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Sphincterotomy


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Hello everyone ! I am new at this !!! the urologist is planning the possibility of having a urinary sphincterotomy of my internal sphincter, with two cuts, in order to solve the problem of obstruction of the urinary flow. SOMEONE HAS EXPERIENCE ABOUT THIS? I do not have incontinence, I would like to know what effects this intervention would have, whether it would bring incontinence or not. Thank you very much and greetings !!!!!

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I had my internal sphincter removed together with my prostate 3 and a half years ago. I was given physiotherapy to learn such things as automatically clenching when standing up from a chair or coughing. I needed to wear pads for 10 weeks, the maximum leak in a 24 hour period being 1 fl oz.  One needs to be extra careful passing wind. More recently, drips have been a concern, possibly 'cause I use catheters a lot. Now I am more comfortable using a thin pad when not using diapers or catheters.  Good luck!   

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There's an older thread here from an ex-member who had this done voluntarily. IIRC his wasn't very successful as it seems the surgeon was hesitant to do the procedure. He had to have it done more than once because it wasn't effective enough. If you're seeking this without a medical reason compelling it, you'll find it tough to get someone to do it. That is not something to be taken lightly as it's effects are forever and irreversible.

Bettypooh

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Hello !! thanks for write ! The urologist has already told me that I have to do it, all the pharmacological alternatives have already failed in me and the only thing left to prove is the sphincterotomy. Anyway, he's going to do it to me. That's why I'm asking the effects!

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  • 2 weeks later...
On 6/16/2018 at 11:33 PM, Teodoro said:

Hello everyone ! I am new at this !!! the urologist is planning the possibility of having a urinary sphincterotomy of my internal sphincter, with two cuts, in order to solve the problem of obstruction of the urinary flow. SOMEONE HAS EXPERIENCE ABOUT THIS? I do not have incontinence, I would like to know what effects this intervention would have, whether it would bring incontinence or not. Thank you very much and greetings !!!!!

 

37 minutes ago, MarkSmith said:

The Urologist performing the procedure cannot provide you with these answers?

Sorry I didn't find this sooner. Don't do anything too soon! My sphincter does not respond to messages sent by the bladder. In fact it is almost always clenched. Not until it relaxes because it's tired from clenching, it relaxes and pee comes out. Only when it relaxes can a catheter be inserted. It will not stay without the help of a balloon. It can be painful when the bladder is full and the sphincter won't let it out.

The urologist wanted to replace my sphincter with a fake one. I had two options. The first option, a push button. To let the pee flow, I'd have to push a button. The second option a snap lid. To pee, I'd have to open the lid and insert a catheter directly into the bladder. For the most part, I was leaking a fair amount and because of that I took the third option: Do nothing. That was 20+ years ago. It recently became an issue again, but again chose to do nothing. Doctor gave me Valium to help with pain and to relax the muscle. It has worked well.

The urologist thinks that not messing with it is the best course. I don't know the details of your obstruction, but in any case, don't get too hasty. If it puts you in diapers permanently, it OK. You'll get used to it. It's not all that bad, in fact, you may begin to like it (like me).

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@Teodoro

I have no experience but this should be addressed to your Doctors, for they should have the best answers. Surgery of all kinds is usually the very last form of medical treatment because there is potential for harm- even death- with it which isn't as likely with other methods. It is sometimes necessary, then it is done risks and all. 

From what others have said the two cuts will probably leave you with no bladder control. It is far more effective than a single cut. Catheters and stents are the usual treatment for your problem. It is when they don't work well that surgery is considered. If your Doctors say surgery is necessary then believe them and do it whatever the effects may be. They should know best. Living with no bladder control does not have to have an adverse effect on your life and your activities. It just takes more planning each day to allow for it. It is far better than having many other health problems that do have a bad impact on your life.

Bettypooh

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For those wishing to loose control over the bladder I guess a procedure like this is what they most wish for, I could just guess how it would feel just before getting put to sleap and knowing that one of the big wishes in life will be true in an hour or so when waking up again. Or is it even made with the patient awake and just partly sedated?

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I had an internal sphincterotomy. It only results in incontinence in very few people, less than 1%. Mostly it helps you pee easier. You have to wear a catheter for awhile after the procedure, and it hurts for a few weeks. You will pee clots of blood for a few days. Highly unlikely to make you incontinent because your external sphincter is still in tact. 

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2 hours ago, XyXy said:

Tuve una esfinterotomía interna. Solo produce incontinencia en muy pocas personas, menos del 1%. En general, te ayuda a orinar más fácil. Debe usar un catéter por un tiempo después del procedimiento, y duele por algunas semanas. Usted hará pis de coágulos de sangre durante unos días. Es muy poco probable que lo haga incontinente porque su esfínter externo aún está intacto. 

 

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  • 2 months later...

Using Google Translate to translate Teodoro:  " I had an internal sphincterotomy. It only produces incontinence in very few people, less than 1%. In general, it helps you urinate easier. You should use a catheter for a while after the procedure, and it hurts for a few weeks. You will pee for blood clots for a few days. It is very unlikely to make him incontinent because his external sphincter is still intact."

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I am not sure what that surgery entails. Can you give more detail? At the risk of being redundant, I have a spastic sphincter muscle that ignore electrical signals sent through the nerves and therefore have limited to no control. My options were to surgically replace it or ignore it. Replacements are mechanical; that is a surgically implanted "port" where a catheter is inserted into the bladder though a lid. the other is an a push button used to open/close a valve. I chose to ignore it. I use a diaper for the leaks and floods. Like anything, it's coming to terms with it and getting used to it. After 20+ years, it is no longer a big deal. I am open about it. I let others know if it might be an issue. I don't go out of my way or try to hide it, nor do I try to draw attention to it. It is what it is. I have not had one case where people were not cooperative. It's not the end of the world. You'll be OK! :rolleyes:

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  • 2 weeks later...

but the external sphincter is voluntary and can not be pressed for a long time, which makes it open at some point, as I understand the internal sphincter (neck of the bladder) is one of the pillars, if that opens or it does not close well, is that it would press for the escape to the external sphincter, not?

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Yes, the internal sphincter is first in line and automatic- you cannot normally control it. The external sphincter is after that and through the learned habit of potty training closes just before the internal sphincter relaxes.That is when you feel the need to go to the toilet.

If either one does not work correctly you will have leakage. You can train yourself to keep your external sphincter relaxed and open easily, but it is the internal sphincter which does most of the holding, so that is the one which needs to be dealt with to become incontinent. You can train yourself to do this too, but it takes years and not everyone can achieve that.

Bettypooh

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Yes, as long as you don't make an effort to hold anything in. Those cuts will need to be rather deep or there will be a chance that remaining muscle will still cause some retention. The ex-member who had this done had to have additional surgeries because his timid surgeon didn't cut deeply enough.

Bettypooh

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