I told my doctor about incontinent desires, diapers, and I asked her for help to get surgery.

[BaronBrook]

It's the name for using any chemical to temporarily disable a sphincter. Botox is one option.

Everyone has a voluntary sphincter and an involuntary sphincter controlling their bladder. My thinking is that you'd need to mess with both?

Trouble is, this can cause urine retention for a few weeks before you get the payoff. 

All I can say from experience is that the muscle relaxer route just makes it very easy to go which helps with building habits. 

[Diaperman95]

On 3/4/2021 at 5:27 PM, Ferix said:

Whelp, I had a surprise phone call from my urologist today. He said he had some free time so we went ahead and did the appointment today.

 

I told him everything: I told him about my incontinent desires, life long diaper wearing, my incontinence training, my business selling cloth diapers, and that there are others like me who have gotten help from their urologists. I told him I believe that what I have is a form of BIID and that I experience dysphoria similar to transgender dysphoria.

 

He was an attentive listener and really wanted to understand what I was going through. He said he's been a urologist for 17 years and that he's never had a case like mine. He was also reassuring and said that he wanted to help!

 

He said that he wanted to make sure we go through the proper channels and have a consensus of multiple doctors before we consider surgery as the proper treatment. He said that the type of surgery I was wanting was not something he had done since med-school and said that he was willing to refer me to a university where they have experience in sphincterotomies.

One of my concerns was if going to the university would be covered by insurance. He said that with his referral, it would deem it medically necessary and that the insurance would pay.

 

Before we do that though, he wants to collect all the "low hanging fruit". He first wanted to know if I had any pre-existing urinary problems; He asked if I had any problems that might cause issues, like spinal bifida or sciatica, which I said no. He says he wants to run a couple tests: an x-ray to look at my spine and to do a procedure to look inside the lower urinary tract to see if there's any deformity or scarring. 

 

He seemed pretty eager to help as he was fascinated about incontinence desires. He said he was going to look up what he can about it after our phone call and do his own research.

 

I did mention to him that I'm open to other options other than surgery, but I really am there for permanent incontinence and hope that we can work together to achieve that goal, surgery or not.

 

The next step is to get my x-ray and I'll have an in person visit with the urologist April 1st to see inside the bladder and to discuss more about the path I need to take to become incontinent.

 

So, I mean, awesome! Looks like the gears are getting into place for this to really happen!

 

 

If I could swap continence with you I would! I can only imagine how being incontinent, when you don't want to be, can be the worst. 

I actually want bowel IC too. I have been living as though I am incontinent for the last 4 years. In that time I have never used the toilet, except a couple times when the urge to poo happened in the shower; I just hopped out and took couple steps to the toilet.

 

In my experience, I have found that managing bowel IC is doable. If I anticipate that I will need to mess before I go out for the day, I may take a suppository to encourage a bowel movement before I leave so I wont have one later. That. so far has always worked for me.

Man I am truly happy for you. If that's what you want. Still think the bowel is something I would never do! But if you thought it all through its your body and if he is willing you best jump while you can. I am amazed you found someone. I lot of people are going to want his digits. I wish mine was more of a constant dribble like you will most likely end up with. Just way less chance for leaks and gives the diaper time to soak up.  But keep in mind if you truly have your rectum clipped to or how every they would do that to take your bowel control you wont have a choice of when you go poop. I dont have a clue when it's going to hit.  I have considering doing enemas every morning to try and train mine to only go when I want but with all the loose stool I do t think it would even help. I doubt very many doctors would be that cool about it. I dont see how in the world they will get your insurance to pay unless they lie about the reasons. I mean if it's not medically necessary than most insurance calls those surgeries elective and very few pay.  Like getting a boob job. I hope i am wrong. I imagine it would be a out patient so it would not be as bad as staying in the hospital  to recover but as someone who has had many surgeries I bet anesthesia alone will be ten grand. I bet it will be between 30 to 40k. I really hope they pay. I had a hard time getting my hip surgery approved and I had necrosis in both hips. Not trying to bring your mood down. Please keep me up to date I want to hear more. Best of luck I am truly happy. And if we could trade I would in a min.  

