Urgency/Frequency/Weak Flow

[Jbrooks4002]

I am a 45 year old male who has been suffering from urgency/frequency/weak stream, flow for about 5 years.  Though it has been an up and down battle (taking Cardura now, which only helps a little), I am  currently in a cycle that is triggered by every single bowel movement (and I have frequent constipation).   I went 6 hours a few days last week without urinating, but as soon as I had a bowel movement, my symptoms started (have to urinate every 10 minutes, and the only way for me to get out of the cycle is self-prostatic massage, hot bath in which I feel the urge badly to urinate at least 15 times and do urinate, and then take a xanax).  My quality of life is terrible because of this (I cant plan anything).  Though many are skeptical, including people from the Stanford Protocol on Chronic Pelvic Pain, I am scheduled to try a botox injection at the Brigham and Womens in Boston in a few weeks.  First, does anyone deal with the same type of problem that I have whereby bowel movements trigger the urgency/frequency (I have also awaken many times in the past year and had trouble urinating at 3AM and almost went to the ER each time because I couldnt get anything out..again, hit the bath, etc.).  And, has anyone tried the botox and what is the expected outcome?

Another URO suggested I take valium 3x a day for a month, then do a cystoscopy and videourodynamic study before I consider botox.  I had the urodynamic study about two years ago and my URO says it is not necessary to repeat. The report showed detrusor instability and some level of BPH (33grams).

Until I get this situation resolved, I feel like my life is ruined.

Thanks

[Stephen Liroff, MD]

Your symptoms certainly sound as though they have taken over your life!  A full workup with videourodynamics and cystoscopy is not a bad idea to obtain a current view of things. My experience has been that individuals who have seen multiple specialists without responding to recognized treatments often have an emotional cause for their symptoms. That is not to say that the discomforts are not real, but that the cause is not a physical one and that treatments aimed at the physical will not succeed. Rather, dealing with the emotional side of things often works in these situations. Medications for anxiety and possibly some emotional therapy can be quite effective.
Botox is a relatively new treatment for urination problems and is being tried in many situations to see where it may work. Your defecation/voiding symptoms are not ones that I have come across in the last 33 years dealing with urological problems.
Best of luck in your quest!
S.A.Liroff, M.D.

"This information is provided for general medical educational purposes only. It
does not  necessarily reflect the opinions of Henry Ford  Hospital  or the
Vattikuti Urologic Institute.  Please consult your physician for diagnostic
and treatment options pertaining to your specific medical  condition.”

[bigdxxx]

Actually i have had unbearable abdominal pain for 8 years, along with other symptoms. I do have a fequency to go to the bathroom alot, but very little comes out at times. My problem is a little different, if i hold it or i have slept for a few hours and awake and dont go to the bathroom immediately,i have alot of trouble urinating.My bladder hurts alot and it feels like i have a urinary tract infection. I was tested a time or 2 at the emergency room and it came back negative. I read they culture your urine for a day or 2 to see if you have an infection, but they never did this. Not one doctor has ever suggested antibiotics in 8 years of unbearable abdominal pain that has bed ridden me and kept me at home for years. I think tests might not always be accurate, so i am going to take antibiotics to see if it helps. I have constipation problems.Do you have any other problems like joint pain,headaches, etc. If so read up on cronic lymes disease i think i might have it. Honestly i am really sick of doctors saying these problems are a mental thing, and trying to give people antidepressants for everything. There may be some people with emotional problems that have depression and pain, but it souldnt be put on all of us.
       I had a crazy doctor at mayo clinic tell me walk, walk, walk, and if the pain doesnt go away start ripping your organs out one by one until the pain goes away.He said i was depressed and did i want shock therapy.I said with all due respect you probally need the shock therapy more then me, you crazy mf. I am the most optimistic person i know, and have always been happy, and had a good outlook on life. I have to help relatives and friends with their depression. THe only thing that brings me down is these doctors that wont listen to us. Have you ever heard of a doctor in pain,let him walk in our shoes one day,and they will be seeing things alot different.