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Urology (Expert Forum)
Bladder Spasm or Intestitial Cystitis - Please Please HELP ?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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 Spasm or Intestitial Cystitis - Please Please HELP ?
by Pennieh, Nov 15, 2003 12:00AM
My husband has been having trouble passing urine(since Oct 4th) and has had a urethral catheter which he did not tolerate so we were advised to have a supra pubic catheter(Oct 21st) which then caused a UTI - all this following a successful craneotomy.
He is being prescribed: oxybutynin slow release for bladder spasm plus oramorph etc for pain relief - none of which are controlling the problem.
My concern is that the Urology specialists here in the UK are 'blaming' the glioma and the Neuros are saying that they have never seen a patient with my husbands symptoms as a result of a glioma/craneotomy and that he definately has a bladder problem!
All I want is for my husband to be relieved of his distressing 'needing to pass water' symptoms!
He seems to be fine in the mornings and can pass water comfortably but as the day progresses his distress becomes more acute whereby he passes water OK but then the 'feeling to pass water' just doesn't 'switch off'.The palliative care team have prescribed morphine based pain relief but that just causes constipation which in turn aggrevates the bladder problem.
I have read a little about 'Interstitial Cystitis' and wonder if there is anything in this area which may help my husband.
Also, I am dealing with a 'Consultant Urologist' who is an expert in constructive surgery but I do not believe that this person is necessarily the best person for my husbands condition but am not sure who to approach for help - or where to go next?
The neuro surgeon is very supportive of my circumstances and is convinced that we are facing a 'urology problem' but cannot suggest anything other than another local second opinion...
PLEASE HELP ME -WE'RE DESPERATE ???
He is being prescribed: oxybutynin slow release for bladder spasm plus oramorph etc for pain relief - none of which are controlling the problem.
My concern is that the Urology specialists here in the UK are 'blaming' the glioma and the Neuros are saying that they have never seen a patient with my husbands symptoms as a result of a glioma/craneotomy and that he definately has a bladder problem!
All I want is for my husband to be relieved of his distressing 'needing to pass water' symptoms!
He seems to be fine in the mornings and can pass water comfortably but as the day progresses his distress becomes more acute whereby he passes water OK but then the 'feeling to pass water' just doesn't 'switch off'.The palliative care team have prescribed morphine based pain relief but that just causes constipation which in turn aggrevates the bladder problem.
I have read a little about 'Interstitial Cystitis' and wonder if there is anything in this area which may help my husband.
Also, I am dealing with a 'Consultant Urologist' who is an expert in constructive surgery but I do not believe that this person is necessarily the best person for my husbands condition but am not sure who to approach for help - or where to go next?
The neuro surgeon is very supportive of my circumstances and is convinced that we are facing a 'urology problem' but cannot suggest anything other than another local second opinion...
PLEASE HELP ME -WE'RE DESPERATE ???
Doctor's Answer
by Kevin Pho, MD, Nov 18, 2003 12:00AM
, Nov 18, 2003 12:00AM
If your current urologist is not providing satisfactory options, you may want to consider another opinion.
Bladder spasm is an unfortunate side effect of catheters. However, it should have a lower incidence with suprapubic catheters. The oxybutinin should help control these spasms. There are other agents that also are used in controlling the spasms. You may want to discuss options including Detrol, Propantheline, Flavoxate, or Hyoscyamine as other options with your personal physician.
Another possibility would be prophylactic antibiotics to reduce the incidence of infection which can exacerbate the spasm.
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.
Bladder spasm is an unfortunate side effect of catheters. However, it should have a lower incidence with suprapubic catheters. The oxybutinin should help control these spasms. There are other agents that also are used in controlling the spasms. You may want to discuss options including Detrol, Propantheline, Flavoxate, or Hyoscyamine as other options with your personal physician.
Another possibility would be prophylactic antibiotics to reduce the incidence of infection which can exacerbate the spasm.
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
by jamis, Nov 29, 2003 12:00AM
To: Urology - General
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by Janswen, Dec 12, 2003 12:00AM
To: Urology - General
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