[Ferix]

12 hours ago, Diaperman95 said:

Man I am truly happy for you. If that's what you want. Still think the bowel is something I would never do! But if you thought it all through its your body and if he is willing you best jump while you can. I am amazed you found someone. I lot of people are going to want his digits. I wish mine was more of a constant dribble like you will most likely end up with. Just way less chance for leaks and gives the diaper time to soak up.  But keep in mind if you truly have your rectum clipped to or how every they would do that to take your bowel control you wont have a choice of when you go poop. I dont have a clue when it's going to hit.  I have considering doing enemas every morning to try and train mine to only go when I want but with all the loose stool I do t think it would even help. I doubt very many doctors would be that cool about it. I dont see how in the world they will get your insurance to pay unless they lie about the reasons. I mean if it's not medically necessary than most insurance calls those surgeries elective and very few pay.  Like getting a boob job. I hope i am wrong. I imagine it would be a out patient so it would not be as bad as staying in the hospital  to recover but as someone who has had many surgeries I bet anesthesia alone will be ten grand. I bet it will be between 30 to 40k. I really hope they pay. I had a hard time getting my hip surgery approved and I had necrosis in both hips. Not trying to bring your mood down. Please keep me up to date I want to hear more. Best of luck I am truly happy. And if we could trade I would in a min.  

Thanks for being happy for me. If that's how you feel.

 

I think there's a misunderstanding: I never said I was seeking surgery to become bowel incontinent nor have I discussed that aspect of wanting to be dual incontinent with my doctor. I'd be okay with being bowel incontinent and I'm fine with that happening on its own. Because I'm not seeking to get bowel incontinence surgery, there's no point in speculating about it. Most of what you said is moot and comes off a bit like a positive statement, then doom and gloom, then positive statement, sandwich. Thankfully, what you say is not relevant nor my reality; it would probably cost me 40k in psychiatry fees if I lived in constant fear.

 

I'm going to take this journey one step at a time. I'll share with everyone what happens. The way I see it, these desires are so strong it's worth asking a complete stranger and putting everything out in the open to see if they will help; the worst they can say is no.

 

 

[toddwr250r]

Ferix, I send my good will and support, and I'm looking forward to further updates

[Diaperman95]

I assure you I didnt mean anything in a bad way. I new it was just the bladder you talked to the urologist on. Its when you mentioned that you had been livning as if you was incontinent both ways for the last 4 years. I think so what you said. I might kind of assumed you might seak that after the bladder. I am sorry I assumed.

But I am 100% happy for you. I mean you are going to wear a diaper either way and you thought it through. So no reason not too if it makes you happy. And I truly do believe that if they make it so you cant hold no real volume at all it will be way easier than flooding a diaper. Sometimes I  flood other times it is smaller way more often. Kinda depend on my interstitial cystitis and how bad it's flared to what it's like. But when you flood is when you can really over whelm a already wet diaper as I am sure y ou know. So I would think that would make the hole experience a little easier.  The worst part about mine is to can be down right painful in the bladder if the spasm are hard enough.  I meant no disrespect saying that I thought it would be rather expensive if your insurance had not paid. I know a lot of people have never had surgery and would have no clue what something cost. And I really have no clue exactly what it would cost either I just know what some of my most recent ones cost. It is outrageous what they charge to put a person under. I just was trying to make sure you was aware that if they refused it would be a lot. I have no doubt that if it came to it you would be able to save it and have it done. I mean people save up for all kinds of electives from face lifts to sex changes. I have no doubt you are going to make it happen. When you told me how you told your doctor the way you felt word for word. Man you convinced me. If I was a doctor I would of done it for you in a minute  and I know exactly what it feels like to be incontinent. The doctor may and may know personally but most likely not. He just knows that most hos patients are annoyed to down right depressed about it. So you kind of surprised me when you said that he was wanting to help you but in a way I was like.  Well shit his story convinced me. So it really in a way did not surprise me. I mean from the oath a doctor takes to do no harm and all. But then if they can still do sex changes and stuff to people without loosing their licences then this should be nothing. It hurts no one but you and to you it's a blessing. So  for real no strings honest to God I am happy for you man.  And I really do want to follow your story. I am very curious to see what happens next and how they achieve it. I assume they cut your sphincter and you just leak as you produce and would hold very little but I guess we will see one day hopefully soon.  I am okay with diapers for life it doesnt brother me much most the time. Except the occasional load of shit I drop in my diaper every now and again.  But with today's diapers urine isnt no big thing. It sucked to live though in the 90s. When vintage depends was the best. Well I guess truth be known attends was the best. But hard to find.   Anyway I way  I am heading off topic so best of luck to you and again I am happy for you.

