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Thread: Retraining Bladder neck sphincter to allow voiding.

  1. #1

    Retraining Bladder neck sphincter to allow voiding.

    L-1 burst fracture 5+ years ago. Conus medullaris damage. Saddle numbness. Can feel bladder emptying need quite well at about 200-300 ml. Maybe even less. Use IC. The bladder fullness detection works best when drinking water. I know that the detrussor muscles are involuntary but bladder neck sphincter muscles are voluntary. Is there any way to retrain or stimulate so that the sphincter can relax and allow emptying. I know that the catheter goes thru the sphincter area. Have the muscles or tissue degraded beyond restoration. Since I am fully functional walking and working and my injury is a LMNI, i am not able to find much info on this. Any thoughts?

  2. #2
    Do you void on own? Or self cath?
    pbr
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  3. #3
    Senior Member
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    If I understand your question the classic advice is to tap lightly around the pubic bone area. Sometimes it helps to lean forward.

  4. #4
    if you were performing your ic and emptying your bladder before it was over filled/stretched out, i think 400 to 450ml is the max you want to retain,you stand a good chance for bladder recovery. i think you need good elasticity of the bladder combined with relaxing of the external sphincter.
    i remember going for bio feedback for my anal sphincter muscles control maybe biofeedback is also used for bladder control . My injury is also Lower motor neuron Injury
    Last edited by metronycguy; 09-07-2018 at 11:29 PM. Reason: LMN def
    cauda equina

  5. #5
    I have to use the intermittent catheter to void. I cannot self void. I have no leaking at all. Will the tapping help to relax the spinchter. If I strain I can get a little bit of voiding. I want to somehow regain control of the ability to open the spigot. My perineal area feels constant pressure and tightness so I am wondering if all the muscles are in a constant state of tetany including my bns. (Bladder Neck Sphincter). My goal is to be able to void without the need of the catheters. Again It’s been over 5 years.

  6. #6
    Urodynamic studies are needed to determine the neurologic status of your bladder, internal, and external sphincter. If they show that you have volitional control of your external sphincter, and that your internal sphincter opens when your bladder contracts, you may be a candidate for biofeedback training. Not a lot urologists offer this therapy, so you may need to get yours to refer you.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  7. #7
    Once again caught by my ignorance of the anatomy of the bladder. The internal sphincter is not voluntary the external is. Yes, I would need to know the status, as you have stated, by having urodynamic studies of bladder done. Only a guess but I am thinking that the internal sphincter will not budge. If I have control of the external sphincter but the internal is frozen then probably not feasible. If by straining I can expel urine does that mean that I am forcibly bypassing the sphincters?

  8. #8
    Probably, and with undoubtedly unsafe high pressure.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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