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Thread: A common occurance?

  1. #1
    Senior Member TD's Avatar
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    A common occurance?

    I have been on Ditropan XL (25mg once a day) for about six months and have recently been instilling regular ditropan at night before going to bed. As with most SCI my urine output during the day is minimal until I raise my feet at night while sleeping. My overnight output has reached as much as 900 ml in four hours some of which I leak into a bedside bag through a condom catheter. My urologist says my bladder pressures reach dangerous levels at 300 ml and wants me to cath often enough to keep my bladder volumes below this level. I have tried limiting my fluids in the evening to reduce my overnight output to no avail. I have tried raising my feet early which has produced enough urine to cause leaks every two hours with volumes of 400 to 500 ml and still my overnight output is high.

    I have recently begun noticing that my urine is a little cloudy which indicates an infection but I am not running any fever or suffering any of the normal symptoms of a UTI. With my high volumes I have become concerned that this mild infection will back up into my kidneys causing damage.

    I would like to know if there is anything I can do to raise my output while I am awake to prevent high volumes overnight. I would like to get at least 5 hours of uninterrupted sleep but to do so means I have to put up with high volumes.

    Does anyone else have these sorts of problems? If so, what did you do to alleviate them? It has become such a nuisance that I am seriously considering having a stent placed to alleviate the pressure problems even though I know the stent comes with problems of its own.

    "And so it begins."

  2. #2
    TD, this is a very common problem. Do you wear compression hose during the day? This will limit the extent of this problem. Elevating your legs for a while mid-day will also help it (but don't elevate all the time as this increases your risk of ischial skin breakdown).

    How much fluid do you take during the day, and when?

    You may also have a problem with insufficient ADH (anti-diuretic hormone) release at night. This occurs in some people with SCI. The only way to tell is to have your blood levels measured at 2AM and 2PM and compare the two. If this is the case, medication such as DDAVP has been used to decrease urine output at night.

    (KLD)

  3. #3
    TD, it seems to me that perhaps the solution is for you to raise your feet up for an hour or so every few hours during the evening so that you can shift some of your fluid from your legs into your systemic circulation and cath, so that you don't have all this accumulated fluid from the legs loading your bladder at night. If you are able to get rid of 500 ml of fluid this way, you won't overfill your bladder at night. Wise.

  4. #4
    Senior Member smokey's Avatar
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    IC at night

    I cath myself during the day a couple of times and only get 200cc-400cc with each cath. At night, I insert an interrmittent catheter, tape it to my penis, connect it to a bedside night drainage bag and piss 1500cc-3000cc during the night. I get a good night's sleep, don't experience and wake up from AD, and can drink liberal amounts of fluid before I go to bed AND during the night. It seems to work for me, I do wonder if in the long term my bladder will shrink up to the size of a walnut and won't be able to hold much during the day.

  5. #5
    TD, I've found that exercise, especially on the floor, has helped tremendously with this problem. The more I move the better the flow.

    Onward and Upward!

  6. #6
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    My 21 yr old son is C-7 complete - 3 mos post. He has extremely high volumes of urine output at night. During the day he caths every 6 hours and only gets about 200 cc. At night he has to cath every 2-3 hours to keep the volumes down and has had as much as 1400 cc within a 2 hour cath period. We are new to this, but know that is way too much. At first he would get AD symptoms and we would know that we needed to cath. Now most of the time he doesn't know, so he feels like he caths all night, which makes him extremely tired during the day. We have tried Lasix, elevating feet, going to bed earlier - but he still has high volumes within the first 5 hours of sleep. What can he do??? What exact damage can this do to his bladder and kidneys, and how would we know? Thanks for any help!

  7. #7
    Senior Member alan's Avatar
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    The nurses once said in an earlier thread to do most of your drinking early in the day, and not much in the evening, so most urine will be formed during waking hours. More urine is produced when laying down (the reason why able-bodied people usually have to pee first thing in the morning), but if there's less fluid in your system from which to create urine, you'll produce less during the night.

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