[BaronBrook]

@Ferix, which spinchter(s) do you think need to be addressed with surgery? Both? The voluntary one? The involuntary one?

It would suck to get a surgery only to find out another is needed.

[Ferix]

13 hours ago, BaronBrook said:

@Ferix, which spinchter(s) do you think need to be addressed with surgery? Both? The voluntary one? The involuntary one?

It would suck to get a surgery only to find out another is needed.

I'm going to talk to my urologist about this to really get their input because I would prefer to get this done in one surgery.

 

I know an external sphincterotomy would completely remove any control I have over my bladder: the external sphincter is in charge of voluntary control. However, it would still allow for situations that I would retain urine without control since it leaves the internal urinary sphincter in tact. The internal urinary sphincter is controlled involuntarily and can retain urine during sleep or while having an erection.

 

I really don't want to retain any urine at any point, especially while asleep since I wake up every night once or twice a night because of the urge to urinate. I wouldn't mind being incontinent while having an erection, my husband wouldn't mind at all either (he'd probably enjoy it). I'll try to express that I want total urinary incontinence and see what my urologist thinks. I'll explain that I know just getting surgery on the external sphincter leaves a chance that I may have situations where I am still retaining urine. I'll make sure he knows that not only am I okay with having complete loss of control, it's exactly what I want, even if it means cutting both sphincters.

 

Could they do this surgery and only need to cut one sphincter? Do they need to cut both sphincters to get the type of incontinence I want? Are they only willing to cut one and not the other? I can't say what's going to happen until I talk with my urologist about what I want. I'll see what he says: I'm open to any information and insight he may have that I don't. When I suggest surgery options to my urologist, I first want to make sure that I've communicated my goals and make sure he understands my vision of total urinary incontinence. When I'm confident he understands I want no control at any time, we'll talk about options on which sphincter to cut.

 

This may take months before I can even talk to him about the surgery in detail. He still wants to make sure there's a full care team on board with the surgery before the surgery is considered. I can't really say when the conversation will happen but when it does, I'll be certain to share it here.

[DAQ]

On 3/4/2021 at 4:27 PM, Ferix said:

If I could swap continence with you I would! I can only imagine how being incontinent, when you don't want to be, can be the worst. 

I actually want bowel IC too. I have been living as though I am incontinent for the last 4 years. In that time I have never used the toilet, except a couple times when the urge to poo happened in the shower; I just hopped out and took couple steps to the toilet.

I haven't read the rest of this thread yet but, I suspect you living like you are IC for the last 4 years is a huge benefit. I would bring that up to your Psychiatrist and any doctor that gives you a hard time.

I have been working from home for the last 12 months (almost to the day) and have worn 24/7 for all but maybe 25 days in that time. I actively sought incontinence for at least 9 or 10 months. I have noticed almost decrease in continence what so ever. There are times that I still can't pee at all. It is so frustrating. I can't imagine doing this for 4 years+ and still struggling with this.

Best of luck getting it done and getting what you desire, looking forward to hearing more of your journey as it progresses.

[Ferix]

I spoke with the psychiatrist today!

 

The visit was by video call. It went well and was fairly unremarkable. I told the psychiatrist everything I've told my urologist and doctor about my incontinent desires and using diapers as though I were incontinent. I told her I was there because I want surgery to become incontinent and that part of my plan is to get the endorsement for that surgery from a psychiatrist.

 

She had a lot of questions about my current mental health, living situation, social interactions, and asked if I had any previous trauma or abuse. She indicated that a lot of the information was standard questions but she was also asking questions establishing a basis for an endorsement; she states that for transgender operations, the goal for a psychiatrist endorsement is to make sure the desire is not driven by psychosis or some other severe mental heath issue. So far I have not indicated any problems.

