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Urology (Expert Forum)
Problems with not being able to urinate AT ALL after Sling Procedure
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Problems with not being able to urinate AT ALL after Sling Procedure
by Wendy, Sep 10, 1999 12:00AM
Let me start by asking for your forgivness for not knowing the proper terms for some of the things I'm going to post.
I'm writing for my Aunt. She is in her mid 50's and recently (2 months ago) underwent a bladder suspension surgery. Approximately a month later she had an additional surgery called a Sling (or maybe that's the same thing...I don't know). Anyway, she originally had the surgery because she would "leak" if she sneezed, coughed, laughed, etc. However, ever since she had the surgery she has been unable to urinate. It has been roughly 3 months now and she still hasn't been able to urinate on her own. She has to catheterize herself several times a day. She has since become very depressed and discouraged. I've tried for HOURS to look on the net to see if anyone else has experienced this same problem and have unfortunately come up with little information for my Aunt. If there is any information that you can give her regarding her problem, it would be GREATLY appreciated!
Thanks,
Wendy
I'm writing for my Aunt. She is in her mid 50's and recently (2 months ago) underwent a bladder suspension surgery. Approximately a month later she had an additional surgery called a Sling (or maybe that's the same thing...I don't know). Anyway, she originally had the surgery because she would "leak" if she sneezed, coughed, laughed, etc. However, ever since she had the surgery she has been unable to urinate. It has been roughly 3 months now and she still hasn't been able to urinate on her own. She has to catheterize herself several times a day. She has since become very depressed and discouraged. I've tried for HOURS to look on the net to see if anyone else has experienced this same problem and have unfortunately come up with little information for my Aunt. If there is any information that you can give her regarding her problem, it would be GREATLY appreciated!
Thanks,
Wendy
Doctor's Answer
by HFHS M.D.-BE, Sep 13, 1999 12:00AM
============================================
Dear Wendy,
It is quite understandable that your aunt is discouraged with what she has had to endure. I hope this information helps you make some sense of what has been happening.
Bladder neck suspension is a procedure that involves the lifting and supporting and tightening of the bladder neck and the nearby urethra in patients who have stress urinary incontinence. This is essentially the same as a Sling procedure. There are different variants and approaches to performing this surgery, each with its own pros and cons. I am not sure what you mean by your aunt having a suspension and a sling procedure in a one month period. Regardless, it appears that she had a procedure for her symptoms of stress incontinence as you outlined above. As in any surgery there are always risks and benefits, and different outcomes , as well as potential complications.
One of the potential post-operative complications of a bladder neck suspension/sling procedure is urinary retention. This is often a temporary event and could be due to swelling, pain, anesthesia and pain medications. Usually the problem is dealt with by leaving a catheter in the bladder for one to two days followed by a course of self catheterization as in the case of your aunt. Some other doctors leave a suprapubic catheter ( a catheter entering the bladder, inserted through the skin above the pubic region) in for up to 2 to 3 weeks followed by a course of self catheterization. The problem will gradually and eventually resolves, with the patient being able to void on her own, at which time the suprapubic catheter will be taken out.
Permanent urinary retention, however, is rare. The most common cause is post operative obstruction of the urethra (i.e., the tube that carries the urine out from the bladder). This could be due to too tight a repair or a misplaced suture. These could be more of a problem in patients whose bladder function and ability to contract was poor to begin with.
When urinary retention persists past 3 post-operative months, a complete urodynamic evaluation (a special pressure flow study) should be performed. Depending on the findings a procedure named urethrolysis ( releasing the urethra in the area of obstruction and narrowing) may be performed, which often restores the ability to urinate spontaneously and at will. You must see your urologist as soon as possible. I hope all goes well.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-BE
*keyword: bladder neck suspension and urinary retention
Dear Wendy,
It is quite understandable that your aunt is discouraged with what she has had to endure. I hope this information helps you make some sense of what has been happening.
Bladder neck suspension is a procedure that involves the lifting and supporting and tightening of the bladder neck and the nearby urethra in patients who have stress urinary incontinence. This is essentially the same as a Sling procedure. There are different variants and approaches to performing this surgery, each with its own pros and cons. I am not sure what you mean by your aunt having a suspension and a sling procedure in a one month period. Regardless, it appears that she had a procedure for her symptoms of stress incontinence as you outlined above. As in any surgery there are always risks and benefits, and different outcomes , as well as potential complications.
One of the potential post-operative complications of a bladder neck suspension/sling procedure is urinary retention. This is often a temporary event and could be due to swelling, pain, anesthesia and pain medications. Usually the problem is dealt with by leaving a catheter in the bladder for one to two days followed by a course of self catheterization as in the case of your aunt. Some other doctors leave a suprapubic catheter ( a catheter entering the bladder, inserted through the skin above the pubic region) in for up to 2 to 3 weeks followed by a course of self catheterization. The problem will gradually and eventually resolves, with the patient being able to void on her own, at which time the suprapubic catheter will be taken out.
Permanent urinary retention, however, is rare. The most common cause is post operative obstruction of the urethra (i.e., the tube that carries the urine out from the bladder). This could be due to too tight a repair or a misplaced suture. These could be more of a problem in patients whose bladder function and ability to contract was poor to begin with.
When urinary retention persists past 3 post-operative months, a complete urodynamic evaluation (a special pressure flow study) should be performed. Depending on the findings a procedure named urethrolysis ( releasing the urethra in the area of obstruction and narrowing) may be performed, which often restores the ability to urinate spontaneously and at will. You must see your urologist as soon as possible. I hope all goes well.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-BE
*keyword: bladder neck suspension and urinary retention
