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Thread: question about bladder issue

  1. #1

    Question question about bladder issue

    Hi Everyone,
    I have a question about a bladder problem my son is having. A few months ago David started having some leakage of the bladder. They gave him oxybutynin to help that but it really never stopped it. Now, in between him cathing himself every 4 hours, he is actually urinating. Not leaking but urinating. I was doing something for him the other day and he starting urinating a normal stream. Lately, at night he is soaking wet in between caths and his whole bed is soaked. I also notice he has some sediment in the urine but the doctor didn't seem too concerned about that. My question is, is it possible he will be able to urinate on his own when I was told he never would? Is this a good or bad thing? I was thinking maybe it is time to get him to a urologist and see what is going on. If he can urinate on his own can he wear an external catheter instead of cathing himself. He has wounds healing up beautifully and the only problem is I don't like him wet and it is not always possible to know when he does it. Any information is appreciated.
    DavesMom, Diane

  2. #2
    He has been injuried for less than a year I believe? (It would be VERY helpful if you would complete your profile!)

    It is likely that he is now fully out of spinal shock and you are seeing the true picture of his neurogenic bladder. If he cannot voluntary control this, it is still leakage, not voiding. It is unstable bladder "kicking off" from uninhibited bladder contractions.

    Emptying your bladder by reflex voiding may seem to be more convenient than intermittent cath or other bladder management methods, but if he is doing it with high pressures, he is putting his kidneys at risk. High residuals can also result, increasing the risks for stones and infections. Even without high pressures now he can later develop high pressures, and reflex voiding done for years may result in decompensated, flabby, bladder that will no longer work. This then requires a change to either intermittent cath (if he did not also have the sphincter cut, often required for reflex voiding) or an indwelling catheter.

    Of course reflex voiding also requires having a condom catheter on all the time and having to drag around a bag all the time, and having to find an external condom catheter (ECC) that works all the time, worrying about external failures, and having to take special care of the penis skin to prevent breakdown.

    Who started him on the Ditropan? How much? Was this based on leakage or also on urodynamics studies? When did he last have urodynamics? We recommend them at 6 months post injury and at at year, then every 1-2 years after that.


    (KLD)

  3. #3
    Hi,
    David's doctor at rehab started him on the oxybutynin. He gave him 15 mg. but since then his primary care doctor put him on 10mg. That seems to have made things worse. David is coming up on his first year of sci on June 4th. He has not had any urodynamic studies as yet which is why I thought he should go to a urologist to have it checked out. The intermitent catheter is no big deal to do. I guess I was just hoping things were going to be somewhat normal for my son. He is really doing well otherwise and considering the multiple life threatening injuries he had is a miracle in itself. He went to shock trauma clinic this past Wednesday and the doctor said his aortic graft repair has healed so well there is no evidence it was ever injured. As I said earlier, he came home with huge wounds on his butt that are healing beautifully and we are just looking forward to getting back to life as a family. He had a colostomy 2 months ago so he wouldn't have to worry about accidents when he can get out and about. I guess tomorrow I will be making an appointment for him to be seen by the urologist to check things out. Thank you KLD for your input on this.

    DavesMom, Diane

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