 

She was also interested about what the plan was that I made with the urologist and what kind of surgery I wanted. I used this as an opportunity to go over what I've been planning on telling the urologist: I want to get a sphincterotomy of both of my urinary sphincters, as much as can be reasonably removed. This is a procedure used for patient's with a neurogenic bladder: Their bladders do not empty causing urine to backup into the kidneys which can cause serious infections. A treatment for this is to remove the sphincters and make them incontinent. That is the surgery I want. I know from my research and from talking with others who have gotten the surgery, that there's a chance the surgery may heal back to normal. I want to make sure that I don't get control back and, as much as possible, have both of my urinary sphincters removed.

 

We changed subjects and she asked if I ever was treated for mental health issues before or if I've spoken to a therapist. I told her no. She stated the next thing she wants me to do is speak to a therapist about what's going on since I've never spoken to one before and getting their endorsement would add to my case for getting the surgery, which may take a while anyways.

 

And that was that... she asked if I had any other questions and I did not. I said that I just want to make sure I come across as serious about this and it's definitely something I want to do, if I could have started this process a long time ago I would have. She seemed to understand and I thanked her for her time.

 

Now I have to wait for a phone call from the therapist's office to set up an appointment. In the mean time, I have my next appointment this Thursday with the urologist.

[Ferix]

I had my second visit with my urologist today! Overall, it went very well. He again made it clear he wanted to help. He checked out my urinary tract and talked about a referral to a specialist.

 

We started off with checking out the inside of my lower urinary tract and bladder with a camera. The camera was like a catheter with a camera on the tip. He showed me my functioning sphincter and even had me squeeze it so we could see it work on the camera. We looked into the bladder and everything inside looked normal. It wasn't terribly uncomfortable and almost felt like nothing compared to the stent play I have experience with. That took a total of 5 minutes.

 

After that was over. he spoke a lot about how doing a sphincterotomy should be done by someone with experience doing them. He said the last one he did was 22 years ago and that whenever he has to do surgery near the sphincter, he avoids the sphincter as it would bleed a lot if cut, so it's been something he's actively avoided working on. He said he has a couple urologists in mind that do sphincterotomies a few times a year, one at the VA and one at a nearby University.

 

He says if I talk to the referred urologist, he doesn't know if they are willing to help. He says he can't recommend surgery, it would be something they would need to decide. He does state he will take good notes and support treatment for me that so that the other urologist would see it in my chart. He said if I got the surgery, it would likely take 30 minutes and I would be able to leave right after. I would have to wear a catheter for a week while it heals.

 

He's not sure if the insurance will cover the surgery. He said he looked up the cost and it could be up to $10k if insurance doesn't cover it. $10k does sound like a lot but it's a roadblock I would be willing to work around; I'll try to do everything I can to not pay that much and hope that insurance covers a good portion of it. I'm really not going to worry about it until I have an actual number for an actual surgery.

 

He says that at this point, the only things holding me back from the surgery is a willing urologist to do the surgery and the endorsement from a psychiatrist, which I'm already working on. He says the endorsement from the psychiatrist would take the longest and compared to transgender surgery patients, they have to wait at least a couple years, so it might take me some time as well.

 

He says the referral to the urologist will take about a week to be approved, at which point I can schedule the appointment.

 

My big worry now is having to convince the new urologist. I will definitely have to make my best pitch and paint the best story I possibly can about myself, incontinence desires, and that the best treatment for me is surgery. I feel like I can make a strong case and it's even stronger now with the support of my primary care doctor, urologist, and that I'm working towards getting the endorsement from my psychiatrist.

 

So far everything has goon super smoothly but it seems like there's potential for a critical roadblock if the new urologist isn't on board with the surgery. It sounds like I have the possibility of asking two if need be but I hope to convince the first urologist on the first try. I'll of course keep you all updated.

[Incontinenceluv]

I just read through this entire thread up to your last update. I must say that I am very happy for you and I can relate to your situation. Above all else I am very happy that you were able to find some healthcare professionals willing to work with you. The only hiccup I have can see for you in the near future is convincing a more experience urologist to perform the surgery and getting the insurance to cover it. Its nice to know that it is such a quick procedure. 

