bladder problem and low blood pressure

[justbecrusin]

I am C5 since 2004
My bladder capicity is 100 cc and am using a condom and am taking tablets ' itren ( terazosin hydrochloride ) ' 2 mg 2 times a day and ' dimra ( methocarbamol 500 mg ± diclofenac potassium 50 mg) 2 times a day
Am fine using the condom but my blood pressure is very low 80/40 by using this tablets
What should I do ?

[gjnl]

It would be helpful to know why you are taking these drugs.

Terazosin hydrochloride (Hytrin) possibly for enlarged prostate or high blood pressure or________________?

Methocarbamol 500 mg ± diclofenac potassium 50 mg (Dimra) possibly for muscle spasms?

Have you discussed the use of these two drugs and the low blood pressure you are experiencing with your doctor. There may be other drugs you can use or different dosing methods to ameliorate the low blood pressure you are experiencing.

All the best,
GJ

[november]

80/40 wouldn't worry me unless you are having symptoms like extreme dizziness on the verge of fainting.

[justbecrusin]

I am using these drugs to help the urine pass out through the condom am wearing with no pain. Otherwise I will have a blocked bladder and it is very painfull each time I pass out urine with a very high blood pressure and sweating during the pee

[gjnl]

You may be nearing the end of your ability to use condom catheters. The sweating and high blood pressure you are experiencing are symptoms of autonomic dysreflexia, no doubt from high pressure in the bladder/ Detrusor External Sphincter Dyssynergia. (DESD)
"DESD is a serious urologic condition most frequently seen in patients with spinal cord injury and multiple sclerosis. It is caused by lesions between the brain stem and the lower part (sacral region) of the spinal cord. Damage to the nervous system can create a lack of coordination between the bladder and the external sphincter muscle, which is the muscle that controls the emptying of the bladder.

As a result, the bladder can't empty completely, which creates a buildup of urinary pressure. DESD is a combination of these two factors and can lead to serious urinary tract damage and life-threatening consequences."
http://www.americanmedicalsystems.co...mens_desd.html

You probably need to speak with the urologist and get an appointment for a urodynamics study to understand what is going on with your bladder. Neurogenic bladders change with time, and a method of bladder management you once used may not work for you as time passes.

It is likely, you will need to begin mananging your bladder with intermittent catheterization. Since you are only on the medications you mention to help urine pass, you will probably be able to discontinue those medication and/or just take an anticholinergic to deal with bladder spasms that may cause leakage and the premature need to cath.

All the best,
GJ

[SCI-Nurse]

I agree. Your bladder must have fairly high (unsafe) pressures, probably due to DSD and also bladder instability. This can worsen with time after injury, and it puts your kidneys at risk, as well as causing AD.

Terazosin hydrochloride may help with INTERNAL detrussor dysynergia, but does little for EXTERNAL DSD, and it can significantly drop your blood pressure.

Options would be intermittent cath, but only if you have sufficient assistance to do this 5-6X daily. While I do have a few male clients at the C5 level who can do this, it is difficult without a good tenodesis. In addition, with only a 100 cc. capacity, you would undoubtably require a bladder (clamshell) augmentation to be able to go as long as 4-6 hours between caths.

You might also need to consider either an indwelling catheter (urethral or SP), or consider a sphincterotomy, although this often is not sufficient to provide safe and complete emptying by reflex alone.

(KLD)

[SLIQNES]

Originally Posted by justbecrusin

I am using these drugs to help the urine pass out through the condom am wearing with no pain. Otherwise I will have a blocked bladder and it is very painfull each time I pass out urine with a very high blood pressure and sweating during the pee

Has anything changed with your symptoms?

[russianrob]

i would agree and echo everything SCI-Nurse KLD stated.