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Thread: Reflexive Bladder and Alcohol - Voiding Priblems

  1. #1

    Reflexive Bladder and Alcohol - Voiding Priblems

    I?m a C7 20 years post injury and have always voided by reflexive bladder (also cath 2x a day to remove PVR) but recently when drinking alcohol my voiding spasms get out of sync when drinking alcohol; even if i have just one beer. It just gets too spastic but won?t release so will cause me to retain everything until I cath for relief (which while out and about isn?t always easy). Urologist thinking of putting me on something to relax my voiding pressure (currently 300).

    Just curious if anyone else has encountered this and/or thoughts on an easier fix i?m Not thinking about (aside from not drinking).

    Thanks

  2. #2
    Alcohol is a natural diuretic, increases urine output and is a bladder irritant. So your bladder is probably filling sooner than when you just drink water and spasms are being triggered by both the full bladder and irritation.

    That said, the question is why does this seem like a new problem for you? Bladder function changes over time with Spinal Cord Injury. What worked for years doesn't work as well. Often it means re-evaluating your bladder management. Have you been evaluated for detrusor sphincter dysynergia (DSD), which is a disturbance of the normal coordination between bladder contraction and external urethral sphincter muscles relaxation during voiding.

    An anticholinergic maybe helpful.
    Last edited by gjnl; 09-28-2018 at 06:02 PM.

  3. #3
    Senior Member zagam's Avatar
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    Transurethral external sphincterotomy?

    It is bad for the bladder to contract when the external urethral sphincter is stuck shut. It is also bad if residuals are high. The fix is the same.

    I am on mirabegron to settle bladder. Less effect on the guts than anticholinergics.

    Always drink 0.5L of beer with a meal.

  4. #4
    An anticholnergic may reduce your bladder pressures (300 is dangerously high) but it also may increase your urinary retention. Over time, voiding with high pressures and a uncoordinated external urinary sphincter can lead to a decompensated bladder, which no longer empties sufficiently with reflex voiding. A sphincterotomy may not help this, and meds to relax the external sphincter (Baclofen, etc.) or internal sphincter (Flomax, or other sympathetic-blockers) may not be sufficient. This may then require you to cath 4-6X daily.

    Another option, although not the first choice for this, is to go with an indwelling catheter, usually a suprapubic (SP).

    (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.

  5. #5
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    What does "remove PVR" mean and can you expound upon " voiding spasms get out of sync."

  6. #6
    PVR = post-void residual. It is the amount of urine left in your bladder after a reflex void.

    I suspect that by out of sync he means that his bladder spasms cause his urinary external sphincter to tighten instead of release. This is a condition called sphincter-bladder dysynergia and is pretty common in men with SCI/D. It is one of the reasons that we rarely recommend reflex voiding as a method of bladder management now days.

    (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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