decompensated bladder

[JVC__0]

  I have been an intermittent catheter patient for 9 years.Prior to this,I was treated for constant  bladder infections and prostititus.I am also an endurance cyclist.No one (urologist)told me that my prostate was exceptionally large.It was restricting the flow of urine and leaving some behind each time. My bladder compensated by slowly enlarging.Over how long a period,I'm not sure, but when I finally went into ER,they drained 2700 cc from my bladder and inserted a foley catheter to give it a rest. After 10 days it was removed, but I was back in two  days later.I had two urodynamics tests about 6 months apart and I flunked them both.(this was over 8 years ago). I cannot urinate on my own, however sometimes two social glasses of wine will allow me to urinate a little.(I do not drink as a rule).
  Are the detrusors gone for good? Would kagles have helped? A TURP under these conditions was obviousley ruled out,but if I had one, couldn't it help a little or would there be a danger of incontinence? I am now a 68 year old male,6:2, 190lbs, in excellent health,all my own hair and none of it gray.

[HFHS M.D.-CK]

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Dear JVC,
Unfortunately, urinary retention secondary to bladder outlet obstruction may have long term consequences.  Not only can the bladder muscle(detrusor) lose its tone, but also pressures can build up in the bladder leading to renal failure.  Patients with symptoms of lower urinary tract problems should have yearly urinanalysis and blood tests for kidney function (creatinine) to help catch such problems before they become irreversible.  
In regards to your specific questions, Kegel pelvic floor muscle exercises would not help.  Currently, we do not have a good medication to make the bladder muscle function correctly.  The best long term treatment for an atonic (noncontracting) bladder is clean intermittant catheterization.  Experimental treatments have included surgically wrapping rectus abdominal musculature around the bladder for voluntary bladder emptying.  This invasive procedure has mixed results and has rarely been performed.
This information is provided for general medical information purposes only. Please consult  your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available through our department at the Henry Ford Hospital  and its suburban locations (I-800-653-6568).
Sincerely;
HFHS M.D.-CK
  * Keyword: atonic bladder, urinary retention

[mike654]

A related discussion, bladder muscle decompensation was started.