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Thread: Flavoxate/Urispass

  1. #1

    Flavoxate/Urispass

    Hi,

    Every now and then, especially when my bladder is full I have difficulty passing my cath. It seems like my sphincter goes into a spasm.

    My Dr prescribed me flavoxate/urispass but what I want to know is will this help relax the sphincter or will it work like Ditropan, which I use intravesically?

    Is there meds I can take this will help relax the sphincter (I was told to take PAX (diazapam)? I would also like to try and get a coude tip cath to try it but I am unable to locate them here in South Africa.

    Thanks.

  2. #2
    Uropas (flavoxate) is a urinary tract spasmolytic used to treat bladder symptoms such as frequent or urgent urination, increased nighttime urination, bladder pain, and incontinence (urine leakage). It does not relax either the internal nor external urinary sphincter; instead relaxing the detrusor (bladder wall muscle). I have not seen this used for making catheters easier to pass. Valium, Baclofen, Dantrium, etc. are striated muscle relaxants than may help to relax the external urinary sphincter, but can also cause incontinence because of decreased outlet resistance.

    Have you had video-urodynamics to see what is actually happening with your internal urinary sphincter when you try to cath? Regular urodynamics only monitors the activity of the external urinary sphincter.

    The former is smooth muscle, innervated by the sympathetic nervous system, and sympathetic blocker medications (like Flomax) may help relax this, while the external urinary sphincter is innervated by peripheral nerves not part of the autonomic nervous system. The bladder (also smooth muscle) itself is innervated by parasympathetic nerves, so drugs like Ditropan, Sanctura, etc. help to relax it or treat bladder spasm.

    I am very surprised you have not been able to find Coud? tipped catheters in South Africa. Can you get Tiemann tipped catheters? They are nearly the same. A hydrophilic catheter may also be helpful.

    (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.

  3. #3
    Thanks for the quick reply.

    No to the video urodynamics.

    Can you give me a list of these drugs; sympathetic blocker medications. I'd like to take your post plus the list to my Dr and discuss it with him. I live in a small town and he is not to clued up on SCI.

    Yes I have asked for Tiemans as well - I could only source a foley Tieman. I have contacted colplast for coude tipped hydrophilics samples, they have confirmed that they have but so far they are not responding re the samples.

    Once again thank you.

  4. #4
    Sympathetic blocker medications, also called alpha-adrenoreceptor antagonists (which work about 50% of the time to relax the internal bladder neck) include:

    • Alfuzosin (Uroxatral)
    • Doxazosin (Cardura XL, Cardura) not usually used for the bladder though.
    • Prazosin (Minipress)
    • Tamsulosin (Flomax)
    • Terazosin (Hytrin)
    • Silodosin (Rapaflo)


    All of these can result in low blood pressure which may cause worsened orthostatic hypotension in people with SCI.

    (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
    Thanks, do these meds have to be taken continuously to be effective or can one take it when needed? My BP is 120/80 (give or take a few points) so the lowering of my BP shouldn't be much of an issue, right?

  6. #6
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    Quote Originally Posted by 4quad View Post
    Thanks for the quick reply.

    No to the video urodynamics.

    Can you give me a list of these drugs; sympathetic blocker medications. I'd like to take your post plus the list to my Dr and discuss it with him. I live in a small town and he is not to clued up on SCI.

    Yes I have asked for Tiemans as well - I could only source a foley Tieman. I have contacted colplast for coude tipped hydrophilics samples, they have confirmed that they have but so far they are not responding re the samples.

    Once again thank you.
    I sent you a PM with the contact details of the person at Coloplast that I always deal with.
    T4 complete since 30 April 2012

  7. #7
    Quote Originally Posted by 4quad View Post
    Thanks, do these meds have to be taken continuously to be effective or can one take it when needed? My BP is 120/80 (give or take a few points) so the lowering of my BP shouldn't be much of an issue, right?

    You would need to take it routinely. It doesn't act fast enough to take only when you have difficulty passing the catheter.

    (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.

  8. #8
    Thanks a bunch. I am off to see my Dr today.

  9. #9
    My Dr prescribed Urodoxa (Doxazosin) 4mg when I go to bed.

  10. #10
    Let us know if this helps. Meanwhile, follow through with TheVillageIdiot above about obtaining better catheters.

    (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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