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Urogynecology  (Expert Forum)
 | 
bladder discomfort and upcoming surgery
Answered by
Lennox Hoyte, M.D. - UroGynecology, Pelvic Surgery
USF College College of Medicine Tampa - FL
Questions in the Urogynecology forum are answered by medical professionals affiliated with USF Health. Topics covered include overactive bladders, bladder pain, fallen/drooping bladder, bowel urgency, bowel prolapse, cystitis, incontinence, pain with intercourse, rectal prolapse, surgery, urinary urgency, and uterine prolapse.

bladder discomfort and upcoming surgery

by krp74, Apr 21, 2007 12:00AM
In a few weeks, I'll be having surgery to remove a solid mass on my right ovary (which is enlarged), and possibly the ovary itself if it's encased in adhesions as my ob/gyn suspects.  Although my gyn has seen me through a lot, I still freeze up in his office and rarely volunteer info, like the fact that I have almost a constant feeling of needing to pee, regarless of if I just went.  Is this something that should be looked into before my surgery?  I just don't know...  I like to think it's just adhesions or things that have moved since my hysterectomy 3 years ago.

Background: age 32, 2 kids, 4 miscarrages, hysterectomy (I still have my ovaries) at age 29 (adenomyosis was pathology result), endo removed in my 2 previous scopes, pelvic pain to some degree for the last 10 years.

Should I bite the bullet and tell him about this, or would it make a difference?

by Lennox Hoyte, M.D., Apr 21, 2007 12:00AM
Sounds like you may have overactive bladder symptoms (the feeling of having to urinate a lot, in the absence of a bladder infection). This can sometimes occur in women with pelvic pain, of muscular origin.  The thing that needs to be ruled out is bladder infection (this can be accomplished with a urine culture- the kind that takes 3 days to perform, not the in office dipstick test). Once the bladder infection is out of the way, issues of prolapse, and uterine fibroids, or large ovarian cysts, also need to be ruled out, this is easily done with a bimanual examination by your gynecologist or NP.  Although the most common therapy is medication (e.g., Detrol, Ditropan, Enablex), other therapies exist. Examples of these are timed voiding, kegel exercises (with emphasis on the relaxation part), pelvic floor physical therapy (performed weekly by a trained pelvic floor physical therapist), and vaginal electrical stimulation (which can be self-administered at home twice daily for 8 weeks). Other conditions which can cause frequency/urgency, include kidney stones (these are usually painful, and accompanied by blood in the urine), and bladder cancer (this is very rare, but smokers can have an increased risk of this).  Please be sure to mention your symptoms to your surgeon prior to surgery, and have this evaluated prior to your operation.
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