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Thread: bladder issues (appreciate nurse input)

  1. #1

    bladder issues (appreciate nurse input)

    Over the past few years I have been having more frequent urges to urinate, sometimes waking up a time or two during the night. It always felt like I completely emptied each time and I never had problems with leakage. My prostate checked out fine. Wasn’t a real issue and I was able to live with it. I have a neuropathy (probably CIDP) and my neurologist thinks that I have a neurogenic bladder.
    The last 4 weeks the problem has worsened significantly. I need to go every hour or two. I never feel emptied and my bladder always feels tight or full, but I don’t leak. It’s hard to get a stream going and I have less flow than I used to. I have a constant mild achiness and I can feel spasms. I saw a neurologist last week – no UTI and prostate still fine. Ultrasound showed 400 ml retained one hour after urinating. He started me on Flowmax, but after a week it had no effect on the symptoms. He now wants me to try Vesicare. But their website says it is for urgency, frequency and leakage and not to take it if you have trouble emptying your bladder. Is this the wrong medication for me?

  2. #2
    You need to have urodynamics studies with VCUG. Did you see a neuro urologist such as Dr. Tim Boone or Chris Smith?
    Keep taking the Flomax.

  3. #3
    Thanks for the reply.
    I didn't see either of the neuro urologists. My neurologist is affiliated with Methodist so I may see if she can refer me to Dr. Boone.
    In the meantime, I will call the current urologist and express my concern about the Vesicare. What's the best way of bringing up the VCUG to him? (some doctors don't take kindly to patient suggestions)

  4. #4
    If you are in an area with plenty of doctors, and yours doesn't like patient suggestions - find a different doctor that does. Your concerns and ideas deserve polite consideration.

    If you need to keep a doctor who doesn't, I think I would say "I read about .... - what is your opinion of that?" - sort of stroke the ego, keep asking for his opinion. You shouldn't have to dance around though, ideally.

  5. #5
    Senior Member
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    Central NJ
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    Sorry, no help on your situation. But KLD's suggested neuro uro has been a blessing (THANKS KLD!), like night and day vs. still very competent community urologists. I think they just see it more, get it differrently. I say this without even knowing what VCUG is, unless it's video.

  6. #6
    Al SCI pts should have complete Urodynamics with VCUG and the prostate over age 50 can start a decreased stream etc.. so the only way you can tell is to do the complete work up. I worked at Methodist for 13 years-totaly biased- loved it! Mention Dr. Boone and he won't ask questions- he is that well known especially for SCI. If you're a veteran you could go to VA in Houston -where both doctors also go and Dr. Boone is over that area. He is Chief of Urology at Methodist and over Urodynamics.
    Great staff in Urodynamics lab at Methodist. I know them well.


  7. #7
    Had a simular problem as yours that began about 2-3 years ago. I thought I was emptying when I would go but I wasn't. This lead to an enlarged bladder. The problem got way worse after I had hernia surgery last November. I tried the Flomax and it helped for about a week or two. Prostate was not enlarged but I had a laser TURP in the hopes it would help me empty. It helped only minor and I ended up with a staff infection. Took antibiotics for 6 months to get rid of it. All this time I am REALLY straining to go. The evenings were even worse. Got to where I was going probably 18-20 times in a 24 hr perioud. Not fun. Went to Vanderbilt Univesity in Nashville and had another urodynamics test. They have all state of the art equipment. Results were that I have about 1/3 of the normal bladder funtion so I can only empty about 1/3 of my bladder each time I go. Began to self cath about 3 months ago 4-6 times a day. Had tons of anxiety and fear about self cathing. It's life changing. The good part in all this is I feel SOOOOOO much better now. No abdomin pain, no testicle pain, no bladder pain, not achey or tired all the time like I was. I will probably have to do a yearly kidney ultrasound just to be sure I am doing okay but I can live with that. Hopefully you will not end up like me but if you do just know that it is not all that bad. I did major research on prostates, bladders, TURPS, and urology and I am thankful I did. Do your homework on the subject so you know all your options. For the record I am 53 yrs old and not a SCI person. Good luck to you.

  8. #8
    I finally made contact with the neurologist I've been seeing. He told me that VCUG's are rarely done anymore, except for children with reflux. He's only done one in 14 years and doesn't think it's necessary for me. He really wants me to go ahead with the Vesicare, even though I feel like I'm retaining a lot of urine. Guess I'll see what happens.

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