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An_191894 posted:
I am 54 years old and have suffered with urinary incontinence since I was 27... Had Total Abd Hyst with both ovaries and tubes removed at age 24....
I had my first surgery when I was thirty, an anterior and posterior repair (I also had a rectecele). I still had the SUI by the time I got home from the hospital. I just tolerated it until I couldn't tolerate it any longer. About 5 years later, I was referred by my PCP to a Urologist at a large teaching facility. He did the first Video urodynamics I ever had and deemed that I needed a pubo-vaginal sling utilizing my own fascia. I had that done about 3 months later and it lasted about 3 months, although I was not completely dry, but I was dryer. So over the next year I had four collagen injections, the last one ruptured my urethra. He sent me to PT where I was given exercises to do which did not help at all. I was told "you really can't fix broken down muscles" so that was why the exercises didn't work.... He then recommended another pubo-vaginal sling again utilizing my own fascia... IT WORKED!!!!!!! ................. for about a year and a half..... I was then back to square one. I then started seeing a urogyn that had opened up practice here locally. He did one collagen which worked for about a month. He then took me to surgery where he did an enterocele and rectocele (second time) repair. I was not dry after that surgery. He did perform a urethral bulking injection with Durasphere carbonated beads.. I still leaked...
I saw him recently (about 5 years later) and the urodynamics showed SUI. He has recomended a TVT sling. I have also started having fecal incontinence as wellin the last two years. He is sending me to a colorectal surgeon that I see in two days. Urogyn wants to see if there is a procedure that can be done to help and if so, coordinate the two to be done at the same time.....
Questions (whew!!! finally!!!!!!!!) With my 24 year history of SUI, and my surgical history, I am very leary of doing anything further. But I would desparately want to be dry as I am having to wear large pads 24/7 and go through about 4-5/day. And, I have developed problems with tissue breakdown on my bottom from the pads and/or wetness. I do change immediately when I become soiled. I was wondering if you could give me any information or questions to ask the urogyn AND the colo-rectal guy I see in two days? I would appreciate your input on this....
Thanks in advance for your comments!
Diane K Newman, RN-C, MSN, ANP responded:
You really have had many pelvic procedures. The research shows that the success decreases after each procedure so I am not sure another procedure is going to make you dry. All the procedures may have actually caused your fecal incontinence. I suggest you see the colorectal surgeon but ask anyone who recommends any more surgery what will be the success rate and if you will eliminate your SUI and fecal incontinence. You probably have a great deal of scar tissue from all the surgery.

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