Vaginoplasty. Did something go wrong?

I am 2 weeks post op for the full vaginoplasty, they lifted my bladder as well. I still can hardly urinate, I was told it should be OK after 2 weeks, but it's not. I do empty the urine with the catheter at night and get about 200 ml at the moment. I wonder if something went wrong. Please advise.

Doctor Answers 5

Vaginal Surgery and Bladder Lift with inability to empty bladder

Hello Nana2013,

Thank you for sharing your question with us. Unfortunately based just on your descriptive terms there is not enough specific information regarding the exact type and extent of surgery you had to include whether or not a sling was placed as part of your "bladder lift" which would definitely have an effect on your ability to empty your bladder. A traditional vaginoplasty would not normally have an effect on your ability to empty your bladder well. This far out from surgery and still needing catheterization to empty the bladder would warrant an in office evaluation with your surgeon. 

Greenville Physician
5.0 out of 5 stars 3 reviews

Urinary retention after vaginoplasty + "bladder lift"

YES, SOMETHING IS WRONG. No way you should still have a catheter in place 2 weeks after surgery. (Shouldn't be more than 2-3 days in absence of complication...). I have performed > 125 "full vaginoplasties" some with "bladder lift," and have RARELY had to insert a catheter in my patients. Absolutely no need for catheter for vaginoplasty; your "bladder lift" is the culprit, & if it is a "TVT" or "TOT" it may be too tight & may need to be released. Something is wrong here. See your surgeon and ask her or him to fully explain to you what is going on.

Keep us posted please re: outcome; then we both learn!

Michael P Goodman, MD

Davis, CA, USA

Vaginoplasty. Did something go wrong?

I'm sorry to hear you are having problems post operatively. Vaginoplasty surgery itself should not cause urinary retention however the bladder lift may be the cause of your symptoms. There are a few things to take into consideration after surgery when there is difficulty voiding including: was there a urethral sling placed, is there bladder mobility after the surgery, how well is your constipation controlled and how well is your pain controlled. Medications can often improve voiding function postoperatively, but in some case surgical revision is necessary. These are all best addressed by your surgeon and should be followed very closely if voiding difficulty is present or persists.

George Shashoua, MD
Austin Urogynecologist
4.9 out of 5 stars 38 reviews

Urinary retention is a bladder lift problem, not a vaginoplasty problem

If you can't urinate for weeks after a bladder lift, you might have been lifted too high. You need to be examined. If it was a sling, it will probably need to be revised. Your other options are drugs (which might not work), and self catheterization which is neither convenient nor pleasant.

Marco A. Pelosi III, MD
Jersey City OB/GYN
4.7 out of 5 stars 26 reviews

I have problems urinating after my bladder lift and vaginoplasty

Its hard to say whether you are having a problem that is still requiring the placement of the catheter.  200 ml from your bladder may be a sign that your bladder is emptying or may be a sign that it is not emptying.  What matter is how much you are able to urinate on your own without using a catheter.  You can measure this easily with a "bladder hat" that fits in the toilet.  Urinate into this and see what your volume is.  If you are emptying 3 or 400 ml on your own then you are likely fine and don't have to use the catheter.  If you are urinating less than 200 on your own then you do have  an issue.  Sometimes things have to be loosened in an operating room setting but this thankfully is not too common.  

Michael Litrel, MD, FPMRS, FACOG
Woodstock Urogynecologist
5.0 out of 5 stars 4 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.