Tammy Anderson didn’t stop working because of her urinary incontinence.
But it certainly made things miserable.
Working as a practice manager at Spectrum Health, Anderson often had to work on her feet during long and busy days. And she’d always kept an eye on the restroom door, measuring the distance for the inevitable quick trip.
She could find nothing to end her struggles.
“I had a sling put in about 10 years ago,” Anderson said. “Then another sling—and then a third.”
Sling surgery is one of the most common procedures for urinary incontinence. Quite simply, it helps control leaks with coughing, laughing, and other similar activities.
Picture a hammock that lifts and supports the urethra and bladder. A surgeon creates the sling out of mesh or human tissue and places it under the urethra, where urine passes through.
Doctors had placed three slings in Anderson, but in the long run, none of them offered long-term relief from incontinence and discomfort.
At one point, she had to use a catheter several times a day to empty her bladder.
“I was in pain,” she said. “My doctor began talking about some kind of remote control device using radio frequency to control urination, but I didn’t want that. I wanted a second opinion.”
No time to blush
Anderson soon met with Nima Shah, MD, a urogynecologist at Spectrum Health Medical Group.
“Tammy had been using a catheter three, four times a day when she came to see me,” Dr. Shah said. “She was on her third sling, but still couldn’t urinate in a normal manner and often felt pain. She also told me that she felt like the catheter was hitting something inside her urethra every time she used it.”
On examining Anderson, Dr. Shah discovered she had suffered prolapse.
Anderson’s bladder had dropped lower, as had her uterus and cervix. She also suffered from rectocele—the wall between the rectum and vagina weakened and the rectum had pushed into the vagina.
“A variety of reasons can cause difficulty in emptying the bladder,” Dr. Shah said. “It could be neurological or it could be due to prolapse creating a blockage. So we do tests to determine the cause.”
After that productive meeting with Dr. Shah, Anderson regretted not seeking care sooner.
“Dr. Shah assured me I didn’t have to live with this kind of discomfort,” Anderson said. “It’s OK to ask questions. There is so much more that we can do these days than we could do 10 years ago.”
Anderson underwent a procedure called urodynamic testing, which helped Dr. Shah identify the problem areas more precisely. The test involved filling the bladder to see what would happen when Anderson tried to empty it.
“We found that there was a kink in her urethra and that the slings had become part of the problem along with the prolapse,” Dr. Shah said. “And we discussed a hysterectomy because her uterus was dropping.”
Anderson, 45, a mother of two, agreed to have the hysterectomy.
Dr. Shah later also removed part of the slings and the kinking, corrected the prolapse, repaired the rectocele and lifted the top of the vagina with support stitches.
The surgery lasted 4 1/2 hours. Anderson went home the same day.
She used a catheter for the first few days after surgery. Shortly thereafter, Anderson finally saw a halt to the urgency and spasms that had plagued her for years.
She could stop eyeing the restroom door all day. She could also stop using a catheter.
“If there is one thing I’ve learned from all this, it is that I would recommend to other women suffering from incontinence to seek out your women’s health specialist,” Anderson said. “You don’t have to feel there are no options. There are.
“Different providers can have a different perspective,” she said. “A specialist in women’s health may consider factors you didn’t even think about. Ask the questions. Just ask.”
Dr. Shah seconds that.
“The quality of the life we live is so important,” Dr. Shah said. “Women need to know they are not alone. Never be embarrassed to see your doctor about these kinds of problems.”