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Treatment Options for a Neurogenic Bladder

My Urologist has indicated that I probably have a neurogenic bladder (NB).  NB seems likely from what I have read online.  Once I straight catherized myself (first time ever...ouch...couln't deal with someone else doing it) at the doctors office I found that I had retained 1500 ml of urine.  Subsequent ultrasound of kidney's showed no damage (thank goodness).  Unfortunately before my visit to the urologist I had been, apparently, misdiagnosed with BPH in 1999.  Therefore, I believed that difficulty urinating was a result of BPH.  I'm 44 years old/230 lbs otherwise in good health.  I was catherized as a child as an attempt to diagnos bed wetting cause. Cause of NB is unknown at this time.

I have been scoped with light anethesia. I anticipate my new Urologist will be sending me for testing to determine pressure capability of my bladder.  I now catherize 4 to 5 times per day.  At night I wake with a sensation of fullness.  Max offload of urine at night has been +/- 1000ml.

I would appreciate any advice or treatment recommendations you might have as I confront this NB challenge.  I have some questions:
1. What can I do (exercise, weight loss), if anything, to reverse the apparent atony of my bladder?
2. Is there a preferred catheter that will minimize damage (scarring) of the urether?

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To answer your questions:
1) The following are treatment considerations for neurogenic bladder that you may want to discuss with your urologist:
- prophylactic (preventive) antibiotic therapy (to reduce the incidence of infection)
- placement of an artificial sphincter - a procedure that involves placing an artificial cuff around the neck of the bladder that can be inflated to prevent urinary incontinence and deflated when it is time to empty the bladder. You will still require intermittent catheterization to completely empty the bladder.
- surgery

2) To my knowledge, I am not aware of a specific catheter that would be less scarring than others.  I would think that the catheter that was recommended by your urologist would be safe for the intermittent catheterizations you are doing.

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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