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Urology (Expert Forum)
BLADDER
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
BLADDER
by dlb, Jan 18, 2004 12:00AM
First of all - I’m a 51 year old female. I am what is called head injured, due to an accident I had 18 years ago. Reading the prior info really hit home, because my main injury was to the brain stem! Up until about five years ago, everything worked very normally. Then I started having what physicians have told me are bladder spasms. I would like to add that none of the people I’ve dealt with have given me any satisfaction. Not at all!
When prompted for problem, there were so many on there that I’ve dealt with! I’m plagued with UTIs! I’m afraid my problem seams to be neurological and I am ever so sick of going to Urologists and physicians in general that do not seem to have the first inkling of how to handle my problem! Their answer was to catherize (SP) me which does help with # of spasms, but certainly doesn’t stop them. I am in a wheelchair and have found out over the past years that my spasms are much better the once a year Medicare allows physical therapy! (I’m afraid the therapy involves exercise I can not do alone!) My question is simply where to go for help?
When prompted for problem, there were so many on there that I’ve dealt with! I’m plagued with UTIs! I’m afraid my problem seams to be neurological and I am ever so sick of going to Urologists and physicians in general that do not seem to have the first inkling of how to handle my problem! Their answer was to catherize (SP) me which does help with # of spasms, but certainly doesn’t stop them. I am in a wheelchair and have found out over the past years that my spasms are much better the once a year Medicare allows physical therapy! (I’m afraid the therapy involves exercise I can not do alone!) My question is simply where to go for help?
Doctor's Answer
by Kevin Pho, MD, Jan 20, 2004 12:00AM
, Jan 20, 2004 12:00AM
Unfortunately, a neurogenic bladder can be a difficult situation to treat. A urologist would be the most logical specialist to evaluate this problem. There are also physiatrists and rehabilitation specialists which may help if the urology referral is not revealing.
A spastic bladder is best treated with medications that "slow" the bladder by decreasing transmission in the nerves to the bladder that cause it to empty. These include oxybutynin (Ditropan), tolterodine tartrate (Detrol), hyoscyamine (Levsinex, Levbid, Cystospaz), flavoxate hydrochloride (Urispas), and imipramine (Tofranil). These medications lengthen the intervals between urination and decrease urgency.
Make sure that infection is ruled out - since this is one of the more common causes of spasm. You may want to consider chronic antibiotic supression to improve the symptoms.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
A spastic bladder is best treated with medications that "slow" the bladder by decreasing transmission in the nerves to the bladder that cause it to empty. These include oxybutynin (Ditropan), tolterodine tartrate (Detrol), hyoscyamine (Levsinex, Levbid, Cystospaz), flavoxate hydrochloride (Urispas), and imipramine (Tofranil). These medications lengthen the intervals between urination and decrease urgency.
Make sure that infection is ruled out - since this is one of the more common causes of spasm. You may want to consider chronic antibiotic supression to improve the symptoms.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Member Comments (1)
by chilloutguy, Jan 28, 2004 12:00AM
To: Urinary Tract Infections
0
by chilloutguy, Jan 28, 2004 12:00AM
To: Urinary Tract Infections
0
