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Re: TVT and voiding dysfunctionFrom: Steve & Eryl Raymond (eryl@intekom.co.za)Fri Jul 28 00:02:08 2000
That is such a significant factor - "the psychological overlay". It is very important not to be hasty with these cases. The reason I am so sure of this is that I was involved in trying to help restore continence in a young woman - a competitive swimmer - who had had urinary retention after a shoulder operation. The orthopaedic surgeon asked for urological help, and for some unexplained reason the urologist saw fit to perform a urethrotomy. This young lady never had proper bladder control after that, despite sling procedures and urethral reconstruction of varying types. Give it time, time, and more time. Eventually the disadvantages of remaining retentive will outweigh the advantages and she'll come right. On 26 Jul 2000, at 9:25, Ron Jewell wrote: Fellow cybergynaecologists will recall that I asked for advice about a woman with voiding dysfunction post TVT procedure. I performed a "pull down" procedure with no improvement and then a week later divided the sling in the midline. The TVT mesh immediately retracted about 5mm on each side. Unfortunately there has still been no improvement to her residual urines of about 2oo ml with 100 ml voids, even though there is no anatomical reason. This lady has a large psychological overlay and I have removed her suprapubic catheter and discharged her, hoping and praying that she doesn't develop retention. Ron Jewell Dr. Steve Raymond Head of Department of O & G Empangeni Hospital Empangeni SOUTH AFRICA 3880 Ph:(+27)(035)77721111
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