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Incontinence

Timeliness of successive bladder surgery

11/14/2007

Question:

Three months ago, I had a sling release surgery from a urethral sling obstruction I had implanted a month prior to that. During the release, I had a small perforation of the bladder neck and not sure if it healed. I have since been diagnosed with a diverticuli around the bladder neck, and a possible fistula, slight urethral scar tissue, and something is hanging down in my vagina. (prolapse?) I got a first opinion from the original urologist and I have another opinion scheduled in a month and a half. I have significant stress and urinary incontinence, but have no UTI`s or pain or problems otherwise. The urologist I will be seeing hinted that he might look at taking this sling out. My question is: If I wait another 5 weeks for my second consult for surgery, am I probably going to be fine waiting until then or should I get a second opinion someone where else sooner? Is time of the essence? I just heard that the longer one waits, the harder it is to get these out? Maybe I should see if someone else can see me sooner? Also, will my fistula become worse if I wait that long? The original doctor recommends a fistula and diverticuli repair with a Martius flap and a Bio-Arc sling. The second opinion is pending and I am worried that 5 weeks is too long? Just want to be sure I am doing the right thing. Thank you so much.

Answer:

I thought you had the sling removed? It is difficult to remove the entire sling after weeks. I assume a piece of it is still there to bother you.  The second opinion you have obtained sound  practical. Time is the best healer if you don't have a fistula. But if you do have the fistula, the repair suggested is a good idea. Don't confuse yourself with more opinions. 

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Response by:

Ahmad  Hamidinia, MD Ahmad Hamidinia, MD
Formerly, Professor of Clinical Surgery
College of Medicine
University of Cincinnati