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Dr. Tharun
Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3682
Experience:  MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
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I had a TVT and anterior lift about 7 weeks ago and my bladder

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I had a TVT and anterior lift about 7 weeks ago and my bladder is just as bad if not worse than before I had the surgery. My Dr. is competent and has performed these for years. He says the surgery went well and everything is where it is supposed to be. I still leak when I sneeze, cough or when it gets full. Even when I go to the bathroom I have to go again soon because it doesn't empty fully. This was an issue even before I had the surgery. I had to go back a few days after the surgery because I was having so much pressure and even after I had voided twice while waiting to see him he had to put a catheter in and 900cc's was drained out. He has me on bethanechol and that seems to help some but I definitely haven't improved in the leaking issue. It does take me longer to void now but I just wish I could empty it completely. Any info would be greatly appreciated. Thanks!
Hi

You seem to have two problems at the same time.

One is a weak bladder which is not able to pump the urine out of the bladder which is causing the retention of urine.

Second problem is weak sphincter which allows the urine to leak when the pressure raises in situations like coughing sneezing etc.

Usually after the tape surgery there is a problem of retention and rarely do we encounter a leak.It can happen in rare cases if the tape is not tight enough.
In your case I presume the leak is not due to bad surgery or loose tape.In fact the weak bladder allows too much urine to be collected to exceed its capacity which just gives away .This is called over flow incontinence.It would have happened in normal sphincter too if the bladder becomes too full.So how ever tight the tape is , it will allow the urine to escape once the bladder is overfull to the extent of 900 ml.

So the main problem seems to be the weak bladder.This is an absolute indication to do an Urodynamic study of the bladder and document it.If it is indeed a weak bladder then is nothing else to do than bethanechol and self intermittent catheterization.

I hope this answers your question.

Regards

Dr.Tharun
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