A 39-year-old mother of three from the United Arab Emirates has regained her quality of life after undergoing a groundbreaking surgical procedure that addressed a long-standing medical mystery. The woman, known only by her initial Iman, suffered from severe urinary incontinence since the age of 25, following a serious road accident in Oman in 2011. After years of ineffective treatments and a loss of hope, she received a new lease of life through advanced medical care in Abu Dhabi. Iman was involved in a high-speed collision in Oman, which resulted in multiple pelvic fractures and a displaced bone fragment that entered her vagina. Initially treated in Oman, she was later transferred to the UAE for further care. Metal plates and screws were surgically placed in her pelvis to stabilize the fractures, but this led to complications. She developed severe sepsis, requiring additional interventions. Despite surviving the accident, Iman faced a new challenge, urinary leakage that persisted despite numerous medical treatments. Over the years, Iman endured continuous episodes of incontinence, recurrent infections, and an overactive bladder, all of which were treated with medications that offered little relief. By 2018, she had lost hope, feeling as though her life had come to a standstill. However, encouragement from her family prompted her to seek further treatment in Abu Dhabi. She was initially referred to Dr Amin El Helw, an orthopaedic surgeon at Sheikh Shakhbout Medical City (SSMC). Recognizing the complexity of her symptoms, he directed her to Dr Manal Elredy, a specialist in obstetrics, gynaecology, and urogynaecology at the same facility. At SMMC, Iman's condition was found to involve multiple vesicovaginal fistulas, abnormal connections between the bladder and vagina. These openings, which had remained undetected due to the displaced bone fragment obstructing the vaginal canal, were responsible for her constant urine leakage. Dr Elredy explained that such fistulas do not respond to medication and must be repaired surgically. The discovery marked a turning point in Iman’s health journey. The surgery revealed the true nature of her condition, which had eluded earlier diagnostic efforts. Dr Elredy emphasized the importance of investigating persistent urinary incontinence, especially after traumatic injuries. She noted that approximately one-third of women under 45 experience some form of urinary incontinence, with the prevalence increasing to around 50 percent after the age of 45. Common causes include pregnancy, childbirth, chronic constipation, and pelvic floor weakness. Some cases arise from congenital conditions or connective tissue disorders. In Iman’s case, the root issue was not an overactive bladder but an undiagnosed fistula. This highlights the need for thorough evaluation when symptoms persist despite standard treatments. Dr Elredy stated that roughly two-thirds of patients with such issues eventually require surgery, while a smaller proportion can manage their condition with medication. Reflecting on her experience, Iman described the emotional toll of living with untreated incontinence. “I tried everything, but nothing changed. I felt my life had stopped.” Now, having undergone successful surgery, she is beginning to reclaim her life, supported by the expertise and dedication of the medical team at SMMC. Her story underscores the critical role of accurate diagnosis and specialized care in addressing complex medical challenges.
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