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Confused by urodynamic results & treatment options
  I have MS, but while it seems that everyone else with MS has
  urge incontinence, dyssynergia, etc., my urodynamic results
  revealed detrusor areflexia, large bladder capacity and residual
  urine, and severe stress incontinence with open bladder neck,
  which is why I sought evaluation. I'm sick of being wet.
  Urologist recommends Contigen injections before resorting to
  bladder neck surgery or insertion of artificial sphincter. My
  research indicates that in the presence of detrusor dysfunction
  Contigen is unlikely to be helpful (Stricker PD, Sydney). I rely
  on IC and have had 3 episodes of transverse myelitis. Any ideas
  and an explanation as to why I differ from all others with MS?  
Multiple sclerosis (MS) may affect bladder function.  This neurological disorder ususually causes detrusor hyperreflexia (overactive bladder), but in many patients detrusor areflexia (a bladder that does not contract well) is the presentation.  The accompanying residual urine increases the risk of overflow and stress types of incontinence. (Stress incontinence refers to leakage with cough, straining, changing positions etc.)
For detrusor areflexia the usual treatment is clean intermittant catheterization to help prevent urinary tract infections, renal failure, or incontinence.  If the incontinence persists, Contigen (collagen) periurethral injections may be added.  If this is unsuccessful, more invasive surgery with vesicle urethral slings or artificial urinary sphincters may be discussed with your urologist.
  More individualized care is available in person  at the Henry Ford Hospital and its urban campuses. Please call  (1 800 653 6568) if interested in setting up an appointment to meet with us in person. . We can also arrange local accommodations through this number if this is your need. Please bring any physicians
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