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Urology (Expert Forum)
Re: Stones with Neurogenic Bladder..few questions
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: Stones with Neurogenic Bladder..few questions
by HFHS M.D.-MS, Jan 01, 1995 12:00AM
Posted By HFHS M.D.-MS on December 20, 1998 at 19:19:01:
In Reply to: Stones with Neurogenic Bladder..few questions posted by Diane on December 09, 1998 at 18:56:17:
Hi,
I posted on your forum previously, and was very happy with your suggestions. I'm a 32 yo female and have had a neurogenic bladder since June of this year. Started with chronic UTI's and then found I was retaining urine which caused the infections. I started self-cath 3 X's per day and it has rapidly increased to 8-10 times per day. I cant go on my own at all..no sensation or urgency until 1400-1600 CC full. Went to Mayo Scottsdale and was tested for MS...received possible MS diagnosis. I developed another UTI which turned into a kidney infection almost 2 weeks ago. I'm on ampicillan 4 x's day, Cipro 2 x's per day, and had IV antibiotics twice within the last week. I also had taken 3 other antibiotics in succession just before starting these for UTI and bronchitis. They also put on a Foley Cath 6 days ago that I am still wearing. Dr. did an IVP yesterday and found a small stone right where the bladder (or Ureter) curves. Also said both uterers are stretched ( or swollen?) so he thinks Ive been passing stones previously. Said to wait another week or so and see if it passes on its own, if not we'll look into having it removed. My questions are as follows:
1) I am in an incredible amount of pain, both my back (kidney area) and my lower abdomen, as well as pain in the bladder itself. Can a small stone hurt this bad?
2) Since I am unable to void on my own and normally use a 14 self cath, can I possibly pass this on my own?
3) Im back to having a fever again today of almost 102 degrees. Do you think its advisable to continue to wait this out?
4) If I cant or dont pass it on my own, what are the options as far as getting rid of it?
Thanks in advance for your help, it's greatly appreciated!
Diane
=
Dear Diane
Thanks for your questions. Realize that I do not have privy to your entire medical case but
obstruction of the urinary system (secondary to a stone) and infection / fever do not mix. At our institution, we emergently pass a stent ( a small tube up the ureter ( tube from kidney to bladder) )to bypass this blockage caused by the stone. The stone blockage , if complete does not allow the antibiotics to get excreted by the kidney and into the urine above the stone where the infection is. The stent will allow decompression of the system so the antibiotics can work. If this is not done, you could become very sick ( sepsis i.e. blood poison ) rapidly and possibly die. We have seen young health patients with small stones get very sick this way and have to go to the intensive care unit. I would call my urologist immediately to discuss these points of concern.
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: urinary stone obstruction , Urosepsis
In Reply to: Stones with Neurogenic Bladder..few questions posted by Diane on December 09, 1998 at 18:56:17:
Hi,
I posted on your forum previously, and was very happy with your suggestions. I'm a 32 yo female and have had a neurogenic bladder since June of this year. Started with chronic UTI's and then found I was retaining urine which caused the infections. I started self-cath 3 X's per day and it has rapidly increased to 8-10 times per day. I cant go on my own at all..no sensation or urgency until 1400-1600 CC full. Went to Mayo Scottsdale and was tested for MS...received possible MS diagnosis. I developed another UTI which turned into a kidney infection almost 2 weeks ago. I'm on ampicillan 4 x's day, Cipro 2 x's per day, and had IV antibiotics twice within the last week. I also had taken 3 other antibiotics in succession just before starting these for UTI and bronchitis. They also put on a Foley Cath 6 days ago that I am still wearing. Dr. did an IVP yesterday and found a small stone right where the bladder (or Ureter) curves. Also said both uterers are stretched ( or swollen?) so he thinks Ive been passing stones previously. Said to wait another week or so and see if it passes on its own, if not we'll look into having it removed. My questions are as follows:
1) I am in an incredible amount of pain, both my back (kidney area) and my lower abdomen, as well as pain in the bladder itself. Can a small stone hurt this bad?
2) Since I am unable to void on my own and normally use a 14 self cath, can I possibly pass this on my own?
3) Im back to having a fever again today of almost 102 degrees. Do you think its advisable to continue to wait this out?
4) If I cant or dont pass it on my own, what are the options as far as getting rid of it?
Thanks in advance for your help, it's greatly appreciated!
Diane
=
Dear Diane
Thanks for your questions. Realize that I do not have privy to your entire medical case but
obstruction of the urinary system (secondary to a stone) and infection / fever do not mix. At our institution, we emergently pass a stent ( a small tube up the ureter ( tube from kidney to bladder) )to bypass this blockage caused by the stone. The stone blockage , if complete does not allow the antibiotics to get excreted by the kidney and into the urine above the stone where the infection is. The stent will allow decompression of the system so the antibiotics can work. If this is not done, you could become very sick ( sepsis i.e. blood poison ) rapidly and possibly die. We have seen young health patients with small stones get very sick this way and have to go to the intensive care unit. I would call my urologist immediately to discuss these points of concern.
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: urinary stone obstruction , Urosepsis