I have the overwhelming desire and urge to become incontinent as well. Up until now I have had to repress any action on my part to achieve this goal as I still live at home. I have been able to go 24/7 for brief periods but my parents have no idea and it is just plain and simply too hard to conceal it from them. I am also fairly young, so at this point, I do not want to do any irreversible damage to my body, for now I am just looking to simulate the feeling of incontinence temporarily and I plan to do that by taking the risky dive into catheters once I move away from home in the next year.  

Everything else aside, once again I cant explain how glad I am for you and to know that doctors are willing to do this. As someone said above, maybe just as transgender surgeries have become common place, maybe in the future it wont be such a struggle to have a sphincterotomy done. I am very interested to hear your updates and I wish you the absolute best of luck!

[musicaddict]

I will say, regarding the psych clear, I got cleared for hormones within a few months and top surgery within a year. That being said, I was already on the butch side prior, working with a queer friendly therapist, and going for her for a different issue. But my point here is - trans surgery which is becoming more commonly accepted doesn’t necessarily take years anymore. I imagine if you find a good/open minded psych it may be less of a process than you think, though it’s probably best to brace yourself anyway.

I would reckon the urologist may be the difficult part.

[Ferix]

Well unfortunately I hit a critical road block with my psychiatrist.

 

She had messaged me this week about referring me to therapy, stating, going that option would not get me surgery but would help treat my dysphoria. I responded, saying I am open to trying other options but I also want to continue to pursue a surgical option.

 

She responded by saying I should not pursue surgery and "in down the road I might have regrets"

 

In a longer message, I responded reiterating that I had been wearing and using diapers as though I was incontinent for the past 4 years and that basically my whole life is accepting of that lifestyle; I explained in more than a couple angles that I'm prepared for the lifestyle. I reiterated that I have a urologist willing to help and that there may be other options that I might need an endorsement for, such as getting botox injections if surgery does not pan out.

 

I closed stating, " I have the support of my primary care doctor and my urologist. I hope I can gain yours."

 

She responded by saying neither she nor the therapist will endorse surgery. She said, "for me medical treatment comes under the heading: 'First do no harm'. I know you are certain that you want to be permanently incontinent. But forever might be a long time, and you just might change your mind after a few years or decades."

 

I responded, saying that I had hoped for the opportunity to get a similar workup for those seeking transgender surgery and I'm willing to not get the surgery on merit. I am willing to seek the help from another psychiatrist if need be because I know it's possible. If you really can't see a situation where you would endorse some form of incontinence for me, even through a test of time and sanity with standards similar to that of transgender surgery, that I can't really see working with you.

 

She simply responded, "I understand, but I still hope you reconsider"

 

After I got that message, I scheduled an appointment with my primary care doctor this Thursday. I'll talk to her about a second referral and maybe talk about a strategy to try and convince a hesitant psychiatrist. I will also ask her to find a psychiatrist that specializes with transgender patients.

 

I'm definitely more than disappointed with how that turned out. I think it was important to establish early on if she was willing to make an endorsement or not, when that clearly wasn't an option there's really no point in continuing to work with her and try to convince her otherwise. What was notable was that it felt as though she was hiding the fact that she would not endorse surgery from me. She didn't clearly state she would not endorse surgery on our video appointment and it took me a few messages for her to directly say that she, or the therapist, would not endorse surgery.

 

The journey is not over. I do not give up that easily. I don't regret trying as much as I have. Even though this is a significant setback, I can only keep trying until all options are expended.

[oznl]

This was always going to be a saga.  Although frustrating for you, I think I can see her line of thought here.

Whilst self-harm (through DIY efforts) is on the table, surgery is an avoidable harm.

As a non-IC patient requesting to be IC, logically it would not be possible for that patient to give truly “informed consent” to an intervention that would render them incontinent since they lack full insight into the condition.  Emulated IC may not cut the mustard here.  Who is to say that instead of relief, some deep emotional fuse wouldn’t blow if we were rendered truly IC.

What if alternatively, the patient was loaded up with anti-depressants (or whatever) and this fixation then vanished?  She would be thinking this too.  (I realise that this is unlikely but this is one of those bizarre scenarios where we may have far more insight into this condition than the practitioner we are consulting).  In this scenario too, surgery would have been a very poor choice.

Putting myself in the shoes of your psych here, what you WANT is the symptom of a disorder and not something that should be directly satiated by her.  I suspect that she will want to have a crack at less interventional treatment of the underlying dysphoria.

