pubovaginal urethra sling

[Meldoy]

SherriP,
I had started leaking uring 2 1/2 wks post POP sx. I went for my 5 wk check up, and let the dr know. She recommended Pubovaginal urethral sling sx in a few months. Of course she also gave me other options, bulking injections and another different mesh sx. I just wanted some insight on this. The leaking has progressively getting worse, I am wearing a depends pad all the time, now. Feeling very frustrated and a little depressed. Thanks, Mel

[sherrieP]

I don't give advise/recommendations about what kind of surgical procedure to have done, every woman's body is different and variables are unique. In scenarios like yours where there are more complicated issues being worked on it's even trickier. I really feel the most important thing a woman can do is find out as much as she can about the physician doing the procedure because often complications are the result of procedures not being done the best way possible-especially with mesh. Too loose, too tight, wrong attachment points, that kind of thing. Also the reason I always recommend a urogynecologist, the specialist for POP. Any surgery can have complications and since the pelvic cavity is so intricate, the risks of complications do exist.

I would stay away from bulking injections, this is a tricky manuver and I've read some negative reports regarding cathing being needed because of improperly injected materials. There is some positive result from tibial nerve stimulation but it is not a common procedure here and you may have difficulty finding someone who does them. Myofascial release therapy may be worth checking out, often when scar tissue is present in the pelvic cavity, it prevents proper contraction of pc muscle and other tissues and when the adhesions are released you can contract more normally. I was amazed at the difference in my contractability after having this done. There is also that product you can order online, I'll send you a PM with that info. I do think it would be a good idea to ask your physician about referring you to a physical therapist (should be one that specializes in womens pelvic floor health), using biofeedback she may be able to help you isolate where the problem is and come up with a treatment program that will help.

PM coming shortly!
Sher

[Meldoy]

Sorry for not getting back to you. My doctor did not mention PT. I'm thinking because we talked alot about the sx that had been done. She said she probably should have done the  Pubovaginal urethra sling sx, but I was in sx for such a long time and this sx is more invasive that the urethra mesh sling, she was really HOPING it would do the trick. She did explain that the mesh sling may not work --before hand. I don't blame her and I told her that. I just want it fixed and what was the best thing she could do/or recommend I do . Do you know anything about the sx? And do you think it is wise to have another sx done for this, does this happen?Any info you have about sx, devices and therapy, you may have, I would appreciate. Thx, Mel PS We did sched sx 5/27

[sherrieP]

Hey kiddo, good to hear from you. I'm sorry to hear however that the issues with leakage continue after having surgery to correct it. I have to wonder if you still have a lot of scar tissue inside if that may have hampered the quality of procedure-that was a very long procedure you had done. Has your dr talked to you about a physical therapist to try some treatments to see what they can do to improve the situation? There are several that are utilized for leakage but in particular I'm wondering if myofascial release therapy might be beneficial. There is also a device available online that is often beneficial for urinary incontinence (it is only in stores in Europe, not in the US yet) that may be of some help. If you are interested in trying the myofascial release therapy let me know and I can send you some info and see if I my contacts know of anyone in your area that is good with women's pelvic floor issues. Hang in there Mel, I'm hopeful we can get something helpful rolling.

Sher