No bladder contraction/signal

[vanvechten]

I just returned from a urodynamics bladder test where I learned that I have NO muscle signal for the bladder to contract; hence my bladder retention problem and the need for catheter use.  Isn't the following "true" in most MS cases: bladder incontinence is more common than retention; SOMETHING would have shown up on an MRI after more than a year of worsening symptoms; muscle cramping/fasiculations;hoarseness; leg weakness, all which are constant with no remissions, probably point to something other than MS?  I'm also 52.

[vanvechten]

Thank you to all who responded.  Quix, remember that I am the one with the pacemaker who had an MRI at the Univ.of PA.  A complete MRI of the head and spine was done--a very long procedure. I am using a catheter regularly.  I also have constant symptoms---absolutely no remissions/relapses. In an earlier response, you shared the possibility of Primary Progressive MS.  Whatever this is, I am getting worse by the day.  My legs cramp; when they aren't cramping, they feel like jelly.  Yesterday, I had the feeling that they could not carry me. Muscle fasc. and generalf atigue continue; left arm feels weak, although I can use it. I take Baclofen, Amantidine, Clanazepam,Wellbutrin. This week, I return to neuro with the expectation of a repeat EMG (3rd time over the course of this year.)  He told me this in last visit-Nov.2009. I get more info from you than I do him! What do you think?  Many thanks.

[summerluvr]

Hi bladder retention is one of my issues, and I have not been diagnosed with anything either, other then to say mine is due to a nerve issue also (negative MRI). I have had some instance of overflow incontinence, but usually only a smaller amount (that I am not completley embarassed!) I may not have MS, but I have something going on, but no one can figure me out. So I just wanted to let you know you are not alone in this!  

[Quixotic1]

Well, in my reading urge incontinence is the almost universal problem.  However, retention is, by far, the more serious problem.  It is also common.  It tends to occur more often as the disease worsens, but some people present with it.

It really doesn't matter.  They have found the retention, and you have the classic neurogenic bladder.  Are they discussing self catherization?

Please read the Neurology of Urinary Incontinence on the Health Pages.  It describes the various ways - beyond overflow incontinence that the whole system can be out of whack.  With pure urge incontinence, the two main muscles responsible for keep the urine in or expelling it are out of synchronization with each other.

http://www.medhelp.org/health_pages/Multiple-Sclerosis/The-Neurology-of-Bladder-Incontinence/show/758?cid=36

Sorry you are suffering from this without a diagnosis.

Yes, the tests you need if not done are a spinal cord MRI done on the highest resolution MRI around, an LP, and the evoked potential testing.

Quix

[Lulu54]

I believe retention is the more common problem.  It appears to be incontinence, but that's because since the bladder never fully empties on its on, it tends to get too full - if I understand it correctly that overflow is the incontience and urgency signals.  

At least that's the root of my problem.  

You would think SOMETHING would show up but that's not always the case.  The imaging technology, although so far ahead of 20 years ago, still has far to go.  We know there needs to be imaging of both the gray and white matter - those early forming lesions are not always visible.

Jen also asks the right question - has your spine been imaged?  That is most likely where the culprit lesion for bladder problems would be found.

be well,
Lulu

[jensequitur]

Have you ever had a thoracic spine MRI?