Page 1 of 2 12 LastLast
Results 1 to 10 of 11

Thread: Female sling/mesh for bladder incontinence around a Foley catheter

  1. #1

    Female sling/mesh for bladder incontinence around a Foley catheter

    This may have been covered before but has any female quad here had to resort to a sling/mesh from spontaneous leaking around a Foley catheter? If so, is it safe? I have had a urologist suggest this from my urethra being stretched in January of this year and never recovering.

    It was stretched by a home health agency nurse and was not my fault before, when changing my catheter (a routine procedure that has been done over the last 37 years as a
    C 4/5 complete female quad with no nurse ever doing this to me.

    This falls under the category of "negligence" according to the Arizona Disability Law Center and one attorney said we could go after the agency if I had to have surgery but now he has been hard to reach for months now even though he said to call him any time. Trying to "prove" that this actually happened despite my live-in caregiver seen it happened and my urologist confirming that my urethra was stretched is another story.

    Having said that, my current urologist who is familiar with neurogenic bladder is and has been my urologist since 2006 and knows my bladder inside and out and has always, after doing cystoscopies and removing bladder stones twice, said that my bladder and urethra looked "pristine" (her words) as if I have never had a Foley catheter in my bladder through my urethra let alone having a Foley catheter for 33 years the last time she was checking me BEFORE the event that happened above occurred.

    My urologist did a cystoscopy in July confirming that my urethra was indeed very very stretched and she has done everything to help me without success but she is not qualified for any reconstructive surgery and she thought if I needed a bladder neck closure or something to stop the spontaneous leaking around my around my catheter.

    I saw a urologist for her opinion and she suggested that if my bladder was eroded she would suggest having the sling/mesh to stop it and if it is not eroded but just stretched... to consider a bladder neck closure and resorting to a suprapubic catheter.

    This urologist that I have just seen yesterday was very cold and not friendly. I saw her nurse practitioner first it was very nice and friendly but I am so used to my very friendly urologist that I have had since 2006 but there is nothing more she can do to help me. Thus referring me to another urologist who does reconstructive surgery.

    Thank you for anyone who is familiar with this type of surgery for a female quad.
    Last edited by Brinda41; 11-30-2016 at 05:17 PM. Reason: typos

  2. #2
    Senior Member goldnucs's Avatar
    Join Date
    Dec 2001
    Location
    Tucson, AZ USA / San Carlos, Sonora, Mexico
    Posts
    556
    Hi Brinda,

    Can't help with the female aspects of your post but I'm a male, c5-6 quad for 39 yrs (in Tucson BTW) and have had UT issues forever, that is, until I got an SP. I'd say just do it; get an SP! You'll wish you'd done it years earlier.

    Rick
    Rick Goldstein
    GO! Mobility Solutions
    facebook.com/goes.anywhere

  3. #3
    We have done some urethral slings on a number of our female SCI clients. I would caution though against doing any procedure like this that involves using mesh! There have been a number of large class action suits against physicians and medical device manufacturers due to patients having bad reactions to the use of mesh. Better to use a small piece of your own body tissue (muscle or tendon) to create the sling.

    http://www.mayoclinic.org/diseases-c...s/art-20110300

    http://www.webmd.com/urinary-inconti...nence-in-women

    There is a significant amount of literature about the long term development of what is called a "patulous" (stretched out) urethra in women who have used an indwelling urethral catheter for more than 20 years. The patulous urethra will nearly always lead to leakage, as the short female urethral tissue can no longer seal well around the catheter. This condition can be made worse by going through menopause, as the decreased levels of estrogen can make your urethral mucosa thinner and less moist (just like occurs with vaginal mucosa after menopause).

    Management and prevention include consideration early of a suprapubic indwelling catheter instead of a urethral one for women who are determined to use an indwelling catheter long-term. Often people try to manage this by using larger and larger Fr. sized catheters, but this actually only increases the rate at which a patulous urethra can develop.

    I would also caution you again any procedure that would include urethral ligation (bladder neck closure). Our experience with this is that the bladder REALLY wants to have an opening to the perineum, and if it is closed off with this procedure, often a fistula develops to that area from the bladder, which is very difficult to manage or surgically close again.

    (KLD)

  4. #4
    Senior Member CapnGimp's Avatar
    Join Date
    Jun 2004
    Location
    Alpine, TX USA male T4complete
    Posts
    3,470
    Blog Entries
    1
    There was a female here Becca, Rebbecca or something, college attending, go getter until the surgery with mesh started a train of events that was unreal over the few years she was on the forums. So bad that I remember her troubles, wonder if she ever got involved in the class action or not and whatever became of her... it was a sad story, shame these companies rake in fortunes and ruin peoples lives.

  5. #5
    Hi Rick!

    Everyone I have spoken to has loved switching to an SP. The urologist and had since 2006 that she could do that but since my urethra was stretched so badly that I would just continue to meet down there and I am leaking like a sieve spontaneously during the day or overnight. Back between July and September I was in bed for two and half months because it got to my skin and scalded my skin. Getting up in my chair made everything worse.

