Urinary Sphincterotomy

I'm surprised this didn't come up in a search here. Anyways, I am urge incontinent, with both bladder sphincter dysenergy, and detrusor sphincter dyssenergya. I have tried every medication there is for urinary problems. I've had botox injection twice and both times they made things worse for a few months before wearing off. I have also had the interstim test implant, which made things permanently worse by a lot.

Since nothing had come close to helping I began pursuing a urinary sphincterotomy. Long story short, I've had an amazing SIX of them in the past two years. And guess what, I'm goi g through the pre-op today to have number seven done.

I go in for a normal surgery prep, and get knocked out. I always keep my diaper on going into the or too. The doc then basically cuts out a layer of my sphincter. They don't remove the whole sphincter muscle, and they can't go too deep though or I'd bleed out. Hence the need for repeat surgeries. When I wake up I have a catheter in, and a lot of blood mixed in.

I go home that day, and in about 3-5 days take the catheter out myself at home. I will be very sore down there for a month or so, and take pain pills to manage it. A perennial donut is also much needed, but I can sit for long periods of time so long as I don't get up and move around too much. About two months in, and the pain and bleeding has slowly decreased to being ok again. However, it takes another one or two months before I start feeling totally normal again.

So round seven, wand god I hope this will be it. Wish me luck.

Lucky seven! Hope everything goes well

Good luck! As Trevor said 7 is a lucky number. Better have a rabbits foot and a four leaf clover with you, and some lucky dice.

I really hope it goes well and you don't need an eighth procedure.

Oh....I want to bend over and hold my crotch just reading that. I really wish you the best of luck with the next surgery, and I'm sorry you have to go through this.

Sounds absolutely awful. I really hope this is your last. Sending love and light

Thanks all, and I cleared the pre-op, with a go for tomorrow.

My surgeon is at the Mayo Clinic, and is the best urologist of more than two dozen I've ever met. And yeah it does hurt bad, but I'd rather trade a lifetime of mild pain for a moment of intense pain followed by a lifetime of relief. Hadn't thought of lucky seven before, maybe it will be.

Well that was interesting. The doc told my wife he cut into me like I was wanting, which was a deep radial cut in my internal sphincter to completely blow it away. However, I have NO bleeding, and NO real pain down there! Heck, my throat is more sore from the breathing tube than my urethra is.

I can also confirm I have very sensitive feeling down there too. My doc did do a linear cut on my internal sphincter once, using the hot knife (which ultimately did not work very well). It hurt and I bled for well over a month, and I had a had time sitting down or transitioning from siting to standing (and vice versa). It's possible this difference is because of him using a green laser this time, but it is not what I've been forced to go through every other time.

I have to say I am elated it was a mostly easy surgery for once (and that I didn't die on the table like last time too), but also kind of pissed for what I had to go through before for the same surgeries. There was one big catch this time though. I had previously asked for anti-nausea meds for my post op recovery. However, when I woke up I was really dizzy and threw up (only a little stomach acid). I was then able to eat a gram cracker and drink some apple juice. On the way home it was all I could do not to throw up again. As soon as we stopped at the pharmacy for my new meds I beelined it to the restroom and lost it all. Anyways, the anaesthesiologist did say he brought me out of it very slowly instead of the usual speedy wake up. This too might have played a part in my bad nausea.

Lesson learned then. If anyone ever needs to get a sphincterotomy done, absolutely insist on getting it done using a green laser. Also make sure the anaesthesiologist wakes you up fast afterwards.

Well it seems my nerves down there have regenerated. I am now in the same kind of pain I was after my last surgeries. I am managing it with oxycodone, and getting by.

On a side note, I also just got a cold. It's making me cough a lot, which in turn makes my sphincter muscle hurt a lot more. Uuuugh.

Ouch! Hope it gets better soon.

Seven surgeries on one or both sphincters seems excessive. I speak with experience, as I have also had 8 urethral operations where I was knocked out. What I found out was 7 of them were unnecessary. That would be the first 7 which were aimed at my external sphincter. I finally got referred to one of the finest urologists (the head of urology at Palo Alto V.A. medical), and he said "what were all the previous doctors smoking?" Come to find out, it was the INTERNAL sphincter causing all my woes, not the external. Well, one last surgery (the first and only one done on my internal sphincter), and my obstruction has been cured for 8 years now. However, because the prior surgeries on the external sphincter, I am most likely incontinent for life. Im not being preachy here, but on DD, there was another who had around this many surgeries (babybrian), and it sounded very similar. I tried to tell him to really ask his doctors if it wasnt maybe the internal sphincter causing the obstruction, but never really concinced him. Heck, maybe you are babybrian here, under another name. No offense meant either way. If this is babybrian, I bet you had ANOTHER pointless surgery done on the external sphincter. uuDUDE, you are on the WRONG sphincter. If its someone else, please take no offense and help me with the next question.

Anyhow, what shpincter have you had these surgeries on? Id almost bet money that like me, you had unnecessary procedures done on the external, with little to no benefit.

When they finally cut my internal, they ended up having to remove 75% in one procedure (the most extreme version). Ive never peed so free and easy since. Zero obstruction problems. The only issue now is I have now is an incompetent exterior sphincter due to 7 unnecessary operations on it. Had they done this surgery first, l would almost certainly be urinary continent today. So thats my beef, part of me feels I got screwed by 7 needless operations on my external sphincter. I would be dead right now if one very smart doctor hadnt realized it was my internal sphincter all along. Incontinence is a small price to pay to be alive!

Anyhow, wishing you the best, as one who has been there, done that, and just sharing my results/regrets.

Hi Slomo. Hope you are doing well now.

Technically two were to remove stricture obstructions that developed from my constant straining. And it was definitely my external that was the worst for me, unfortunately it is actually BOTH though.

I'd love to know how they went after 75% of your muscle in one shot though. It took three to open my external because with each one my doctor could only go so far before my bleeding would become too threatening. As it was, I still bled horribly each time. Going deeper would have been way too much for me. Since he was limited in how much to take, after the first two my muscle closed back up again. With the third one, I can actively reduce my flow if I try, but not stop it.

The other two sphincterotomies have been for going after my internal. The first one my muscle closed back up again. With this last surgery, I am somewhere between mostly open, and still retaining when I'm not moving or doing anything (such as sleeping like a rock, or sitting in a chair and working for hours on end). I do leak with each movement, cough or deep breath though. I'll still need a couple more weeks of healing to know for sure though.