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Thread: Help! My bladder is shrinking!!!

  1. #1

    Help! My bladder is shrinking!!!

    Three months ago I could never void without cathing. Two months ago anything over 500 mls was pushed out. One month ago anything over 250 ml was pushed out. Now my bladder releases when it hits 100. What is going on????
    HELP!

    J.

  2. #2
    Sorry, I forgot to say I just started taking Oxybutinin this should help yes?

    J.

  3. #3
    Senior Member Jeff's Avatar
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    NoDecaf - Oxybutinin should indeed help. Detrol is another drug. Botox injections are also being tested for this. Intravesical oxybutinin [injected directly into the bladder after cathing] is sometimes more effective with fewer side effects than oral oxybutinin. Augmentation operations are major surgery but are nearly 100% effective. Another thing you might be able to do with 100cc residuals is simply switch to an external catheter and leg bag. Urodynamics would tell you if that's a good option or not. Soooo.....if this problem persists you will need to discuss all the options with your urologist. Which it sounds like you are doing already. Oxybutinin is definitely the first line of defense.

    Had you recently started drinking more coffee or other caffeinated beverages? Or taken up any tobacco products? These can make your bladder more spastic.

    My bladder got more spastic for a few years but then leveled off. Sheeeesh. 100cc is not enough capacity for intermittent cathing. Hope you can get it fixed!

    ~See you at the SCIWire-used-to-be-paralyzed Reunion ~

  4. #4
    Hi NoDecaf, I've got exactly the same problem. I do intermittent cathing but I have to do it at +/-200ml (otherwise leakage). I also use oxybutinin but that doesn't do a thing for me Have a urodynamics planned later this month, I really hope they can help find a solution. I'll let you know!

  5. #5
    botox helps quiet a spastic sphincter to allow flow through it when the bladder is simultanously squeezing, it does nothing to quiet a spastic bladder to allow it to hold more. this lack of coordination is what leads to AD, retention, infection, etc. (termed detrusor-sphincter dysynergia)

    the reason is that the external sphincter is skeletal muscle; the bladder wall is smooth muscle. botox targets only the histological skeletal muscle type.

    i made this error too until the uro nurse pointed it out. as far as i know it is not used to target smooth muscle anywhere in the body.

  6. #6
    Plese keep me posted Bke!

    J.

  7. #7
    Your bladder can change over time, esp. if you are within 2 years of your injury date, but also later on in life. This is why it is so important to get urodynamics done at least annually if you are having changes, and also after any new interventions (such as changes in your bladder meds). Do you have a good SCI trained urologist?

    (KLD)

  8. #8
    No, the only contact I have is my physiatrist at Magee. I need to ask him for a recommendation in South Jersey.

    Do you mean a CMG? What does urodynamics
    consist of?

    J.

  9. #9
    Urodynamics

    A combination of tests including simultaneous CMG (cystometrogram), external sphincter EMG, uroflow, and, ideally, fluoroscopy to watch the bladder and bladder neck during contraction. The full test is often called videourodynamics or a VUD.

    (KLD)

  10. #10
    Dr. Todd Linsenmyer at Kessler, West orange, is an excellent SCI urologist.

    _____________
    Tough times don't last - tough people do.

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