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Thread: Anticholinergics and Supra Pubics

  1. #1

    Anticholinergics and Supra Pubics

    I am 7 weeks post Supra Pubic surgery. Before that I was about 6 weeks on a urethral foley. Started having a lot of Automomic Dysreflexia. Not full blown, but a lot of background stuff for about 4 days. NL suggested that maybe I was having bladder spasms and would have to start taking anticholinergics. Talked to the urologist and he said that he doesn't have anyone with a Supra Pubic that isn't on anticholinergics.

    Is this universally the case? Can you have a Supra Pubic and not be on anticholinergics, at least after some short period of time???

    Do I need to get an Rx for anticholinergics.....which one is the best one to go on? Is there and anticholinergics that has less impact for dry mouth?

    I took anticholinergics for a few year around 2003, but hated the impact of dry mouth, dried out sinuses, problems with bowel motility...
    Are there newer and better anticholinergics on the market today that aren't as irritating???

    All of you out there with a Supra Puvic, what is your experience?????

    Many thanks
    gJ

  2. #2
    Senior Member
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    I've had my SP for 3 years and don't take anticholinergics, don't really have a problem with bladder spasms though.
    I think they all have some degree of dry mouth/sinuses/eyes etc side effects, it's the nature of the beast.

  3. #3
    i think the older meds such as ditropan ( oxybutinin ) and detrol have the most side effects. there are newer meds such as sanctura, toviaz, enablex, etc

    i take enablex and i have no side effects. i took detrol and ditropan and couldn't stand the dry mouth.

    you should give it a try!

    lola
    "All that is necessary for the triumph of evil is that good men do nothing" ~ edmund burker

    c4-5 quad

  4. #4
    It is common for indwelling catheters to cause bladder spasm, leakage and AD for many people with SCI. Anticholenergic meds usually are the solution. The newer ones such as Sanctura may have less side effects, but this is very individual for each person, and generally takes a trial-and-error approach to find the one best for you. If all fail or have untoward side effects, then bladder Botox can also be considered.

    (KLD)

  5. #5
    I didn't use anticholinergics when I was on an intermittent cath schedule. I never had a problem when I would wear an indwelling urethral foley catheter, but I never wore one of those for more than a couple of weeks at a time. I guess that was never enough time to have the bladder shrink significantly. Now, 7 weeks after getting the Supra Pubic, I started to have constant, but thankfully low level autonomia. The urologist suggested oxybutynin (generic) and does it ever have the bad side effect of dry mouth!!!!! I am only taking 10 mg per day. The autonomia is gone.

    Question: Why does the small baldder cause bladder spasms? The bladder isn't holding anything, since all the urine just passes right through the bladder with the Supra Pubic. I would like to understand the physiology involved. Thanks

    Thanks also for the names of newer drugs.

    GJ

  6. #6
    I'v had an sp tube since 1977 or 79 and took probanthine for a couple of yrs . Have taken nothing over at least 20. I'm a C5-6.

  7. #7
    Quote Originally Posted by gjnl View Post
    Question: Why does the small baldder cause bladder spasms? The bladder isn't holding anything, since all the urine just passes right through the bladder with the Supra Pubic. I would like to understand the physiology involved. Thanks
    GJ
    It is not the small bladder that causes the bladder spasm, although a shrunken bladder will spasm at a lower volume. It is the constant irritation of the catheter and balloon inside the bladder that causes both the AD and the bladder spasm and leakage.

    (KLD)

  8. #8
    1- the dry mouth and constipation are common side effects of anticholinergics in urological patients.
    2- there are new drug classes that might control bladder spasms without the need for anticholinergics.
    3- most of the suprapubic tube patients need some sort of bladder spasm management especially early on>
    [URL="http://ammanurologist.com"]

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