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self catheterization
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self catheterization

I have BPH and have had a cytoscopy and two TURPS to allow me to urinate. After these operations, I still couldn't urinate. My urologist said my bladder was no longer functioning and I would have to self-catheterize myself the rest of my life. I tried it and it didn't work. My urologist now tells me that "due to scarring at the bladder neck and a long urethra," I am unable to self-catheterize myself and must wear an indwelling, permanent catheter the rest of my life. This is unacceptable to me. There must be some way to resolve this problem without having to wear this catheter forever. Suggestions?
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There are some options for neurogenic bladder.  However, if none of them are considerations, then either self-catherizations or a suprapubic catheter are options.

When neurogenic bladder is suspected, both the nervous system (including the brain) and the bladder itself are tested. In addition to complete medical history and physical examination, diagnostic procedures may include:

* X-rays of the skull and spine
* an electroencephalogram (EEG) to identify brain dysfunction
* imaging tests of the bladder and ureters
* function tests that involve filling the bladder to see how much it can hold and if it empties completely

Medication for treatment of overactive bladder may improve or relieve irritating symptoms and/or incontinence. Antibiotics are important for treatment and prevention of urinary tract infections (UTIs), especially in patients with vesicoureteral reflux. Other medications may improve bladder control by increasing outlet resistance at the bladder neck.

Surgical cutting of the external urethral sphincter with the use of an endoscope passed through the urethra may allow free flow of urine into an appropriate receptacle and eliminate the need for CIC in order to empty the bladder. Also, endoscopic injection of paralytic agents directly into the external urethral sphincter muscle is another technique that provides temporary relief.

Permanent stents can also be used in the bladder neck for effective urinary transportation.

You may want to discuss these options with your urologist.

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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