If this really is a similar psychological scenario to transgenderism (and I can see some similarities), of course she will be wasting her time (and yours) in attempting to "fix" it.  At this point in history, whether it’s the same or similar thing however seems to be still a big unknown.

Ipso facto: you’re going to be dragged through a "repair cyclet” mill.  If and when such “repairs” fail (as we both suspect they would), more extreme interventions may be countenanced.

Balanced against that however are the concepts of patient autonomy (YOU are the boss of YOU) and that “treatment” is not about “enforcing societal norms”.

It’s interesting to run a thought experiment by pushing a lot of cosmetic surgery through the same analytical mill though…  Funny old world.

[Ferix]

So, I spent a lot of time thinking about what the psychiatrist said; she actually didn't say much. She said: she works under the heading, "First, do no harm"; and she said I may regret my decision down the road. I don't have any other insight into what she was thinking except what she has told me: She's worried that surgery will harm me because it may be something I regret later. It would be a failure in her duty to allow me to get surgery if in the long run it harms me. If I want to gain the help of a psychiatrist, I have to speak to those concerns.

 

How do I talk to a psychiatrist? I do have knowledge and experience about how to work with a doctor and a psychiatrist. I worked as an EMT for 14 years in Seattle. Many of those years were running 911 calls and talking to doctors and other health care professionals on a daily basis as part of my regular job. On top of that, I spent 5 of those years as a medical contractor working in the King County ITA Court working with psychiatrists and mental health professionals. My job at court was caring for some of the most psychotic patients in the county while they were at court for their hearing. (I also had 2 years working on the "baby" ambulance. It had giant pictures of babies in diapers on the sides. I worked on that ambulance with the NICU transporting critically ill babies) I made a lot of working friendships with doctors and psychiatrists over the years and I know when it comes to business, it's best to be direct and honest. 

 

My prime directive for this journey is to be direct and honest about everything.

 

I believe in my argument: I believe that I have a form of BIID which causes incontinence dysphoria. I think my incontinence dysphoria has a lot of similarities to gender dysphoria, so I've been doing research about why transgender surgery is possible. The American Medical Association considers gender transition surgery a medical necessity. Those who get the surgery benefit from decreased gender dysphoria, improved mental health, enhanced self-image and self-esteem, greater comfort with one's body, increased ability to blend into society as a woman, and an enhanced quality of life. Replace gender with incontinence and all of those points could be made for explaining the benefit of having incontinence surgery for treatment of BIID with incontinence dysphoria. This will be an argument that I will need to develop with the goal of addressing a psychiatrist's concern that surgery is not a harm but is a benefit when weighed against the despair that comes with incontinence dysphoria.

 

Onto the next topic: I had my appointment with my doctor today. I told her I need a new psychiatrist.

 

We went over what happened between me and the psychiatrist. I let her know that the psychiatrist will not give the endorsement for incontinence regardless of the circumstance. I told her that the psychiatrist said she believes in her duty to "first, do no harm" and that later down the road, I may regret my decision. I told her I may not have been able to advocate for myself as clearly as I could have and she makes valid points. What I need to do is speak to those points. My doctor agreed.

 

My doctor said that the psychiatrist was probably scared about authorizing surgery: How can she be sure surgery is the proper treatment when it's not something studied. But she also added, "why should it be up to her to deny the surgery?" She said transgender surgery was not something accepted early on so it was harder for patients to find doctors willing to help. She thinks I may have the same problem.

 

My doctor was more than willing to setup another referral to a new psychiatrist. I told her I think there may be a generational gap as well as a cultural gap at play with the first psychiatrist. My first psychiatrist was an older German woman, probably around 50. I told my doctor about my ex's psychiatrist being a trans woman and that I wonder if finding a psychiatrist like that, or at least more culturally and generationally compatible with me, could better help with my wanted outcome. She stated she doesn't have the ability to select psychiatrists like that within the network. She stated that if I found a psychiatrist out of network by name, she could then refer me to that specific psychiatrist. So for now, I'll wait for the referral to go through and then talk with a new psychaitrist. I'll start looking for psychiatrists out of network when I exhaust all my options in network.

 

After my appointment with my doctor I got a message from my psychiatrist! I used it as an opportunity to speak to her concerns about duty to do no harm and later regret.

