My sister was born with congenital defects which her doctor describes as 'Cloaca with Colon pouch syndrome'. She is now around 30 years old and has undergone several major and minor surgeries. Although she has managed to get educated and employed as an online journalist, she still has problems - severe urinary and bowel incontinence and frequent urinary infections.
Her doctor's letter is enclosed for more clarity. Both my sister and her doctor live in Mangalore, India. Her doctor recognizes the fact that the technology in India is insufficient to make further progress in her condition. For example, the doctors in India are of the opinion that artificial sphincter could be explored as an option. However it is not available in India. I would therefore like to consult and explore all options while I'm here in the US, in Maryland. It would be great if the initial explorations are made before she travels to US and if we can prepare the ground for whatever procedure she may need to undergo, before she travels.

What is the best way to get her continence? Her bladder shape and size, and the current structure of that area may need to be considered before arriving at an option. The reports may help in understanding this.

I have enclosed some of her reports. Please let me know if you need more reports.