Serana]

Mainly for post-ops but if anyone has knowledge it's appreciated!

So I'm coming up for being 2 months post-op and I've been using stent no. 3 from Dr. Chettawut. I keep up a very healthy dilation routine.
I'm sill experiencing pressure when I use the third stent and I'm now doing it for 20-25 minutes each session.

While checking, I noticed a white area around the edges of the urethral graft at the vaginal opening, but through the last week this white area has crept up a little more.

I spend a LOT of time sitting or with crossed-legs.

I'm keeping up with all my post-op needs, but had issue getting an antiseptic until lately, due to issues with getting a prescription for it, and am using 10% Videne Solution instead of Betadine. They told me it was pretty much the same thing anyway.

Do you think the lack of having antiseptic at the time may have caused an issue? Is there any reason why the skin urethral tissue is turning white from the pressure of the dilation from stent 3?

I'm posting this here and not in the body issues as I'm hoping more people will see it here and it's pretty important I can get as much advice as possible!
Thanks!

[mikiSJ]

This could be some sort of an ischemia and that is not good. Please see your doctor yesterday.

[Serana]

It might be worth mentioning I use an e-cigarette moderately, and perhaps the nicotine in it could be starving the healing area of oxygen? I had worked under a, perhaps bad assumption that it would have been OK.

I'll also put that down in hopes that it was just being starved of oxygen in such a case too, and that it might recover with the extra oxygen in the body.

I'm not able to find much information about gential ischemia but I will try and get an emergency appointment with my doctor in the morning also. Or would it be better to consider going to an A&E/ER/Hospital about this now?

[Lorileah]

is the skin warm? does it have feeling? If you press it does it get paler then get some color again? Odor? Pain? Is it colder than surrounding tissue?

If any of the above you need attention ASAP. But still a good idea to get an appointment to have it checked

[Catie2013]

In Australia we have an advice line Nurse on Call....do you have an equivalent in the UK? Otherwise, I would suggest a trip to see someone ASAP, if for no other reason than to ease your mind.

[Nigella]

To put it quite simply, any concerns regarding your area that has been operated on should be discussed with a medical professional.

[Serana]

Well that's the plan now, but it's always good to try and get some information from others of what it might be and to know how important it is when the doctor's are out of hours. I'll be seeing the doctor's very shortly, al I can do here is keep my fingers crossed and just hope it's blood circulation taking time to return to the stitching site and that's it. If it's not then I'll be very worried indeed.

[giuseppina]

I agree with the advice above, and I see you're acting on it. This is important; please let us know the results. Not a MD, but it sounds to me you are losing blood flow to the white area. The blood supplies oxygen and nutrients to the site for healing.

[Nigella]

During my recent review with the surgeon he commented on my "white patches". He was open with me and said that it was necrotic tissue, I knew what he meant due to a job I once did. He was not concerned, just trimmed off the tissue, explained where it had come from, part of the scrotal sack, and made it quite clear that I could contact the hospital/him if I had any concerns.

Get it checked, keep an eye on it yourself, if it starts to smell or you get a discharge, get medical assistance ASP.

[Serana]

Well I spoke with a doctor and had a nurse double check the area and such, and I was told that it probably isn't anything "serious" because I'm not in lots of pain or so. They've taken a swab of the area and a urine test, and I'm waiting for them to get back to me on Monday or Tuesday.

The symptoms are mainly a white area on the stitch edges of the urethral mucosal tissue, and I don't see it at all going onto the scrotal tissue. It looks to me like there is some kind of discharge, that's seemingly yellow-ish/cream in colour.
There is a pain dilating, especially on hte bigger stents around the front of the vaginal introitus, where it feels there is something pulling on it quite tightly.

So until I find out the deal on Monday/Tuesday, I'm playing a rather horrible waiting game. If it turns out it's necrosis of the tissue then I should NOT be waiting for tests, I know that much. But if it's just a simple bacterial infection caused by me being on antibiotics too long or anything silly like that, or just too much moisture causing thrush or something, then it should be fine.

Problem is it's hard to find information on this stuff, and I don't like being an uninformed patient because then I'm putting my health in someone else's hands and opinions.

[Nigella]

If you have had the swab taken today, you may get a result today, it depends upon when your surgery sends their samples. Dilating is a little painful, however, I would not think that is in relation to the other issue. It is unfortunate that whilst your GP/Nurse will know the signs to look for in the way of necrosis/infection etc, they may not know what is happening in the area of SRS and may miss something.

[Serana]

They told me to wait and see for a result by Monday, the swab having been taken on Thursday.

However, after getting off the e-cig, things certainly seemed to have improved. I do think my dilation technique for the third stent is wrong though, or maybe my pelvic girdle is too narrow, because there's a fair bit of pain on the urethral tissue at the introitus. And I think it turning white might be because of the pressure around that area from stent 3 also. If it was a form of necrosis, I think it would have happened and spread a bit quicker than this also, so I hope I'm right on that regard and it's not.

However, there is the risk that they missed something, but they did notice there was some stitched that needed taking out because they were meant to have fallen out, so they paid a good level of attention to detail on what needed to be there or not. It seems these stuff may have had others go through SRS stuff with them before though, as the nurses and emergency doctors seem to have a fair level of knowledge about it.

After dilating just a bit ago though, it does seem to have eased off, and there's no lasting pain post-dilation. Though the pain of trying to get stent 3 in is still there.

I'm dilating a lot every day too, compared to what a lot of surgeons recommend, so I'm wondering if maybe it would be worth easing off on using stent 3 and seeing if it heals a bit more before trying stent 3 again at a later time? I think it might help ease that tissue area and help it heal a bit easier also. But I'm not sure.

[Nigella]

My surgeon has recommended dilation twice a day and there is no need to rush it. I have started a regimen that allows me to continue after I return to work, without disrupting anything. If you are having issues with stent 3, maybe go back to stent 2 and see if that is easier.

[Nigella]

Do you have the results of your tests, hope all is well :)