Urogynecology Expert Forum
Postop midurethral sling, changes in urination.
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Questions in the Urogynecology forum are answered by Bruce Crawford, MD, J. Kyle Mathews, MD, and other medical professionals and experts. Topics covered include overactive bladders, bladder pain, fallen/drooping bladder, bowel urgency, bowel prolapse, cystitis, incontinence, pain with intercourse, rectal prolapse, surgery, urinary urgency, and uterine prolapse.

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Postop midurethral sling, changes in urination.

I'm 3 months postop midurethral sling for stress incontinence.  It was successful in that I have no SI so far.  But I do note the urinary stream is slower than it used to be and dribbling at the end, which my Dr. knows about and I return to her in a month.  She did say that slow stream and dribbling could be stopped with cutting the sling and suggested a medicine for the dribbling, both which I don't want.  In addition now with urination if I strain as if to hurry up a bit, the urine flow stops, but relax those muscles and flow resumes.  Then if I squeeze pelvic muscle to stop the flow, as I learned in doing kegel exercises, the flow continues with dribbling for awhile.  Even if bladder seems emptied, when I go to stand up, more dribbling.  Do these two incidents suggest a problem or would they just be a normal reaction from sling surgery, and something to learn to live with?  Thank you very much.
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The sling changes the bladder anatomy. The urine stream can become slower. Sometimes you have to shift positions on the toilet in order to optimize the flow. Most surgeons believe that if you can completely empty your bladder, then the sling should be left alone. Pushing to empty will activate the sling and make the urine flow stop. It is important to relax your bottom, and let the urine flow upt naturally. Some of these symptoms improve with time.

Lennox Hoyte MD

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