Befuddled by Urodynamics testing

[LoveMyBostons]

So I had my urodynamics testing last week. Boy, what a contraptions they have you sit on! Thankfully the lady who did the testing was SUPER NICE so all of my anxiety went out the window.

I might have made a boo-boo though. I had the testing done one week after finishing IV steroids.

I was shocked when she declared that all of my muscles seemed to be working fine and that any problems I have would not be MS-related. She said that it might just be stress incontinence and encouraged me to come back for pelvic floor training exercises.

I didn’t know what to say. She kept saying “No, this is a good thing” but I can’t help but be confused by this.

When I saw the urologist two weeks before the IV steroids he discovered I was retaining 400 CC’s (13-ish ounces) of urine without even feeling like it.

This week I’m still dealing with leakage. I have it after urinating & wiping when I stand back up, when I sneeze, randomly when I walk, etc. I don't think I'm retaining still - I was urinating almost every hour for a few days last week while my body finally expelled that fluid I retained during IV week.

Is it possible that the steroids “cured” whatever bladder problems I’ve been having? Or am I too quick to blame the MS for all of my health problems? I just can’t believe that nothing was found to be working wrong!

[slightlybroken]

I do believe that you could have a mixture of incontinence issues. You could still have stress incontinence, even though you've never had children. There are other causes to stress incontinence, other than having children. It could be hormonal changes, or pelvic floor weakening problems caused from different reasons, plus there could be issues with a weakening in the sphincter and it closing due to the muscles/nerves.

I would still remind your doctor about the occasion of you retaining before the IV steroids. When they have you come in with a full bladder and then have you use the bathroom, after they cath you, you should have less than 200cc left in the bladder. 400cc is way too much! it is normal to have some urine in the bladder when then cath, even after using the bathroom because the kidneys are constantly making it, but it is not normal to have that much (more than 200cc).

Take Care

[LoveMyBostons]

Thank you guys for your input!

I don't have any children so none of my problems could be due to that.

The urologist did tell me that his bladder could not comfortable hold that much urine. And there I was, having just given them a urine sample and thinking I was empty!

I also feel very weak down there in the mornings. If I take my dogs out in the morning before I go to the bathroom myself, I find myself squeezing my legs together so as to not drip any out!  

[Tiredofbeingnumb]

Hi! I'm glad to hear that your urodynamics went well..well, as well as that test can go, anyway. :) I agree with SlightlyFlighty that you aren't being too quick to think about MS. Retaining that much urine is definitely a problem. Did they test you for urinary retention during the test? When I had mine done, I came to the appointment with a full bladder, then went in this toilet thingy (measured how much I went) and then the tech inserted the cath and got out the rest of the urine. She determined I retained about 130 ccs of urine. It was weird because I could have sworn I was empty. I would think if urinary retention was your problem, and since you did just have steroids, that they would check that to see if it was getting better. If it was, then I would think it was MS related. Of course, I am no doctor.

I guess you could have stress incontinence on its own, but it could also depend on how old you are and if you've had children or not. MS could definitely be the culprit.I mean, in the absence of other obvious issues (which I'm not sure of cause I am not a doctor), MS would be the first thing I'd think of, too. I don't have incontinence, but I did have very strong bladder urges, and she said the only reason I wasn't incontinent was because I hadn't had children. Because everything was contracting so hard (bladder and my pelvic muscles), the concern was that I could have "backflow" towards my kidneys. So, I took some overactive medication for a few days (which I then stopped, because I stopped cathing myself, long story) and I found that my bladder has been "quieter". I think I am in the remitting phase. Whoo hoo! No thanks to any doctors, either.

And, no disrespect meant, but, assuming the person who did your test was not a doctor, I would kind of question a tech that says " oh no, this isn't MS". No offense, but how do they know? I think the urologist and neurologist would know better. So, hopefully you have an appt with the urologist to discuss things. I have an appointment with mine next week. I get to explain to her why I haven't been doing the things they want me to, which, in my defense, I haven't gotten ANY support from the dr office. I have trouble cathing, call you for support, which I don't get, so what else am I supposed to do? Keep causing myself pain??

Sorry about the vent hijack. Anyway, glad the appointment went well, and it sounds like things are getting better. Yay!

[slightlybroken]

I don't think you are too quick to blame your bladder issues on MS. Retaining 400cc is way too much. In fact, I think it is twice the amount that should be in there and your doctors should not forget this occasion when this happened. You were definitely retaining too much.

It does sound like you do have stress incontinence issues as well ( when you sneeze). Stress incontinence will happen when you have a good laugh, sneeze, cough, or sometime lift heavy objects etc..But remember you could also have a mixture of incontinence issues going on.

I had the same issue after my urodynamics test as well, with the exception that I didn't have any IV steroids. I have been suffering with urine incontinence that had nothing to do with stress incontinence issues. I was having problems with that"gotta go feeling" and I also was having issues with loosing urine when I would wake up in the morning. When I would wake up, I didn't even know I was urinating on myself, until I would feel a warm sensation, and then in disbelief, I would run to the bathroom. This keeps happening, but not all the time. It comes and goes. The urodynamics test did not pick up on why this occurs. My urogyn was vague on explaining this too.

In my opinion, and I'm no doctor, I think that your retaining issues might have been helped by the steroids, or it could have just been one of those symptoms that will come and go. The steroids didn't cure your bladder issue, but may have put it in a remission.

I hope your doctor will look at the whole picture, rather just the urodynamics test. My doctor even said that sometimes the urodynamics test will not show all types of incontinence issues. I'm not sure how true this is, but this is what I was told. Maybe your doctor just doesn't understand the neurogenic bladder when it comes to MS.

Take Care