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Bladder Sling Issues
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Bladder Sling Issues

I am 49 years old....since 1985 I have had 13 surgeries....had a total hysterectomy when I was 28 years old and have been on hormone replacement therapy since then.  In 2009 I had a Bladder Sling put in place due to Urinary Incontinence.  At the same time I had Cystocele repair.  I also had to have Lithotripsy done due to a large kidney stone in my right kidney soon after.  In April of 2010 I had to have a 2nd sling operation (another sling placed under the first one) as well as rectocele repair.  After the second sling was placed I developed issues with not being able to urinate at all and was having to self-cath myself as my bladder was not even emptying 50%.  I  ended up in the Dr.'s office where they drained off 2 litres of urine from my bladder.  As you can imagine my belly was very swollen and I was in a lot of pain.  We thought that the sling would heal and I would able to urinate on my own again without self-cathing but it was soon apparent that this was not going to happen.  Three weeks after my first surgery I was in surgery again to loosen the 2nd sling a bit.  I recovered from that surgery but I am now "leaking" again...when I sneeze...cough...and sometimes when I just happen to "move" wrong. Excercise is nearly impossible.   It is very aggravating to have this happening again after all I have been through.   I went back to my Urologist and he suggested two options...placing a 3rd sling under the bladder or doing a collagen injection to the urethra.  My questions are....is it "normal or safe" to place a third sling below the bladder or are collagen injections a better option?  What happens if they inject too much collagen?  Is it reversible?  Due to the cystocele and rectocele repairs I also have a considerable amount of mesh that has been placed for support.   After my first sling was placed my body tried to "reject" the sling and was pushing the sling out of my body.  We were able to trim off the bottom of the sling in the office and the erosion stopped.  I asked my Dr. if it was normal to have multiple slings as opposed to removing the existing ones and starting over?  He said it was more of a "Dr. preference" as far as the procedure goes.  I really like my Urologist but I am hesitant to have another sling put in place and do not know enough about the collagen injection to feel comfortable with it.  I would also add that I have Factor V Leiden (1 copy) and Protein C Resistance for which I am on Coumidan therapy for the rest of my life.  I have had multiple blood clots in my legs and foot.  This presents additional issues having to give myself Lovenox or Heparin injections prior to and after any surgical procedure.  I have my PT and INR monitored monthly or more often as needed.  Depending on my readings my Coumidan dosage is anywhere between 7.5 mg per day to 10 mg or 12.5 mg per day.  My INR has been as below a 1 and as high as 14 at one time.  I find it very hard to keep my blood at a therapeutic level even though I monitor my food intake very carefully due to certain foods effecting my Vitamin K levels.    I know this is a lot of information but I would appreciate your input. Due to my work schedule and not having any more  time off I need to schedule this soon with the least amount of time off from work.  Thank-you.
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