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told me, clearly and sympa5~thetically, that she believed my symptoms were
caused by the dilations. I felt very cold. She went on to explain that dilation creates scar tissue, which builds each time the urethra is torn by dilation and which narrows the urethra rather than widens it. This scar tissue pulls agains the good tissue, simulating a full bladder and causing a constant urge to void. Also, she said, the cilia (tiny hairs) in the urethra lining are many times destroyed by dilation and silver nitrate. The cilia move to expel bacteria from the urethra, and once destroyed, infections enter the bladder much more easily. Two urologists she had worked with at a major medical center had suspected this for years and now it had been confirmed with the invention of the scanning electron microscope. Anger nearly swallowed me. I felt violated. This was the first time a doctor had suggested that dilation had caused my ordeal. But it wasn't the first time I'd been cautioned against any more dilations. In 1975 a urologist, the first one I had seen in New York, had said that dilations did absolutely no good and cautioned against further ones. Another urologist reluctantly told me that they had followed up 300 of their urethrotomy patients and found the operation of "no value." (Urethrotomy is a surgicall procedure to cut the lining and some of the muscle of the urethra. Like dilation, its |
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purpose
is to widen the urethra.) In fact, all the urologists I'd met working at
major medical centers in New York City had been against further dilations. Still there were other prominent urologists who had advised me to have a urethrotomy and two had done dilations following cystoscopy without my foreknowledge or permission. It is still a commonly accepted practice across the country, and is even used on children. I discovered that urologists at major medical centers and teaching institutions are privately debating the issue, and have been since about 1970. Dilations are done because urologists believe that a narrow urethra is a common cause of cystitis. But current research indicates that a narrow urethra may be a very rare occurrence - not the chief cause of the problem at all. Doctors are also starting to realize that each case must be considered individually for several possible contributors to the cystitis. Factors such as infection, sexual intercourse, menopause, cold weather, emotional stress, catheterization, allergies and menstruation seem to induce or aggravate the condition. I remember urologists who treated me asking about all those factors, including allergies. I said no to the allergy question because allergy to me meant hives, hay fever or asthma. None of the 12 urologists or five internists I saw form 1970 to 1981 attributed my bladder |
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