 

What did I say? How did she respond? I hate to leave things on a cliff hanger but I'm tired, I need a nap, and I'll tell you later.

[oznl]

33 minutes ago, Ferix said:

What did I say? How did she respond? I hate to leave things on a cliff hanger but I'm tired, I need a nap, and I'll tell you late

Yep, that's a cliff-hanger for sure ?

[Diapered Dave]

There's a few guys over on FetLife who say they've achieved incontinence by using ever-increasing sizes of foley catheters, starting with a fr14 or fr16, and leaving them in a week or two, (Or longer..) then going up to the next size. Eventually, after wearing a fr28 or fr30 for a long period, (Several months..) they said that the sphincters seem to be permanently enlarged and won't completely close, resulting in constant dribbling. 

I would think that the doctor who seems eager to help you, would perhaps prescribe catheters and antibiotics for you, to see if this route would work.

At the very least, you could start with this method, while continuing to pursue the surgery method. 

[BrownBobby]

I understand the "do no harm" idea here, and I also understand how applying it would lead to this decision.  I make no guarantees about how it goes, but I can offer the line of logic that's worked for most people I've talked to who are open to a more unusual idea like this.

 

I explained I was here because I was trying to avoid harm.  I've felt a similar urge for literally as long as I can remember, and attempts to "work through it" or "try to deny it" have led to me being more miserable and frustrated, even to the point of major depression and suicidal ideation.  This isn't something that's going to go away, and acting as though it'll somehow not be part of my life when it has for as long as I can recall doesn't help.

 

Given that, I explained I've tried other methods to try to get to a similar result, and several of the safe methods didn't work for achieving that result.  That led the more risky, but still probably safe if I exercise caution ideas.  I tried those, and also wasn't successful.  That only left one bucket left...the dangerous ideas.  I tried for years to avoid going that route, but eventually, when the depression was at a peak, I ended up in the ER during one such attempt.  Thankfully, it was temporary and didn't cause any serious harm...but at the same time, I'm trying everything I can to avoid being in that situation again.  If there's a safe way to obtain this, even if it takes humiliating and uncomfortable conversations with people to get, I'd rather pursue that than wait for another truly unsafe method to become appealing again.

 

For both of my psychologists, they agreed that we needed to explore the decision and its effects to make sure that I was of sound enough mind to request this, that I knew how permanent the procedure was, and that this was truly an unquenchable, nearly-built-in desire instead of something linked to trauma that wouldn't be resolved by the surgery.  I admired their thoroughness and open-mindedness.  One used a cognitive-behavioral framework to analyze the thoughts and behaviors I was experiencing; the other used a BIID framework to explore how my self-image of myself differed from my continent self.  Regardless of "do no harm," both saw that it was actually reducing harm to help, and I'm still very, very thankful.

 

I hope that another psychologist is willing to listen to what you have to say, and realize the context for what you're asking.  Hang in there--there are people who'll help.

[Bonsai]

It requires some bravery to be the first psychiatric to endorse this sort of surgery. Should this become a case, the whole medical team that helped you would be in a dire position when shit starts hitting the fan.

[musicaddict]

Given the similar attitude of "you may regret it" or being told you're doing harm to yourself experienced in transitioning gender - have you checked any lists online for doctors in your area that are either kink friendly or have a history of working with the lgbt population? Either might be more open minded to non-traditional approached than you'd get with a random psych.

[oznl]

I wonder if some kind of internal, urethral stent could provide such therapy whilst at the same time, being reversible (thus removing one of the primary objections).  I recall an extended family member who was suddenly catapulted into total urinary incontinence when her ureteral stent became dislodged after a kidney stone procedure.  She had no other symptoms and her incontinence was resolved instantly when the misplaced stent was simply removed, an outcome for which she, of course being one of the 99.99% of the population, was very pleased about.

I suppose there could be complications from long-term stent use.

[BaronBrook]

On 4/9/2021 at 5:04 AM, Ferix said:

It would be a failure in her duty to allow me to get surgery if in the long run it harms me. If I want to gain the help of a psychiatrist, I have to speak to those concerns.

Well, like Bobby said, the big deal is to convince them that you'll be in more harm without treatment. 

