Neurogenic Bladder - Underactive

I have been self-cathing for 4 months, 3 times per day.  Today, my urologist advised that my options were limited due to the length of time I lived with a full or nearly full bladder. The first urges to urinate come to me when the bladder is nearly full. With the exception of the above inconvenience I am 77 and in in good health. Am I doomed to self-cathing indefinitely? Should I talk to a urologist at Cleveland Clinic for a different approach?
Damage to my #5 lumbar is a possible connection. Is Sacral nerve stimulation to excite the bladder an option? I have had multiple Cystometries and Cystoscopies, both static and dynamic.

[Kevin Pho, MD]

I would discuss with the urologist the possibility of placing a more permanent catheter - like a suprapubic catheter.  This should be considered if there is a regular and increasing frequency of self-catheterization.

I don't know too much about sacral nerve stimulation, but from what I read, it is typically used in those with urge incontinence.  It stops leaks completely in half of patients and improves symptoms in three-quarters of patients.  If your type of incontinence is urge-incontinence in nature, this approach may be considered.

You can discuss these options with your personal physician.

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.

Kevin, M.D.
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