You need to discuss this with your specialist to review all of the options and to make an objective decision. One option is to consider a sling using your own tissue, which is put in quite tight, but there is a high risk of difficulty voiding after this - but that may be a better option for you. If ...

You can certainly consider an alternative which is the use of an injectable agent into the urethra. This is not as effective as the other surgical options, but you could certainly discuss this with a specialist and decide how you wish to proceed.

This is a complex situation and you need to be seen by your paediatric specialist to discuss this further.

You need to be seen by the specialist nurse advisory service at community level, there is usually a community continence nurse who would be well versed in the different devices and who can suggest alternative catheters.

You need to seek advice from your specialist relating to this. Intermittent self-catheterisation is the most effective way of emptying the bladder if it is not emptying by itself on attempted voiding.

I'm afraid there is nothing you can do to preserve the tract, it will close if the catheter is not in place. The most important thing is to tape the catheter in with some tape on your abdomen, but unfortunately the balloons holding these catheters in often do deflate, which can be very troublesome. ...

If this is proving to be a problem, then certainly you should seek medical advice from your general practitioner.

This needs to be assessed by a specialist nurse practitioner in the community setting with appropriate referral to a specialist or hospital.

A bladder diary would be helpful in assessing the amount that you drink. If the oxybutinin is not working then there are alternatives and clearly your doctor may wish to refer you to a specialist nurse or urologist.

I feel you need to be seen by a general practitioner and to be examined. Potentially either a barrier cream or other therapy might be helpful.