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Thread: another sling surgery? hard choice

  1. #21
    I have to laugh at her 'doesn't express herself appropriately.' Bad feelings are like gas - better out than in! lol I became extremely introverted and didn't talk about my feelings at all. I tried once with my mom (she died 14yrs ago by the way) but all she said was, "No one's going to want to be your friend if you talk like that." So I slammed that door and shut down.
    Yes ~ bad feeling are like gas and she is good at letting out gas. Not introverted!!!! I don't think anything I could say would make her less extroverted. She likes to write a lot and I'm planning to get her a journal with a good lock. She has a lot of gas to expel, especially since she no longer has texting or the internet.

    My parents weren't allowed to visit during the week, only on weekends. I was allowed a phone call on Wednesday nights, on the hospital's bill .. (it was long distance as they were an hour away). I resented that I had to go through that experience myself, with no one in my family to relate to or guide me. It's a very frightening solitary experience.
    Very sorry to hear this! I'm sure it was extremely hard on your parents knowing you were alone. I only kept it together when I was with her. We were also an hour away. So very unfair for you!!

    P.S. I had urgency as well ... it came in the form of a particular headache near the front of my head (back of my head for bowels). I would flush red, feel hot and sometimes get goosebumps. I would even feel 'pressure' ... like a super bloated feeling. Then I knew I had minutes or I wasn't going to make it. Wonder if any of those symptoms sound familiar to her? Might try asking .. if she'll let you!
    She has said the urgency is like before the injury. When not urgent she says she can tell her bladder is full. She also likes to say what we want to hear so I just really don't know. She does get hot flashes sometimes, but she hasn't related them to needing to go.

    He said injured soldiers would die because if you don't empty out the bladder, you can stroke out and die (the blood pressure increases). I'm uncertain of the validity of this claim, but 'stroking out' sounded pretty darn scary to me at age 12 and for the most part, I certainly complied!
    I doubt this would scare her as when the urologist stated how important it was to deal with her backed up bowels she told me that he was just trying to scare her and that she knew it wasn't that serious.

    If she has a flaccid bladder and bowel and no reflex, then I would guess the only way to get the fecal matter into the rectum (for removal) is for it to back up to the point that pressure from more fecal matter would push it down. I'm not sure how to keep her from getting backed up unless she was very loose and then she would have bowel accidents. Is it safe to use a fleet enema once a month or so?

    I would love to hear about other alternatives for leaking bladders if anyone has anything to add. Sounds like collagen might work?? Has anyone had success with Sudafen?

  2. #22
    been there and done just about everything on these posts.
    05' injury-
    08, interstem device put in spine for bladder / bowel incontinence as well as neurogenic bowel/ bladder
    worked 90 % for bowel, but in 09' had to have bladder sling, which result was self cathing from that moment on.
    I have no sensory to bowel or bladder, yet have severe neuropathy and spasms. Just last week, I had botox injected in bladder to help eliminate spasms.
    My dr did recommend having a pubovaginal sling if the mesh sling did not work.
    My bowel only empties when my stomach pains are so severe that the contractions of my stomach muscles push the bowel out.
    I have had many procedures done, tests, surgeries and taken lots of meds. So far, I am better than I was yesterday, but do not know what tomorrrow will bring.
    Each day is a new experience, some more challenging than others esp with this kind of injury.

  3. #23
    With Flaccid bladder, catheterization is required. Use of anticholinergics might help . IF leaking is not due to overflow and they think coaptite might help but we haven't seen much help with coaptite for the majority due to very weak muscles. What does Urodynamics show as the leak point pressure- usually options are based on that
    CWO

  4. #24
    With Flaccid bladder, catheterization is required. Use of anticholinergics might help . IF leaking is not due to overflow and they think coaptite might help but we haven't seen much help with coaptite for the majority due to very weak muscles. What does Urodynamics show as the leak point pressure- usually options are based on that
    Why is catheterization required for a flaccid bladder? My daughter's urologist thought it was safe for her to push just so she wasn't using the Ditropan.

    I found this interesting information: http://www.aafp.org/afp/2005/0115/p315.html

  5. #25
    If it was flaccid why did she need Ditropan?
    You need to have urodynamics to see if it is safe. With pushing you are actually pushing the sphincter open, depending on how tight it is closed, you can have high pressure that can back up to the kidneys. Also, over time, you might mess up your sphincter and then would leak.
    cwo

  6. #26
    She had a urodynamic study and this is where he found she could void without too much pressure. He wasn't worried about sphincter or kidney damage. I'm assuming she is flaccid since she is having so much trouble with stress incontience. Good question on the Ditropan. How does the Urologist determine if someone is flaccid or if they have bladder spasms? Can you have spasms and be flaccid? I'm not seeing that the Ditropan is working for her.

  7. #27
    My understanding is that with a flaccid bladder, as they fill the bladder with water during the urodynamic study, there is no evidence of bladder contractions. It just fills with water without triggering contractions which would be evidenced as rapid increases in bladder pressure. The contractions or spasms would look like spikes in pressure in the urodynamic study. That pretty much describes my bladder. Flaccid, high capacity , but fortunately with low pressures even with 700 cc sitting in it.

  8. #28
    With a flaccid bladder you wouldn't expect , usually leaks only with over flow or at a certain pressure.
    CWO.

  9. #29
    My urologist has me almost talked into this other sling surgery. It is tighter and higher which holds the ureter into more of an upside down "v" instead of a "u" so it blocks the flow like a kinked hose. He's concerned about the high risk of complications like erosion and fissures developing with the artificial sphincter and says there's a 30% risk of complications with a diversion like a mitranoff. The only risk here is that it may not prevent as much leakage as I'd like, but there are few risks.There just aren't many statistics for women with flaccid bladders who have had that surgery!

    For me I'm concerned about the recovery time and losing my hard-worked-for muscles that are slowly developing in my legs and glutes as I put the regular exercise time in. I will have to have help transferring the first couple weeks and take it easy for a few more weeks. But if it lessens my leakage during exercise and certain movements then it will in the long run give me more freedom to move more often (now I can only do a lot of movements right after I empty my bladder) and lead to being able to exercise/move more often and maybe I can get to my goal of walking with my afo's and walker quicker. The other thing is that I will definitely have to start cathing again.

  10. #30
    Senior Member lynnifer's Avatar
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    Did you end up going for the sling? I ask because this is what my urologist in Toronto offered to me this week. That with a suprapubic.

    We're going to try Fampyra first though and see if I have any kind of reaction.

    She keeps wanting to give me botox in the bladder! Flaccid here too.
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

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