If you bring up homemade stents, or the amount of distress you're experiencing it should help avoid "do no harm" fears.

@oznl, stents could be a temporary option, but they're one that's known for side effects. They often break, encrust, or migrate and then need follow-up procedures.

@BrownBobby, how's your own progress going after your surgery?

[rick50]

Perhaps it would be worth asking for a medical urethral stent to be inserted as a first step. There is medical precedent for this procedure so the urologist may be happier to go down this route of treatment. The Memokath urethral stent was used successfully in Japan to make elderly patients incontinent who relied on catheters due to enlarged prostate so their bladder drained into a diaper. This avoided UTI's from the catheter and the general problems of catheterisation. They used the longer Memokath (7 or 8 cm) to pass through both inner and outer sphincters. The Memokath is also removable. I wonder if the medics might look at this more favourable as it has been done before and is not permanent as is surgery so it would overcome their concerns about you changing your mind?

[Ferix]

What a crazy week last week. It was pretty emotionally heavy calling it quits with the first psychiatrist and getting a referral for a second one. It just motivates me more than ever.

 

I left off last week mentioning that my psychiatrist messaged me. This was actually my first psychiatrist asking if I still wanted to do therapy, even though I was not interested in talking with her. I informed her that I had already requested a referral for a second opinion on a psychiatrist. I also thought, maybe there's a chance I can get some insight from her and try one last time to speak to her concerns.

 

To quickly recap: I already told my psychiatrist during my video appointment that my desires were sever, increasing, and has driven me to do things such as living as though I was incontinent for 4 years and using catheters and stents to simulate incontinence. I told her I knew that surgery was permanent and that's what I want. She said she would not endorse surgery, regardless of the circumstance. 

 

In my response, I asked her to reconsider. I told her that I was coming for professional help because I was afraid that my desires were going to drive me to do increasingly dangerous things with stents, risking bodily harm, until I made myself incontinent or failed trying. I explained that as a testament to my need to rid myself of these desires, the stents I use are home made. I explained how I researched anatomy and developed my own methods through trail and error and uti after uti (not an exaggeration) until I finally made one that works. I am hoping I can get a "hail marry" from a professional before I try harder than I have before to make myself incontinent.

 

I also said that I am open to therapy and less radical options but I understand that these desires are a part of me, not caused by a life event. I imagine that no amount of therapy can remove the desires, the same desires that drive me to use home made stents, until I'm incontinent. I reiterated that I'd be willing to work with her and any other doctor on a progression of treatments to make sure we exhaust all options.

 

Lastly, once I get surgery it will be an immediate quality of life improvement. The desires will be over, I will no longer have to worry about putting myself at risk with stents, and I can return all of that focus I spend on developing stents and figuring out how to make myself incontinent to living the rest of my life. Being incontinent for the rest of my life may seem like a very long time but the benefits I gain from the surgery greatly outweigh the negatives of a lifetime of despair with incontinence dysphoria.

 

I sent the message but I shouldn't have expected much because she didn't even speak to what I said. She thanked me for letting her know I had a referral for a second opinion and that's all. My referral to the second psychiatrist is pending and should be approved any day.

 

On a good note, my referral to a urologist with the experience to do the surgery went through! I'll be seeing a urologist who does the surgery multiple times a year. I am still working on scheduling the appointment as the hospital hasn't received the approval for referral on their end. I did call and talk with the clinic about it and they said it may take a couple days to process. The receptionist asked what I was wanting to be seen for so I used what my current urologist wrote on the referral, "a consult for continuous leakage of urine". For some reason I must have had slurred speech because she asked me to repeat why I wanted to visit twice, then she asked me to spell it! That felt so akward! I said again but slowly "continuos. leakage. of urine."

 

She suddenly was like, "oh, I could not understand what you were saying! I was trying to type it into google to see if something came up!" I didn't need to spell it after that.

 

Below is my stent for those curious about my stent. The longest I have had it in was for 10 days. I usually don't have it in for more than a day or two because I don't like how it limits mobility and I get scared I'm developing a UTI. It would be so nice if I didn't ever have to use this again to feel like myself.

[Spicey Lettuce]

If you convince her that you are a danger to yourself, you may end up involuntarily incarcerated in a mental hospital.  Be careful.