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Thread: Crede and Urocholine?

  1. #1
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    Crede and Urocholine?

    Is anyone aware of a drug called Urocholine being used to facilitate better emptying of the bladder during crede?

    Eric Texley

  2. #2
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    Eric;

    They gave it to me in rehab ('96).... didn't do anything for me though.

  3. #3
    I use the crede method but I've never been prescribed anything to help facilitate it.

  4. #4

    Old methods

    Both the use of urecholine and the Crede maneuver for people with SCI is currently considered outmoded and potentially dangerous.

    Back in the "olden days" of SCI care (like the 1960s and 1970s) when we thought the only goal was to empty the bladder, these were used extensively. Urecholine makes the bladder spastic, and causes it to contract more frequently and more forcefully (read
    "with higher pressures"). It also results in incontinence, so an external catheter or padding is nearly always needed, and can have serious cardiac side effects.

    Crede was done to manually push urine out of the bladder, by pushing above the pubic bone, past an often tight external urinary sphincter or bladder neck (internal sphincter). This often caused reflux of urine from the bladder up to the kidney due to the high pressures generated.

    What we now know is that while emptying the bladder is important, it is even more important to prevent high pressures and reflux in trying to prevent both UTI and preserve the long-term function of the kidneys.

    There are very few circumstances today when the use of this drug and/or technique would be considered appropriate for persons with SCI or MS, and anyone suggesting it would be considered with some suspicion as far as how up to date they are on SCI urologic care.

    (KLD)

  5. #5
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    What about the combination of Flomax for the urinary sphincter and urecholine for the bladder itself?

    Eric Texley

  6. #6

    Combination

    This could be done, but it would have to be very carefully monitored and there would also need to be urodynamics that indicate that there is no external sphincter dysynergia. Flomax only helps with bladder neck (internal sphincter) dysynergia, and even then it only helps about 50% of the people with SCI who are prescribed it. Serial urodynamics would be needed on a frequent basis during initiation of this therapy to be sure it was safe and continuing to be safe as doses are adjusted.

    (KLD)

  7. #7
    Senior Member lynnifer's Avatar
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    I've been using crede for 17 years now. I get monitored by a Urologist once every two years and so far, no problems. Although, I do get quite a few UTI's but I believe it's because I don't drink enough. My job entails sitting monitoring a phone line and radio (police) for ten hour shifts. Since it's such a small service, you often work alone. I've gone ten hours without drinking or urinating at all ... try not to do it too often though. As I'm getting older, I've had to make some demands at work to change that ...

  8. #8
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    I would imagine that my quality of life would improve IMMENSELY if I didn't have to rely on intermittent catheterization to empty my bladder.

    In the days of the "Spin Transistor" putting something down my urethra to make me void seems like some weird practice from the dark ages. And I don't want to weird surgery either to cut my sacral nerves...

    I can't understand the lack of innovation in this area. Is the community really satisfied with this? We not only need to be concerned with CURES for our condition, but also what can be done with current technology to improve our lives NOW.

    The problem is obviously stimming both the urinary sphincter as well as the bladder in the proper manner and in the right sequence.

    Yet it seems that there are many members on this board that use Crede regularly. This was never made an option to me...

    Eric Texley

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