Urethrocele and Redundant Vaginal Tissue - what can be done to improve my quality of life?

Thank you for reaching out with your concerns regarding your small urethrocele and redundant vaginal tissue. I understand how challenging and life-altering these symptoms can be, especially when conservative measures have not provided relief.

A urethrocele, or prolapse of the urethra into the vaginal wall, can cause discomfort, pressure, and the sensation you described, particularly when accompanied by redundant vaginal tissue. While stress urinary incontinence (SUI) is a common reason for surgical intervention, the absence of SUI does not mean your symptoms are not significant or worthy of treatment.

You have already tried pelvic floor physical therapy and conservative pain management without improvement, which can be frustrating. In cases like yours, where symptoms are severe and impact daily life, further evaluation by a urogynecologist or pelvic reconstructive surgeon is warranted, even if initial consultations have not led to a solution.

Surgical options may include procedures to remove or tighten redundant vaginal tissue (vaginal wall repair) or to support the urethra. While a mini sling or similar support can sometimes help, as you noted, there is a risk of urinary retention, especially in patients without SUI. However, some surgeons may consider a tailored approach, such as a site-specific repair or a less invasive support procedure, particularly if you experience significant relief with manual support.

It is important to seek a second or even third opinion, ideally with a specialist who has experience in complex pelvic floor disorders and is open to individualized treatment plans. Bringing a detailed symptom diary and describing the relief you get from manual support may help guide the discussion.

In the meantime, continue to manage symptoms as best as possible with pain relief and supportive measures. If your symptoms worsen or you develop new issues such as difficulty urinating, recurrent infections, or bleeding, seek prompt medical attention.

You are not alone in this, and there are options to explore. Advocacy for your own care is important, and sometimes finding the right specialist can make a significant difference.

If you have further questions or would like assistance finding a specialist, please let me know.