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Thread: SCI Nurse, Please explain my urodynamic report and advise

  1. #1
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    SCI Nurse, Please explain my urodynamic report and advise

    I am sci c6 8years post injury person. From last 6 years I am on external catheter. Previous month I had my urodynamic test. Dr was saying that external catheter is not a safe option as it has the potential to harm kidneys by urine backflow. As I cannot do intermittant catheterization my self so I have only two choices ie indwelling and superapubic. He advised me to take Taivor tablet daily.

    I am attaching my urodynamic report.please explain in simple words my bladder condition. looking at bladder condition in the report can I continue with external cathater because I am at ease and happy with it.
    thanks
    Last edited by asif; 05-21-2010 at 03:57 AM.

  2. #2
    Quote Originally Posted by asif View Post
    ...I cannot do intermittant catheterization my self...
    why not? lots of folks w/ C6 injuries IC, including myself.

  3. #3
    ASIF
    You are 28 years old and you have a long life ahead of you, you do not want to mess up your kidneys because of high pressures!!!! can you catheterize yourself? Your urodynamics study shows you do not empty your bladder. You probably get infections all the time and you are going to get kidney and bladder stones and possibly kidney damage eventually.
    Your bladder is leaking constantly because you have a small overactive bladder (the newest term-NDO-neurogenic detrusor overactivity with detrusor sphincter dysynergy (DSD) the sphincter won't let the bladder empty because it spasms and there is nothing that we can really give to totally help it- but cathing and anticholinergic to relax and help the bladder hold more.
    That is why your are leaking all the time-take the medication and see if it helps relax it and decreases your pressures? You MUST cath your self because your pressure is too high and this pressure can cause back up in to the kidneys and the tubes that come from the kidneys may back up.
    So take the medication- an anticholinergic such as prescribed- my physician loves Oxybutynin but whatever your physician orders. Catheterize every 4-6 hours and if you leak wear condom cath in between. Botox is a possible future option if you leak in between. For future thought- and can't cath through penis-intestine can be added to bladder to enlarge bladder and put stoma opening on abdomen so catheter can be in inserted through little opening on abdomen to make you independent-(Mitranoff procedure)
    CWO

  4. #4
    Nurse what is considered a high bladder pressure? I thought on his report I read the average was 20 but it spiked up to 38.

    I ask because when I had mine done the nurse acted like 20 wasn't anything to be worried about. It would be best if I get a report of mine too.
    The place wasn't a SCI facility.
    Aerodynamically, the bumble bee shouldn't be able to fly, but the bumble bee doesn't know that, so it goes on flying anyways--Mary Kay Ash

  5. #5
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    i'm 33 years post, C5/6 complete. Condom drainage since start. Urodynamics reveal a high bladder pressure but the kidneys are in great condition due in part to the formation of a not insignificant diverticulum which acts like a safety-valve, a kind of twin-sister blown out from the side of my bladder. Bladder walls trabeculated also. My urologist advises a flip-flow s/p cath with operation to remove diverticulum and repair bladder wall. However, my Consultant has over-ruled this as my bladder functions OK, infrequent infections (controlled with Vit C and cranberry juice, about 2L water) and she just loves my kidneys telling me they're in no danger! Whose advice do I take SCI-nurse?

  6. #6
    20 ml might be great. I had 50 ml pressure when I had my urodynamics May 18, 2010.
    My urologist said my pressure had been 100 ml in my last test.

    I had a Botox injection in the sphincter Jan 12, 2010 and have not had a UTI since then.

  7. #7
    Definitely nothing over 40 at rest, prefer nothing over 13. When voiding, prefer nothing over 50. If it is one little spike might be okay a little over 50(called your pdet.
    Re: diverticuli, as long as it is a wide mouth diverticuli(tic) and not having a lot of UTIs and if you cath you can press on it(crede) and it drains, we don't advocate or see the need for doing surgery on it- kind of like your own little bladder augmentation of course you have to keep the pressures down because theoretically it could bust/leak from increase pressures so....take the anticholinergics,do the Botox, have routine urodynamics and cath regularly and crede' the tic to empty it and surgery really shouldn't be indicated BUT if the pressure is really high or the surgeon sees that it is thin walled on CT scan or you are a noncompliant(don't do what we tell you to do) patient, pressures are high,tic can't be emptied with cathing, too many infections, or some other indication- then surgical removal of tic might be indicate beause you don't want that tic to leak or burse.
    You might can tell I am very handson with Urodynamics everyday.
    So ask these questions and find out where the doctor is coming from to make your decision. It is all about keeping you and your bladder and kidneys safe.
    CWO

  8. #8
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    Quote Originally Posted by SCI-Nurse View Post
    ASIF
    You are 28 years old and you have a long life ahead of you, you do not want to mess up your kidneys because of high pressures!!!! can you catheterize yourself? Your urodynamics study shows you do not empty your bladder. You probably get infections all the time and you are going to get kidney and bladder stones and possibly kidney damage eventually.
    Your bladder is leaking constantly ....)
    CWO
    Thanks SCI Nurse for all the explanation and telling about all the potential dangers. you mean that I have two problems
    1.High bladder pressure
    2.Low bladder capacity
    Now because of high bladder pressure urine flow back to my kidneys and there can be danger of kidneys damage. Because of not proper emptying there can be danger of bladder stone. Right now I cannot use intermittant catheter. Now if I regularly start using oxybutynin tablets for bladder pressure reduction then will my kidneys be safe?
    Will the tablets also increase my bladder capacity ,how can I increase my bladder capacity?
    What about all those who are using only condom for decades, what are ideal bladder pressure and capacity for using condom catheter?
    My Dr is thinking about superapubic catheter for me, Now please tell me about that I mean what can be its potential dangers and is it reversible ?
    Thanks alot
    Last edited by asif; 05-23-2010 at 11:25 AM.

  9. #9
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    great info, SCI-Nurse, invaluable actually, many thanks. so, urodynamics indicated, say, every 2 years?

  10. #10
    Let me look back and see if your pressure at rest was high- we call that loss of compliance- over time collagen builds up around the bladder and makes it harder to fill and the pressure builds -"stiff bladder". Can some one cath you? Also there is a product called the "Quad cath"? have you tried that? the problem with taking the anticholinergic is it relaxes your bladder and your won't leak as much and it will decrease your pressure in one way but you don't empty and might make yournot emptying problem and pressures worse.Doctors usually won't prescribe if you don't cath atleast 2-3 times a day but ask him. Can someone cath you and empty you atleast 2-3 times a day?Have you tried cathing with devices? ask OT.Do you have tenodesis/splint?
    Have you tried the quad cath? I can' think of the name of the company right now-try googling - quad cath-it but I will get it at work tomorrow and put it in. or someone else has probably tried them.They will send you free samples to try.
    RE: UDS arudies-Every year or every other year-if not an areflexic bladder, bladder aug who might only have every 4-5 years, no frequent , change in pattern , change in annual renal ultrasound or something ike that everyother year might be okay. They typically don't need as often.VA does yearly on most.Recommendations should come from your SCI doctor after getting history and SCI urologist based on your study and what is going on with you every year and results of the the current Renal ultrasound.
    Those with indwelling catheters should have a screening cystoscopy with bladder washing after 6-8 years to look for bladder cancer- there is an 8-10 increase of bladder cancer with an indwelling tube in. This should be done or every 1-3 years of if hematuria develops without an infection yearly.
    CWO

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