Pelvic surgery by urogynecologist stops urine leakage, gives suburban woman her life back

Everyday activities, like grocery shopping or meeting friends at a restaurant, had become too painful and distressing for Lisa Welz to tolerate.

The Yorkville, Illinois, resident was dealing with rare complications from a 2019 hysterectomy during which surgeons removed a 16-pound cyst from her abdomen. Afterward, a fistula — an abnormal passageway — developed between her bladder and vagina. It prevented urine in her bladder from going into her urethra. Instead, urine constantly leaked from her vagina.

Getting out of bed in the morning, she’d stand up and urine would flow onto the floor. While shopping, she’d race to the bathroom, never making it in time.

To stop the leakage, Welz’s doctor inserted a catheter into her bladder, which she said was painful and still occasionally leaked while she was out in public. After 14 weeks of around-the-clock discomfort from the catheter, Welz asked her doctor if there were any other options for her. He offered none.

So Welz, a former journalist, began to do research to find a doctor who could help her. She’d never heard of a urogynecologist — an obstetrician-gynecologist with advanced training in female pelvic medicine and reconstructive surgery. Once she discovered this subspecialty, she found that one of the top urogynecology teams was at the University of Chicago Medicine.

We often get patients who other doctors can’t help, and that’s the strength of UChicago Medicine’s urogynecology team.

Within days, Welz was sitting in the South Loop office of UChicago Medicine urogynecologist Juraj Letko, MD, who told her that a specialized fistula surgery could fix her problem.

“We often get patients who other doctors can’t help, and that’s the strength of UChicago Medicine’s urogynecology team,” Letko said. “This is an example of how we deal with problems head on, in a very safe way.”

During a seven-hour, robot-assisted surgery in October 2019 at UChicago Medicine's main campus in the Hyde Park neighborhood, Letko repaired Welz’s fistula and created a barrier to prevent a new one from forming. He disconnected her bladder from the vagina and restored the connection between the bladder and urethra.

The surgery was performed using a minimally invasive approach with very small incisions in Welz’s abdomen. The benefits included a shorter hospital stay and quicker recovery.

Dr. Letko gave me my life back. That’s a powerful thing.

After the surgery, Welz’s urine leakage stopped immediately. She hasn’t needed a catheter, medication or a panicked race to the bathroom ever since.

“Dr. Letko gave me my life back. That’s a powerful thing,” Welz said. “I will forever be indebted to him. When I told him, ‘Thank you; you saved my life,’ he lowered his head and said, ‘I just did my job.’ But it was so much more than that. It wasn’t a typical life-or-death scenario, but I was in constant pain and getting depressed. If I had to keep that catheter, I would have had a lifetime of challenges.”

Letko is one of the few doctors in the United States trained in both obstetrics and gynecology as well as urology. He treats women with a wide range of pelvic conditions, including pelvic organ prolapse, urinary incontinence, urinary infections, and painful and irritating voiding disorders.

Fistula surgeries are rare, and Letko said Welz’s case was particularly complex due to her obesity and excessive scar tissue from her previous surgery.

Welz praised Letko’s expertise, quiet confidence and personal care, noting that he called her at home regularly to make sure she was doing well following the surgery.

She believes a divine power led her to Letko when she was at her lowest point, thinking she might have to live with a painful catheter for the rest of her life.

“He made it possible for me to not have ongoing problems,” she said. “I hope this story offers people hope. This surgery saves people’s lives and transforms people’s lives. Dr. Letko is truly the best.”