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Thread: Bladder neck incision to resolve autonomic dysreflexia

  1. #1

    Bladder neck incision to resolve autonomic dysreflexia

    I get autonomic dysreflexia that seems to be triggered by spasms of the internal sphincter i.e. bladder neck (I am otherwise very functional---I can walk, run, urinate without a catheter, etc.). I may need to have a bladder neck incision. I'm just curious, has anyone here undergone this procedure for the purpose of resolving autonomic dysreflexia, and how have the results been over the long term?

  2. #2
    Senior Member rdf's Avatar
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    Quote Originally Posted by etseq View Post
    I get autonomic dysreflexia that seems to be triggered by spasms of the internal sphincter i.e. bladder neck (I am otherwise very functional---I can walk, run, urinate without a catheter, etc.). I may need to have a bladder neck incision. I'm just curious, has anyone here undergone this procedure for the purpose of resolving autonomic dysreflexia, and how have the results been over the long term?
    I think it could make you incontinet if the internal bladder sphincter is cut. Make sure you check with your uro about what if any changes you will undergo with your voiding routine. Good luck.
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    Senior Member goldnucs's Avatar
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    I've had the sphinctorotomy procedure performed probably 5 or 6 times over the course of my 31 years as a quad. It eliminated problems with dysreflexia as well as reducing the chances of UTI as I void more easily. The tissue does close up as it "heals" over time, thus the need to have the procedure repeated every so many years.
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  4. #4
    Thanks very much for the response, goldnucs. Can I ask, how is the recovery time after the surgery? Do you start feeling the difference right away? Are you uncomfortable for a while after the surgery?

    Also, have you had any side effects, or were the surgeries been completely positive?

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    Senior Member goldnucs's Avatar
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    It's been awhile since the last one but you'll have an indwelling foley for about a week while the site heals. There will be quite a bit of blood in your urine at first but it clwars up after a day or two. The results have always been positive for me; less spasticity, no chills and sweats when I pee......just a nice, unnoticeable easy flow.
    Rick Goldstein
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  6. #6
    Having a sphincterotomy today is very different than it was even 10 years ago. They are able to make small incisions which help to relieve the pressure on the sphincter. There is a slight possibility that during the procedure, the Sacral nerve could be cut. This would leave you with erectile problems. Check with your physician to see if there are anyother possible complications that might occur. Also, I would check to see how many times your physician has done this procedure, the time that he predicts it will take to heal (usually within a couple of weeks at the most) and what to expect immediately after surgery.

    CKF

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    Senior Member goldnucs's Avatar
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    btw, on a couple of occasions, the stretching from the preliminary cystoscopy was all it took to open up my sphincter enough to provide some relief.
    Rick Goldstein
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  8. #8
    Goldnucs, one other question for you: did you find that the procedure improved the quality of your sleep at all (with the reduced spasticity and AD, and probably less urinary urgency at night)?

    I sleep terribly and AD seems to be the most likely cause.

    thanks.

  9. #9
    Senior Member goldnucs's Avatar
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    Yes, absolutely....I used to get chills and sweats so bad when I peed that my sheets would be soaked and I'd have to lay on them wet all night which only made the chills worse.
    Rick Goldstein
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