    Because my urologist is not qualified to do a bladder neck closure or any type of reconstructive surgery (I probably said this is my first post about this) and there is nothing more she can do for me so that urologist on Tuesday of this week gave me a couple of options for reconstructive surgery BUT I just didn't care for her staff or her. The urologist I have had since 2006 here in Tucson (Northwest side) has been great for me all these years until that nurse did this to me (stretching my bladder so terribly that I am having to resort to this) and originally referred me to a urologist at the University. I will probably go to him now because they can accommodate me whereby the urologist I saw on Tuesday is requesting I go to TMC (near Tanque Verde) so she can "examine me" there. She will not take my urologist's opinion on my urethra being stretched without the possibility of it being eroded so she can make a decision as to whether to do a bladder neck closure on me or do the sling/mesh to stop this nonstop leakage that ONE NURSE (after 37 years of many different nurses NOT being negligent and blowing up the balloon and my urethra and leaving it there for 45 minutes after she left my home) ruining me "down there."

    Would not mind meeting you someday. All of us quads are so far away from each other that it is hard to find another in the same area. Although I did meet a girl who went to service dog classes with me between 2002 and 2004 but I had to retire my dog early since she acquired Hip Dysplasia and I wasn't going to make me do work if she was in pain and couldn't tell me so. I lost her in 2009, lost my husband in 2012 and lost the rest of my family last year. They are still in the Northeast (only 3 family members left) and I would've stayed there since I lived with my sister and brother-in-law for 3 years until my sister began having very minor lower leg problems & my brother-in-law wanting to "his house back." Despite me higher in morning and evening home health caregivers and having a great home health agency. I decide I would be happy back here but within two weeks that nurse stretched my urethra and I have been suffering since. My urologist had tried everything and here we are at the end of the year already. I was just hoping it would resolve itself or bladder spasm medication would help it... but nope.

    Take care! And thank you for your advice on switching to the SP like so many others have. I would've done that a long time ago except I never had any problems with my Foley catheter OR having a nurse be that negligent and causing me all this pain physically and emotionally and mentally.
    Last edited by Brinda41; 12-04-2016 at 01:45 AM.

  6. #6
    Yes KLD, the female urologist on Tuesday said that that would require an incision into my lower abdomen (to make the sling) and thereby using my own bodily tissues.

    I understand there is a great amount of literature about patulous urethra with women like myself having a Foley over 20 years but, again, I was perfectly fine until that nurse got a hold of me. In fact, my urethra wanted to hold onto my catheter whenever one of my home health agency nurses came out to change it by having a urethral spasm. She just had to wait a few seconds for my spasm to stop and then it easily slid out.

    Yes, I am also aware that using a larger Foley catheter would only make things worse but thank you for the info anyway!

    It was actually my urologist who suggested the bladder neck closure so I just feel so lost and lonely in this matter. They urologist I saw on Tuesday, like I said, either wanted to use my tissues to create a sling OR do a bladder neck closure depending upon whether my bladder is stretched or eroded. Once again, it was perfectly fine until that nurse got ahold of me and stretched it by blowing the balloon up in my urethra and leaving it there for 45 minutes because we thought it was okay (I should've known better) and by the time she got back to my house to resolve the issue the balloon had been sitting in the urethra far too long and therefore STRETCHING it.

    I will keep your post and show it to the urologist I am going to go to to get a second opinion in January unless he has an earlier opening which is highly unlikely that I could keep trying to see if there are any cancellations.

    Not only frustrated that all of this happened to me when I was fine before hand but now not knowing who to trust.

  7. #7
    I do remember seeing that person's name pop up but I am not always in here either. I stay more on the quad list e-mail list but I have come across this great website a little earlier than 2005. More like around late 2001.

    I imagine that what happened to Becca or Rebecca is that they chose a net material that was not using her own body tissues to make it and that would be the reason for all of her troubles like the SCI nurse here (KLD) just explained.

    Thank you!

  8. #8
    Yes, we get it about how your urethra was damaged. No need to repeat it over, and over, and over. If you are actually seeking legal action again the nurse or the agency, any attorney would strongly recommend that you NOT post anything on public internet forums like this one about the incident.

    (KLD)

  9. #9
    Quote Originally Posted by SCI-Nurse View Post
    Yes, we get it about how your urethra was damaged. No need to repeat it over, and over, and over. If you are actually seeking legal action again the nurse or the agency, any attorney would strongly recommend that you NOT post anything on public internet forums like this one about the incident.

    (KLD)
    Understood KLD and I truly appreciate your candid response. I also appreciate all of your input! Here's hoping you have a great holiday season!!!

