Patient Story: Nocturia, Urgency, Abnormal Emptying and Pelvic Pain Caused by Looseness in the Back Ligaments

Mrs LM was 53 years old. She stated,“ I get up 4-5 times a night. I find this very tiring as I have to work next day. I have a dragging pain on the right side which can be quite distracting by the end of the day. I am always going to the toilet at work. My urine dribbles away after I stand up and I often wet the toilet seat. I have problems with bladder infections. My first GP did a whole lot of xrays, a CT scan, blood tests for the pain. I went to a gynaecologist who put a tube into my tummy and found nothing. She said that she couldn’t find anything wrong and she sent me to a psychiatrist, because she thought the pain was in my head. He said there was nothing wrong psychologically. I saw many GPs and several specialists about the bladder. They gave me tablets to stop the bladder from working so frequently but these made my emptying worse and they gave me a dry mouth as well, so I had to stop taking them. They said they couldn’t do anything else for me. One even said it might all be in my head. Mostly they said I had to learn to put up with these symptoms, because they were incurable. I came here because I felt a lump coming out.”

Mrs LM had symptoms typical of looseness in the back ligaments. When we examined her, we noted that her uterus was protruding outside the vagina. We inserted a TFS “minisling” to repair her back ligaments. This repaired the prolapse and tightened the vaginal membrane. It was minimal surgery performed entirely from the vagina. Mrs LM required only an overnight stay in hospital and she returned to work in 7 days. When reviewed at 9 months, she was getting up only once per night to empty her bladder. She said that her low abdominal pain was still present but was 90% better and it rarely bothered her now. Her bladder emptying also was not entirely cured but had improved significantly and she had not had any bladder infections since the operation.