Urogynecology Expert Forum
Constant Bladder Pressure Before, but worse after hysterectomy
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Questions in the Urogynecology forum are answered by Bruce Crawford, MD, J. Kyle Mathews, MD, and other medical professionals and experts. Topics covered include overactive bladders, bladder pain, fallen/drooping bladder, bowel urgency, bowel prolapse, cystitis, incontinence, pain with intercourse, rectal prolapse, surgery, urinary urgency, and uterine prolapse.

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Constant Bladder Pressure Before, but worse after hysterectomy

In Aug 07 the tips of my 2 big toes went numb.I eventually went to the doctor who said she had no idea what would cause it,so I let it go.In Oct, I began having some bladder issues. I felt like something was pushing on my bladder but the symptoms came and went.I finally went to the GYN in Nov. He said I had prolapsed uterus. I had a TVH on 12/17/07. Surgery was "uneventful".Within a week after surgery the pressure started coming back..gradual at first, then right back to the way it was b4 surgery. At 2 week postop visit I told him about it. He said it was probably my bladder readjusting.Within a few days after that my discomfort was UNBEARABLE and I went to the hospital.They had no explanation.The bladder pressure would ease some but never went away.Within another week I truly thought i was going to die! The pressure had kept me up all day and night for nights.I have been hospitalized for the pressure with my GYN telling me he had no clue! They did a CT scan that showed nothing.No pain medication helped anything.He sent me to a urologist in Atlanta who told me I had retention.I came back in a couple of weeks for a cysto and urodynamics. Cysto showed everything looked fine but the uro showed that my bladder was not contracting.By this time, the pressure had turned into just feeling like I had to urinate all the time.NOTHING HELPED.I could not sleep, eat, and became depressed.The doc gave me flomax.The feeling did start easing but didn't go away.Slowly the feeling eased more.But I got a call from my GYN earlier this week, who told me that the urologist in Atlanta thinks I need to see a neurologist for possible MS. I have been on zoloft now for about 5 weeks.I had a  psychiatrist who gave me heparin and that night I slept all night for the first time in all these months! I am finally starting to feel normal again but am waiting to hear from the neuro. I'm scared.Is it possible that it has just taken me several months to recover from my bladder readjusting? or MS?
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It seems the main symptom is bladder pressure. The urologist should have told you if your bladder is emptying well or not. If your bladder is able to empty well, this should be picked up by passing a catheter in your bladder after you empty your bladder. If your bladder is emptying well, then the amt left after emptying should be under 50cc. If this is the case, then your emptying function is adequate. I Vaginal prolapse (cystocele/rectocele) can also create a feeling of bladder pressure. Get evaluated for prolapse. If there is no significant prolapse, consider an evaluation by a pelvic floor physical therapist to look for pelvic muscle trigger points, which can also create a feeling of bladder pressure. To look for MS, you would need an MRI of the brain and spine, and the radioligost can tell if there are any MS lesions. However, complete the prolapse and PT workup first, unless you have other MS symptoms like difficulty walking..

Dr. Hoyte
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J. Kyle Mathews, MD, DVMBlank
Plano Urogynecology Associates
Plano, TX
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