Can a flaccid bladder be healed?

[Joseph58]

I have a flaccid bladder.  At one time it held as much as 1800cc of urine.  Since I started using a catheter to void, it may have shrunk some. (I usually feel very uncomfortable now if it has as much as 1300 cc in it).  When I void naturally, I still have over 700cc left in the bladder.  So I always void using a cath.  Is there any hope that my bladder may one day function normally again?

[UncleWags]

Thank You, Dr Veena. Thank you, too, Joseph.  I have been emptying my bladder at bedtime via ISC for about 12 years; since age 70. I appreciate  Joseph's enquiry as to whether there is any hope for a resumption of normal bladder function. My bladder does not appear to be as severe as yours, Joseph. I was diagnosed with atonic bladder after a series of recurrent UTIs. Since I began using only "one time use" red catheters about 3-4 years ago, I have not had a UTI.  The stretched typical capacity of my bladder is 1200 cc.  After voiding naturally at bedtime, I SC with an 18 french, coude tipped red catheter yielding between 200 - 400 cc of urine; typically about 200 cc.  As to how I acquired my enlarged atonic bladder, I can only guess.  As a child, I was a parochial school student where we had ben  conditioned to "hold it" from 8 a.m. until 12 noon.  Then again from 12:30 until 3:30 p.m. That practice of "holding it" carried over into my non-school hours throughout my life; until my recurring UTIs
brought me under the care of my urologist. Through my urologist, I learned to recognize the neurological "signals" in my penis; in contrast to my lifelong habit waiting until I would feel bladder pressure.  Does my suspicion of "cause" make any sense? Thank you for educating us all.

[Dr_Veena]

Hi,
    Thanks for writing in. A pathway of nerves from the bladder carries messages to the brain letting it know whether the bladder is full or empty.  The brain, then using another set of nerves, sends messages to the muscles of the bladder telling them to relax and allow the bladder to empty. 

An underactive (flaccid) bladder has a large capacity (up to 2000 ml). Because there is a loss of sensation of the bladder filling, it does not contract as forcefully as it normally should, and thus small amounts of urine dribble out. In other words the bladder fails to empty completely and the urine dribbles out the urethra.

What was the neurological condition for which flaccid bladder has developed in you? If there is a complete damage to the nerves supplying the bladder then there are very little chances of normal functioning of the bladder. In mild cases of flaccid bladder hytrin can be used. In moderate cases intermittent catheterisation helps.

Depending on the nature and type of the problem, surgery (replacing the sphincter with a ring-like muscle at the neck of the bladder that normally stops urine from leaking out) may be an option.
All the best.