Is It Really That Hard To Find A Surgen To Become Incontinent?

[Goerge]

People have said here that any doctor worth his salt would not purposely make somebody incontinent due to doctor's code of ethics, But is that true for accredited doctor's in second world countries who perhaps have trained at the world’s leading medical schools but in their own country have no obligation to follow any code, made especially tantalising with strong western currency and minimal surgical risk? I found this to be the case in some countries such as Egypt, Peru and the Philippines, they have documented case's were if you have the money they will do anything you ask.

What option's does one have surgically to achieving urinary incontinence?

external urethral sphincterotomy, Small cuts are made to both the internal and external sphincters resulting in the sphincter muscle becoming non functional and constant dribble incontinence when in the standing position, since you'll still have the same bladder capacity you'll likely flood your nappy depending on how long you were sitting. Example is sitting on the plane on the return journey after sanding up to change you'll be flooding all the way to the toilet cubicle, noticeable wet marks down back of trousers, nappy bag eg, uncontrollable dribbles when changing and walking back to seat until sitting make's the urethral sphincter kink again and urinary build up. Depending on how long the flight is you'll probably have to change 3/4 times and wear extra thick nappies as one flood would result in leaking nappies. Over time your bladder will shrink resulting in Intrinsic sphincter deficiency, total incontinence in any bodily position, you'll be wet constantly. Everywhere. This maximising the efficiency of your nappies. Risk factors of surgery are loss of erections due to localised nerve damage, blood loss and [scare tissue build up, sphincter may need cutting again??] The surgery is irreversible, total incontinence is for life.

[diapertime42]

People have said here that any doctor worth his salt would not purposely make somebody incontinent due to doctor's code of ethics, But is that true for accredited doctor's in second world countries who perhaps have trained at the world’s leading medical schools but in their own country have no obligation to follow any code, made especially tantalising with strong western currency and minimal surgical risk? I found this to be the case in some countries such as Egypt, Peru and the Philippines, they have documented case's were if you have the money they will do anything you ask.

What option's does one have surgically to achieving urinary incontinence?

external urethral sphincterotomy, Small cuts are made to both the internal and external sphincters resulting in the sphincter muscle becoming non functional and constant dribble incontinence when in the standing position, since you'll still have the same bladder capacity you'll likely flood your nappy depending on how long you were sitting. Example is sitting on the plane on the return journey after sanding up to change you'll be flooding all the way to the toilet cubicle, noticeable wet marks down back of trousers, nappy bag eg, uncontrollable dribbles when changing and walking back to seat until sitting make's the urethral sphincter kink again and urinary build up. Depending on how long the flight is you'll probably have to change 3/4 times and wear extra thick nappies as one flood would result in leaking nappies. Over time your bladder will shrink resulting in Intrinsic sphincter deficiency, total incontinence in any bodily position, you'll be wet constantly. Everywhere. This maximising the efficiency of your nappies. Risk factors of surgery are loss of erections due to localised nerve damage, blood loss and [scare tissue build up, sphincter may need cutting again??] The surgery is irreversible, total incontinence is for life.

Goerge....

Didn't you say once that you found a doctor in Thailand or Bangladesh who would do this?

I think it was a year or so ago. What ever became of that?

[babykeiff]

The specific procedure that Goerge was referring to has an high failure rate, which increases over time. Basically what this is saying is that the patient will suffer from 1/ failure to completely empty his/her bladder OR 2/inability to empty bladder due size reduction of his urethra. Both are causes for concern due to increased risk of bladder infections and associated complications.

Secondly, I personally doubt that any medical professional will willingly perform this procedure on a urinary healthy individual. I would think that a medical professional would not perform this procedure on appropriately selected patient(s) due to the above listed complications.

[Goerge]

Goerge....

Didn't you say once that you found a doctor in Thailand or Bangladesh who would do this?

I think it was a year or so ago. What ever became of that?

Thailand has a new law were all sex reassignment surgery participants have to have a psychological assessment before they do anything, I got around that but it was silly money when everything was added up taking into account that I would need a surplus if complications happened. I'm looking for better alterative's and possibly somebody to come with me who also want's incontinence as much as me.

[Goerge]

The specific procedure that Goerge was referring to has an high failure rate, which increases over time. Basically what this is saying is that the patient will suffer from 1/ failure to completely empty his/her bladder OR 2/inability to empty bladder due size reduction of his urethra. Both are causes for concern due to increased risk of bladder infections and associated complications.

Secondly, I personally doubt that any medical professional will willingly perform this procedure on a urinary healthy individual. I would think that a medical professional would not perform this procedure on appropriately selected patient(s) due to the above listed complications.

High failure rate in people with a urinary retention due to injury in the first place, there is no proof that happens on healthy sphincters.

[AZbearlover]

I'm looking for better alterative's and possibly somebody to come with me who also want's incontinence as much as me.

If it's been over a year since you looked into this, you would have been incontinent by now if you just wore diapers 24/7.

[Santiago]

The physician takes an oath upon matriculation from medical school to first do no harm. This is pretty much a universal statement, and has nothing to do with laws or any country they happen to be located. Whether they later honor that oath is an individual decision - but honoring that oath has nothing to do with geographic location.

[sunwutian]

If it's been over a year since you looked into this, you would have been incontinent by now if you just wore diapers 24/7.

Many people are unable to achieve incontinence despite wearing 24/7 for several years.

[babykeiff]

High failure rate in people with a urinary retention due to injury in the first place, there is no proof that happens on healthy sphincters.

Goerge,

you are correct that the specific study I quoted lists 37 male spinal cord injury patients. As already been stated, no doctor will perform this operation on a healthy individual. However, as stated 'Patients were selected for the operation based on urodynamic criteria and all had some detrusor activity or were able to void by Valsalva's maneuver.' (direct quote from study). This simply states that the selected patients were capable voiding, or telling their sphincters to open by forcing the closure of their bladder by holding their breath and pushing. Although not stated, it is presumed that the patients did not have enough control of their sphincters to allow them to open as normal. Also, the autonomic infantile form of voiding had not occured due to spinal cord injury. This meant that the sphincters were remained in the locked closed position until the brain / loop back from the spinal cord told it otherwise.

The operation, as you correctly described, is to cut both sphincters thus making them inoperative and open. The wanted result is that the bladder will fill, as normal, and will drain via gravity / when full and starts to expand. As the study proves, this does happen, but problems occur. Since the bladder is emptying as fast as it is filling, it never gets the chance to expand.

Resultant problems -

1 - The vessel that handles the back pressure is the bowmans capsule within the kidneys.

2 - Kidney fails to filter blood due to reverse pressure. Chemicals within blood increases.

3 - The weak flow of urine is not enough to keep the urethra clean and germ free.

4 - Bladder never completely empties - since no signal is sent to the bladder to constrict.*

*The normal process of urination is (simplified)

Kidneys filter blood and pas urine to bladder....

1 Bladder fills

2 At capacity, signal is sent to brain.

3 Brain tells external sphincter to close.

4 Bladder continues to fill, and slowly stretches. - Signal sent to brain of increasing urgency.

5 Brain tells internal sphincter to open - to reduce pressure.

6 Bladder continues to fill, and stretches to max. - Pain signal sent to brain.

Either A or B happens, depending on the response

A 7 Loop back sends signal to opens external sphincter AND sends signal to bladder to compress.

B 7 Brain sends signal to opens external sphincter AND sends signal to bladder to compress.

8 Bladder is fully compressed and signal sent to brain & signal to internal sphincter.

9 Internal sphincter closes.

In an newborn (prior to 6m) , #3 doesn't occur, and correspondingly, A is performed. As the child matures, #3 starts to occur, but training is required for the child to acknowledge #2. Since the infant does not close its external sphincter, the bladder never reaches capacity. However, when an infant is startled, the infantile response is to constrict all its muscles - that includes the bladder which will cause it to fully empty. This explains why an infant does not suffer from urine retention. A +6m child reaction occurs at #2, where the brain, due to training, tells the two sphincters to open and the bladder to constrict.

Goerge, what you require, to gain your urinary incontinence, is to forget the toilet training taught OR to remember the toileting actions as a +6m old.

As I have stated many times to you, and others, the only safe way to re-achieve the baby way of urinary voiding is via hypnosis. All other forms that I have seen have huge complications associated to them.

Unfortunately, since the reason for wanting toilet training is 90% self, and 10% the one who directed you, it is extremely difficult without knowing AND conquering the reason to reverse same.

[Goerge]

Resultant problems -

1 - The vessel that handles the back pressure is the bowmans capsule within the kidneys.

2 - Kidney fails to filter blood due to reverse pressure. Chemicals within blood increases.

3 - The weak flow of urine is not enough to keep the urethra clean and germ free.

4 - Bladder never completely empties - since no signal is sent to the bladder to constrict.*

But the whole point of Sphincterotomy in the first place is to open up a neurogenic bladder and totally stop renal reflux and preventing back pressure, making the urethra a low pressure outlet with continuous leakage, effectively type thee incontinence, your unable to store urine in the bladder.

[Creepymouse]

With the possible issue of giving you another bad idea, you'd probably have more luck looking up the procedure, getting the tools, and doing it yourself. You could probably get Botox (the drug, not the DD member) on the black market and do that as an alternative, but you're running a bigger risk of killing yourself (Botox is a potentially lethal neurotoxin)

[babykeiff]

But the whole point of Sphincterotomy in the first place is to open up a neurogenic bladder and totally stop renal reflux and preventing back pressure, making the urethra a low pressure outlet with continuous leakage, effectively type thee incontinence, your unable to store urine in the bladder.

Goerge,

you are stating what you would wish to happen. Clinical trials PROVE what does happen.

Even if the back pressure was not a problem, #3 (The weak flow of urine is not enough to keep the urethra clean and germ free.) and #4 (Bladder never completely empties - since no signal is sent to the bladder to constrict) is enough to create bladder and kidney infection. This warrants enough risk to refuse this procedure to all.