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Urology (Expert Forum)
Re: Neurogenic bladder?? & chonic epididymitis
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.
Re: Neurogenic bladder?? & chonic epididymitis
by HFHS M.D.-MS, Jan 01, 1995 12:00AM
Posted By HFHS M.D.-MS on July 10, 1998 at 14:04:21:
In Reply to: Neurogenic bladder?? & chonic epididymitis posted by Daniel on June 30, 1998 at 18:31:45:
I'm a 33 year old white male who first saw a Urologist 7 years ago for chronic bact. prostatitis and epididymitis. My urine flow/stream was always way below average for someone my age. After chronic repeat infections and a poor stream, he performed video-urodynamic testing on me. I can't pronounce the diagnosis, in short he said it was a nuerogenic bladder. He recommended self-cath, which I don't do because it is very hard on my urethra. I continue to suffer from chronic epididymitis, the cord is always swollen and painfull, whether infection is present or not.
Can I truly have a nuerogenic bladder w/out any presence of other nuerologic disease? Is this a muscle or nerve problem? My Dr. scoped me and ruled out a stricture. He said the neck/sphincture of my bladder, and rectum, "go the wrong way".? I still have a hard time holding urine and voiding completely. The epididymitis is still chronic. Are there other diagnostic tests I should under-go? Please help. THANK YOU.
Dan.
=
Dear Dan
Thanks for your question.
To have a true neurogenic bladder you need a neurological lesion. This requires an MRI of the spine and a neurology consultation. Bowel function abnormalities also suggest a neurologic lesion. There is a rare, proposed diagnosis called nonneurogenic neurogenic bladder which behaves like a neurogenic bladder without the neurologic lesion. It is uncertain this is really a diagnosis. (Are there neurologic lesions which do not show up on routine evaluation?)
Psuedodysynergia is another diagnosis which looks like true dysynergia but is not sustained on fluro urodynamics . This can be treated with alpha blocker medication like BPH benign prostatic hyperplasia (prostatism). Your cystoscpic exam sounds a little like a congenital bladder neck contracture which is curable with a telescopic surgery. Please see the Medhelp SITE Search function and look up bladder neck contracture, or congenital bladder neck contracture for more information.
The urethra becomes use to the self cath with time so try starting out once a day then increase the frequency.
More individualized care is available at the Henry Ford Hospital and its urban campuses by calling (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians notes and lab test results that you may be able to obtain. These will help us greatly.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
Sincerely;
HFHS-M.D. MS
* Keyword:neurogenic bladder, dysynergia, pseudodysynergia, congenital bladder neck contracture
In Reply to: Neurogenic bladder?? & chonic epididymitis posted by Daniel on June 30, 1998 at 18:31:45:
I'm a 33 year old white male who first saw a Urologist 7 years ago for chronic bact. prostatitis and epididymitis. My urine flow/stream was always way below average for someone my age. After chronic repeat infections and a poor stream, he performed video-urodynamic testing on me. I can't pronounce the diagnosis, in short he said it was a nuerogenic bladder. He recommended self-cath, which I don't do because it is very hard on my urethra. I continue to suffer from chronic epididymitis, the cord is always swollen and painfull, whether infection is present or not.
Can I truly have a nuerogenic bladder w/out any presence of other nuerologic disease? Is this a muscle or nerve problem? My Dr. scoped me and ruled out a stricture. He said the neck/sphincture of my bladder, and rectum, "go the wrong way".? I still have a hard time holding urine and voiding completely. The epididymitis is still chronic. Are there other diagnostic tests I should under-go? Please help. THANK YOU.
Dan.
=
Dear Dan
Thanks for your question.
To have a true neurogenic bladder you need a neurological lesion. This requires an MRI of the spine and a neurology consultation. Bowel function abnormalities also suggest a neurologic lesion. There is a rare, proposed diagnosis called nonneurogenic neurogenic bladder which behaves like a neurogenic bladder without the neurologic lesion. It is uncertain this is really a diagnosis. (Are there neurologic lesions which do not show up on routine evaluation?)
Psuedodysynergia is another diagnosis which looks like true dysynergia but is not sustained on fluro urodynamics . This can be treated with alpha blocker medication like BPH benign prostatic hyperplasia (prostatism). Your cystoscpic exam sounds a little like a congenital bladder neck contracture which is curable with a telescopic surgery. Please see the Medhelp SITE Search function and look up bladder neck contracture, or congenital bladder neck contracture for more information.
The urethra becomes use to the self cath with time so try starting out once a day then increase the frequency.
More individualized care is available at the Henry Ford Hospital and its urban campuses by calling (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians notes and lab test results that you may be able to obtain. These will help us greatly.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
Sincerely;
HFHS-M.D. MS
* Keyword:neurogenic bladder, dysynergia, pseudodysynergia, congenital bladder neck contracture
