This topic is about someone who has been experiencing ongoing challenges with urinary incontinence and pain following a significant surgery known as "Barbie-butt" surgery. This procedure involves closing the perineal area, and unfortunately, the person’s quality of life has not improved as expected. Here’s a breakdown of their situation and some advice that might help:

- After undergoing extensive pelvic surgery in December, the person hoped for an improved quality of life. However, things have not gone as planned.
- A surgical drain that should have been removed was left in place, leading to a more complicated outpatient surgery in May. This left the person feeling weak and unwell for the rest of the month.
- While some issues, like recto-vaginal fistulas, were successfully addressed, there seems to be nerve damage affecting the bladder, resulting in total urinary incontinence.
- The person experiences manageable mornings after performing daily colostomy irrigation, allowing them to walk long distances.
- However, after lunch, they face continuous urine leakage, especially when sitting or lying on their side. Thick incontinence pads quickly become saturated, and nighttime leakage requires frequent trips to the bathroom.
- Severe pain is also a constant issue due to the absence of the coccyx and part of the sacrum.
- Medications have not provided relief, and the next step suggested by the urologist is intravesical BOTOX injections.
- Emotionally, the person is dealing with the shock of additional scars, anger over a lack of support from their partner, and frustration over the burden they are carrying.

Here are some helpful insights and advice:

1. Consider using micro-fleece liner pads inside diapers. This fabric helps draw moisture away from the skin, which can improve comfort and reduce costs compared to using full disposable products.
2. Be assertive with healthcare providers. It’s important to communicate that the current management of the situation is inadequate and to push for better solutions or seek input from specialists.