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Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
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Subject: Re: Neurogenic Bladder is from Not MS....now what?? Hi I've posted questions before and have been impressed with your opinions, and appreciate your time. I've been having problems for about 5 months. Started with a UTI that lasted about 10 weeks, antibiotics didnt work. Primary sent me to a very well respected Urologist who diagnosed Nuerogenic Bladder. I was retaining about 600 cc after voiding. Started self-cath and am now up to about 8 per day, with goal of less than 500 cc per cath. Got rid of infection for about a month and now got another one last week. ER said it was kidney infection..high fever, back and flank pain, hard to self cath. Started macrobid. Three days later my doctor says culture came back negative, so I went off antibiotic. Still have fever and lots of pain. When Urologist diagnosed neurogenic bladder she sent me back to Primary doc saying she couldnt help because it is a neurological problem. She speculated that I have MS, and I started having tests to find out. I've had severe fatigue for about 8 months or so an Other symptoms developed like electric shock running up neck and back of skull and bottom of foot, periodic numbness in leg, it feels like it gives out and I fall a few times per week. Minor problem with right eye hurting, dizzyness, etc. Tests and results include Negative Cat Scan, Negative brain MRI, Negative Lumbar MRI, Negative IVP except shows non functioning bladder. I was diagnosed with hematuria 3 yrs ago and at that time had a negative IVP and negative cystoscopy. I went to see a Neurologist at Barrows Institute of Neurology in Phoenix yesterday. He said that although I have a few minor suggestions of MS (32 y.o. female, bladder problems, electric shock, unsteadyness) he doesnt see need for further neurological testing. Said even if I did have MS he wouldnt treat it any differently. Said he cant rule it out completely, but feels my main problem is urological. Said I have a hypo bladder and that the only treatment is long term self cath. He said urologist could do a test to see if the cause of bladder is nerve related, or if its just the way my bladder works, but he wouldnt really recommend it because no matter what the cause is, there is no treatment. Dont get me wrong, Im relieved to know he doesnt think I have MS, but I'm very frustrated with nothing being done to relieve any problems. I'm not working much because of fatigue and constant back and flank pain, headache, fever, etc. I cant help but be frustrated that the Urologist says its neurological and the neurologist says its urological. I dont really no where to turn, I'm not completely comfortable going back to the Urologist who told me she cant help, but feel that I need to do something. I know that it would be hard for you to diagnose me through this forum, but Im hoping you can steer me in the right direction. Does this sound Neurological to you or more Urological? What would you recommend I do at this point? Should I go back to Urologist, find a new one, or seek another opinion from a different Neurologist? Thanks for any suggestions you can give me. Diane
Dear Diane: I believe it is critically important to get to the cause of the neurogenic bladder. Although it is possible that your neurological problem is not treatable, this at least needs to be determined with certainty before a passive stance is taken. Also, if your neurological problem is a progressive one of some kind, it is possible that you may lose bowel control, strength of the legs, leg sensation, or even some other neurological function in the future. You need to know your prognosis. It appears that you may potentially benefit from some tests that you have not yet had. These are a spinal fluid exam and an EMG exam. Causes of a neurogenic bladder other than MS are numerous but rare. I recommend a second neurological opinion. You are welcome to see any of |
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