  10. #10

    Decision Decisions

    Quote Originally Posted by SCI-Nurse View Post
    We have done some urethral slings on a number of our female SCI clients. I would caution though against doing any procedure like this that involves using mesh! There have been a number of large class action suits against physicians and medical device manufacturers due to patients having bad reactions to the use of mesh. Better to use a small piece of your own body tissue (muscle or tendon) to create the sling.

    http://www.mayoclinic.org/diseases-c...s/art-20110300

    http://www.webmd.com/urinary-inconti...nence-in-women

    There is a significant amount of literature about the long term development of what is called a "patulous" (stretched out) urethra in women who have used an indwelling urethral catheter for more than 20 years. The patulous urethra will nearly always lead to leakage, as the short female urethral tissue can no longer seal well around the catheter. This condition can be made worse by going through menopause, as the decreased levels of estrogen can make your urethral mucosa thinner and less moist (just like occurs with vaginal mucosa after menopause).

    Management and prevention include consideration early of a suprapubic indwelling catheter instead of a urethral one for women who are determined to use an indwelling catheter long-term. Often people try to manage this by using larger and larger Fr. sized catheters, but this actually only increases the rate at which a patulous urethra can develop.

    I would also caution you again any procedure that would include urethral ligation (bladder neck closure). Our experience with this is that the bladder REALLY wants to have an opening to the perineum, and if it is closed off with this procedure, often a fistula develops to that area from the bladder, which is very difficult to manage or surgically close again.

    (KLD)
    I went to the Urologist that my urologist of 10 years referred me since my urologist at 10 years is not qualified to do any reconstructive surgery in case I need that. This was Monday.

    I first saw his Nurse Practitioner and she explained everything to me. She explained that they do the mesh slings if need be and the difference between that and a bladder neck closure (which my urologist mentioned). She spent a good 45 minutes with me explaining everything.

    I took your message above with me & asked her what she thought about the lawsuits brought against those who have had the mesh slings and she said they have not had any problems with theirs and those lawsuits are like many... to scare (or comfort) those who have had problems with them. Just like all the other commercials we see whereby if you have had this problem or that problem contact us NOW. She said that the urologist does require a yearly vaginal check up if we go with the mesh.

    They are much more accommodating and have ceiling lifts to be able to lift me and transport me onto a table and she scheduled me for January 12 to do a cystoscopy and urodynamics.

    So I guess my only concern is that the other urologist (whose staff and her were ice cold with no bedside manner and no accommodation) recommended using what you did but this urologist does not. I still have more questions for them but everything is so overwhelming.

    Now I had something else start with me beginning Tuesday, December 13 when I was getting moved up in bed. My caregiver pushed in on my chronic pain area (around T1) and starting bad day and at night on my side I began to have clenching spasms meaning that my back is dramatically causing my stomach to clench inward. It does the intermittently during the day and in bed. And I am in excruciating pain from T1 down my spine and under my right shoulder blade along with my extremities aching to the bone.

    I simply can't imagine what happened & my caregiver said she did not do anything different and she has been moving me in the same way for a year now but I know what I felt and I certainly know and feel what has happened ever since then.

    I do not have a neurologist/neurosurgeon here because I never needed one and I have been terribly overwhelmed with what happened to me at the beginning of the year and dealing with that. My social life has stopped before it ever began and now without my husband or my family I feel so alone.

    I am also not made of money and I only have Original Medicare. That means I have to pay for the 20%. Monday's co-pay was $36 up front. Places used to bill Medicare afterward but recently they now charge upfront for my co-pay.

    Unfortunately I went to college and worked and so did my husband and therefore I am simply not eligible for Medicaid benefits or anything else I have looked into. Just the leaking around the catheter since then they are stretched my urethra and has cost me hundreds of dollars in purchasing chux and baby wipes and even more with emotional trauma from late urine scalding my skin in July causing the equivalent of severe adult diaper rash and it took us two months to figure out that Vaseline came to the rescue. It got so bad no matter how hard we tried to keep me dry that I had to stay in bed 2 1/2 months because getting in the chair only made it worse.

    I am losing hope in the medical professional field. I keep getting hurt dramatically by medical "professionals" and I won't even go into the other nurse and doctor in my life who hurt me but were untouchables to go after.

Similar Threads

  1. Bladder Sling Mesh Lawsuit
    By apache_camp in forum Work, School, & Money
    Replies: 4
    Last Post: 08-20-2012, 09:05 PM
  2. Apex Dynamics - Universal Sling Mesh
    By ginamarie in forum Equipment & Services
    Replies: 1
    Last Post: 05-03-2008, 10:22 AM
  3. Bladder Pain, Foley Catheter Use
    By Rdmayfield in forum Care
    Replies: 2
    Last Post: 04-25-2008, 09:26 PM
  4. Mesh or Dacron Sling?
    By Mona~on~wheels in forum Equipment
    Replies: 12
    Last Post: 02-01-2008, 08:24 PM
  5. Replies: 6
    Last Post: 06-14-2006, 03:00 PM

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •