Urogynecology Expert Forum
Urethrolysis (?)Surgery
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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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Urethrolysis (?)Surgery

I'll try to keep this short.  After 4 months of GYN visits, tests, ultrasounds I was referred to a Urology Center.  I have been self cathing for three weeks now.
Symptoms:  Crampy feeling, bloody show (hysterectomy & TVT Surgery+ 4 years ago), Hematuria, Retention.  
I recently had a Urodynamics study which was a total flop, I couldn't void at all after the tech filled my bladder to the max.  Showed no pressure flow whatsoever.  She cathed me and spoke with the Dr. and they scheduled a Cystoscopy which was today.  He basically said my bladder was very irritated. He believes my urethra is snagged which is causing me not to be able to void.  He is going to snip one side of the TVT and perform a Urethrolysis.

My main concern is that after I do  go through with this surgery I may be back in the same position as before my TVT with constant leakage.  Or worse yet, not being able to void after this procedure.  Then I will have to depend on my cath which I cannot phathom.   Has anyone ever heard of this type of surgery.  If so how long did it take for you to recover.  Thank you in advance.  
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If you are unable to void (i.e. retention), that could be because the bladder muscle (also called the detrusor) is not contracting, or that the outlet (urethra) is not opening up to let the urine flow out. The latter can happen sometimes after sling (e.g., TVT) surgery. If the problem is not resolves by 4-6 weeks, I usually will release the sling, and this usually allows my patient to urinate. Sling release usually does not lead to incontinence. THe release procedure is an outpatient procedure, and you should be back to your usual activities (except intercourse) in short order.
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J. Kyle Mathews, MD, DVMBlank
Plano Urogynecology Associates
Plano, TX
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