leakage...

LBRS · 10-06-2003, 05:27 PM

Hi, my wife wants to know if there is another alternative to urine leakage (below) other than to closing it off completely (below). She had a catherisable stoma April 2002 and it was supposed to stop urine leake from original location below, but it has got to the point that its non-stop in the last few weeks. We have an appointment with the Urologist who performed the original bladder/appendix stoma surgery, but i'm not sure he is taking it seriously. Also its been almost 2 years now since te surgery april/2001 and she still has unpredictable bowel movements (loose) since the surgery, any suggestions? PS: If tis guy doesn't come up with a better plan, we will be looking for a malpractice attorney in TN if you know a good one....or have a suggestion on her health issues...email @ toyz911@bellsouth.net

SCI-Nurse · 10-06-2003, 06:49 PM

Is this urologist an expert in this surgery? How many had he/she done prior to your wife's surgery? What has he/she suggested?

Is your wife taking anticholergic medications to decrease bladder spasm? Did she also have an augmentation in addition to the Mitrofanoff? If not, she may need this procedure now that her bladder has changed some. Has she had video voiding studies (urethrogram or video urodynamics)? Women sometimes have leakage due to their short urethra being too straight (common after childbirth or with excessive weight) and a "sling" procedure may also be needed.

I would definately get a second, and if needed 3rd opinion from another urologist before seeking an attorney, even if you need to travel some to get these other opinions. Be sure you are seeking true experts in female incontinence and SCI.

We do not recommend closing off the urethra surgically. It is a difficult procedure, commonly leads to complications, and very often the bladder eventually will make its own path anyway later by creating a fistula to the outside.

As far as her bowels, has she been tested to be sure she does not have a c. difficile infection? If not, this needs to be done first. If this has been ruled out, I often suggest the use of calcium carbophyl (Fibercon) to "firm-up" stools that are too loose or soft. She can take between 2-6 tablets daily for this.

(KLD)

crags · 10-07-2003, 06:38 AM

bowel incontinence can be a long term side effect of bladder augmentation. my doc made me aware of the possibility (about 10% chance). were you informed of this prior to the surgery?

LBRS · 10-07-2003, 06:38 AM

Hi, the Urologist we are seeing is supposed to be "the expert" in Nashville. I don't think hes taking it seriously at all. She had the urodynamics test (which forced urine back into her kidney and caused a documented infection that ended in a 1 week stay in hospital), shes had a CT scan (this week) of her kidneys which showed nothing and that they were perfect(another facility) and she already has the "sling", her urethra was supposedly closed at the intial surgery, but obviously its not. It seems as though the obvious is not obvious enough, we've been to two different urologist and they still aren't acting on this. This has turned my wife into being basically homebound. I just about had enough, working in the Judiciary area my self, I'm about ready to fire a shot over there bow....

Liz321 · 10-10-2003, 07:19 AM

Good luck!

LBRS · 10-10-2003, 01:39 PM

Yes, Yes....shes had every test under the sun, both for leakage and bowels. Her "expert phycisian" told her today that we would wait and see for a few months, maybe it would clear up. Leakage does not clear up. I suspect, he doesn't want to admit failure. As for closing off the urethra we were told by 3 urologists this was common when patients use stomas. We will see another opinion, but in the mean time we are looking into a malpractice issue. It seems to me that about 90% of SCI victims are afraid to question the wisdom of so called experts.

SCI-Nurse · 10-10-2003, 05:36 PM

Of course to proceed with a suit you would have to prove negligence or malpractice, and that this care is not within usual standards of practice. VERY DIFFICULT! It is very difficult to find physician experts who will testify against anyother physician as well, unless the care is blatantly out of standard, which this does not appear to be.

(KLD)

10-06-2003, 05:27 PM	#1
LBRS Senior Member Join Date: Mar 2002 Location: NC Posts: 110	leakage... Hi, my wife wants to know if there is another alternative to urine leakage (below) other than to closing it off completely (below). She had a catherisable stoma April 2002 and it was supposed to stop urine leake from original location below, but it has got to the point that its non-stop in the last few weeks. We have an appointment with the Urologist who performed the original bladder/appendix stoma surgery, but i'm not sure he is taking it seriously. Also its been almost 2 years now since te surgery april/2001 and she still has unpredictable bowel movements (loose) since the surgery, any suggestions? PS: If tis guy doesn't come up with a better plan, we will be looking for a malpractice attorney in TN if you know a good one....or have a suggestion on her health issues...email @ toyz911@bellsouth.net

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10-06-2003, 06:49 PM	#2
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,354	Is this urologist an expert in this surgery? How many had he/she done prior to your wife's surgery? What has he/she suggested? Is your wife taking anticholergic medications to decrease bladder spasm? Did she also have an augmentation in addition to the Mitrofanoff? If not, she may need this procedure now that her bladder has changed some. Has she had video voiding studies (urethrogram or video urodynamics)? Women sometimes have leakage due to their short urethra being too straight (common after childbirth or with excessive weight) and a "sling" procedure may also be needed. I would definately get a second, and if needed 3rd opinion from another urologist before seeking an attorney, even if you need to travel some to get these other opinions. Be sure you are seeking true experts in female incontinence and SCI. We do not recommend closing off the urethra surgically. It is a difficult procedure, commonly leads to complications, and very often the bladder eventually will make its own path anyway later by creating a fistula to the outside. As far as her bowels, has she been tested to be sure she does not have a c. difficile infection? If not, this needs to be done first. If this has been ruled out, I often suggest the use of calcium carbophyl (Fibercon) to "firm-up" stools that are too loose or soft. She can take between 2-6 tablets daily for this. (KLD)

10-07-2003, 06:38 AM	#3
crags Senior Member Join Date: May 2002 Posts: 1,021	bowel incontinence can be a long term side effect of bladder augmentation. my doc made me aware of the possibility (about 10% chance). were you informed of this prior to the surgery?

10-10-2003, 07:19 AM	#5
Liz321 Senior Member Join Date: Jan 2003 Location: NY Posts: 5,582	Good luck!

10-10-2003, 01:39 PM	#6
LBRS Senior Member Join Date: Mar 2002 Location: NC Posts: 110	Yes, Yes....shes had every test under the sun, both for leakage and bowels. Her "expert phycisian" told her today that we would wait and see for a few months, maybe it would clear up. Leakage does not clear up. I suspect, he doesn't want to admit failure. As for closing off the urethra we were told by 3 urologists this was common when patients use stomas. We will see another opinion, but in the mean time we are looking into a malpractice issue. It seems to me that about 90% of SCI victims are afraid to question the wisdom of so called experts.

10-10-2003, 05:36 PM	#7
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,354	Of course to proceed with a suit you would have to prove negligence or malpractice, and that this care is not within usual standards of practice. VERY DIFFICULT! It is very difficult to find physician experts who will testify against anyother physician as well, unless the care is blatantly out of standard, which this does not appear to be. (KLD)