Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Hello everyone;This is my first ever Reddit post and I am finally turning to the deep dark web for some feedback.I am a 40yr old woman who has some medical issues and I have been my own advocate since July 2019. I am still waiting for a family physician for my son and I here in Canada - it's been too long without support.A little back story...I had my son in 2009 and in 2013, I had the lovely pleasure of having a partial hysterectomy - As a lot of you know these two things can cause the uncomfortable issue of incontinence. Well in 2018, after two and a half years of very uncomfortable sexual activity and very embarrassing incontinence mishaps I finally decided to see a specialist.After all the testing, my only option really was: TVT - which is the procedure where you have your bladder lifted in a mesh/sling. Surgery was unable to be booked as at the time my family had some changes and we had to move away. Finally after a year. I received a phone call from a specialist in the new area, and yet again due to some unforeseen family issues - I had moved away yet again to another area. So in July 2019, I started hitting the ground on my own. From that day I was going to walk in clinics for UTI symptoms (blood in urine each time usually every other month until September) - got antibiotics monthly and went on my way. Finally in September 2021. I had to change my tactics. My life was completely upside down, the pain and the symptoms were increasing and I wasn't getting anywhere. So I started going to the Emergency room. And started asking for referrals. I was there twice a month until March 17. I was confirmed to finally see a specialist for my case in June. However; I was still in the emergency room three more times after.Finally I have a specialist!!! How exciting is that? Finally I can get fixed! After a cystoscopy, I remember three things he said to me;-- "You took that like a champ" (loved this made me laugh, I thought he was funny) -- "Unusual growths" -- "We'll fix you"Had a biopsy surgery on June 20th. And then... I had to wait 4 weeks for my next appointment. Let me tell you ya'll I didn't think I had cancer, I am ill tho I know that. I have no appetite, I don't sleep because of the pain. I am wearing adult diapers because I have no control, and the blood is only sporadic, I am tired, I am anxious, I am nauseated, and sick sometimes. I hold a low grade fever of 99.5-101 daily it will not break.Heading to my results appointment. I was ready for a few things...Not CancerDo the surgery to lift my bladder and while in there they will check others to make sure I am ok everywhere else.Meds to clear up whatever is causing these fake uti's - cause every culture would come back negative. The ONLY thing I didn't want to hear was; "I don't know what's going on, let's try these pills, and not do the surgery..."This is what I remember about the appointment...I told him since he likes to make jokes and laugh I had one for him before we started... He said ok shoot."After my biopsy surgery you tried to poison me". His reaction was inquisitive. I explained that I was prescribed Codeine pain meds and I am allergic and it's in file. He blamed it on one of his staff and then never replaced the medication either. (One reason I already lost trust)2. His exact words "Yay you don't have cancer".Kind of like the first meeting here is what I remember him saying...-- "I made a mistake, there weren't actually growth in your bladder. You have a beautiful bladder. It was just murky from this infection." (Lost trust for the second time - you mean I didn't even need a biopsy surgery?!?) -- "I did measurements of your bladder while you were in surgery because when you are under, your bladder is relaxed. And you don't need it lifted." -- I don't know what's wrong, but we are going to treat you with Overratve Bladder (OAB) with pills and a low grade antibiotic forever.  If in 3 weeks there is no change we will increase your dosage. NEXT ONE'S THE KICKER!!!! -- "If that doesn't work I will refer you to someone SMARTER than me". (Lost all faith - he had a diagnosis from a specialist he was choosing to ignore to what put me on medication he didn't even know as going to help me?!?)So ya'll I am not going to lie. I was angry, frustrated, confused and couldn't speak. I took the script and left. After I left, I was beside myself and totally confused. How one specialist 5yrs ago said my only option when I had NO infections or other symptoms, said I had to have surgery... Now I am 9yrs after a hestorectomy, and this doctor hasn't done half the testing to see about a prolapse bladder (which again was diagnosed in 2018).I called my original specialist, he told me I would need to be referred back to him but he was concerned with the fact that he is over 2 hrs away from me now. He advised me to request a 3rd opinion with someone locally.I can say that has been requested... Now how long do I wait for this 3rd opinion?I am seriously in so much pain. I suffer from fibromyalgia and that is the only medication I am taking, so I am unable to manage. I haven't slept in 4 days. I feel like my right hip/leg are going to snap off me. I want to BIRTH something. I feel like I am in that last push pain of birthing... Everyday ... All day... I have been on medications for 5 days. The only thing that has changed, is that I no longer have blood in my urine. That's it.I am tired... Am I wrong for wanting to have a doctor to just please do an internal ultrasound to see if it's prolapsed? I mean seriously I feel like it's coming out. But they won't do that testing at the ER, and this specialist won't do it. How long do I need to wait?!?Thank you for listening.... ### Response: Incontinence is s vast vast subject, i can't give you definitive answers online.For a tvt one of the most deciding factors if it will help or not is the Marshall Bonney test (you know the one with the urologist inserting 2 fingers in vagina and lifting motion to full bladder and telling you to cough)Has it been done and what was the result?A tvt or tob isn't always the answer, it doesn't work for any woman, there is a host of urodynamics tests and pelvic floor, abdominal pressure etc etc....that need to be done beforehand.The cystoscopy is also a must before the tvt for multiple reasons i cant describe them all (limited English and time) one of the reasons for the cystoscopy to be done and under anesthesia is to relax completely the abdominal muscles so the urologist can apply pressure to lower abdomen and with other hand to look at the roof and forward wall of bladder so not to miss anything. Without anesthesia he will not be able to see clearly and make a good assessment of the forward wall and roof.The biopsie isn't necessarily done only by suspected bladder cancer but also to outrule something called interstitial cystitis which is somehow similar symptoms to uti with clean uricults.Also not all urologists are the same, some like working exclusively in a practice, work fixed hours, ultrasound, diagnostics, cystoscopy, small stuff. And they know urodynamics and incontinence stuff (diagnostics) much better than me.Others like me work almost exclusively in the hospital performing multiple surgical procedures daily and also doing oncall shifts for EREven in hospitals, some do like 5-6 renoscopie procedures daily, others do kids daily, others the lucky ones do mostly DaVinci robot assisted surgeries, others kidney cancers, others tur-p tur-b holep etc... etc......That's why you can always get a second opinion. A urologist who is good with kidneys and works that daily and is concentrated on the malignancies in urology will not be a good fit compared to a urologist who knows his pelvic floor good and all types of incontinence and meds and bands. Also OAB represents similisr symptoms and can be treated with meds, if tjey don't work and marshall bonney test is negative, then botox injection in bladder is an option that works wonders for someIf you can provide me result of marshall bonney test i can give you a "guess" if tvt is right for you or not. A trustworthy diagnosis i cant provide online.Tvt done unnecessarly not only it will not help but can lead to complete shut close urethra and acute urin retention, so we don't want to do unnecessary procedures that will make matters worse. Also there is conservative approaches like pelvic floor exercises which in some patients do work well.Also TVT/TOB procedures aren't emergency and don't get priority so right now the waiting list at my workplace is about 3 months minimum and if another covid wave hits, it will be delayed further.Another Tip: gynecologists are more than capable of placing a tvt or tob. Its not a complicated procedure. Fairly straightforward but carries risks but rare when done by an expert. So if you can get a faster appointment with a gynecologist then do it..