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bladder neck dysfunction

I was referred to a urologist by my gynecologist because she suspected I had Interstitial cystitis. My complaint was lower abdominal ache. A year prior to this I had two procedures to remove CIN III and have developed cervical stenosis. I have had recurrent UTI’s since my 20’s.

I have trouble urinating, frequent urges to urinate for about 3 years but has gotten worse over the past few months. My flow starts and stops and I have to concentrate/relax in order to urinate.  No pain.  When my bladder is really full, I seem to be able to urinate better.

I was examined and asked to void. a bladder scan that showed I still had a decent amount of urine in my bladder. The DR. said I was not emptying my bladder fully and scheduled me for a urodynmaic study. Also was prescribed hydroxyzine HCL 25 mg, o *This has really helped with the lower ache I was getting in my abdomen and allows me to sleep through the night, usually only getting up once to urinate compared to 3+ times without.

urodynmaic study

Uroflow summary
Maximum flow: 17.9 ml/sec
Average flow: 9.2 ml/sec
Flow pattern: continuous but fluctuating

Cystomerty summary
Testing positionspuine sitting standing. No leakage no uninhibited detrusor contraction
Compliance: normal.
EMG during voiding: quiescent
EMG during filling: normal

DR.said that I was a dysfunctional voider, no pelvic floor disorder. I was told that based on the results it was the bladder neck that was closing off while I was urinating and that this is a learned behavior. I was told that my only treatment plan would be to try and teach my self how to urinate again or to go to physical therapy.

The physical therapy is not covered by insurance.
I don’t know what else to do. I’m wondering if this is the only possible reason and treatment for my urination problem.
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647273 tn?1292094741

I don't know if what I will share here will be of benefit to you. Being male this might be different.

In 1995 at the afe of 30 I had a TURP and resection of the bladderneck after several cystoscopies. It was found that I had an obstruction of the bladderneck. I had several UTI and kidney nefections. The urologist thought that I would benefit from the TURP and resection of the bladderneck. Everything seemed to be well of about 6 months and then problems started again. Difficulty urinating.

In 1996 I underwent two urodynamics tests. The first one showed slow urination but nothing that would indicated the problems I was was having. A few months after that I was set up for another urodynamics test. The time they came back with the following "detruser dysinergia" Difficulty in controling the urinary sphynter. They diagnosed me as having a neurogenic bladder. I was told to self cath. and started doing so once a day to ensure that the bladder was emptied.
Upon the request of a neurologist the urodynamics test was repeated in 1998 after I started having some neurological problems. Numbness and lack of strength, muscle in my hands and legs. Late of 1998 I was diagnosed with a neurological disease.
In 2003 at the request of a neurologist at a rehab hospital another urodynamics test was done confirming the other two.

Currently, I have been having gastro and bowel problems for several years, and just recently had more complications because of it. I would have to go in look into my medical files to show you the results of the urodynamics tests., but there were major fluctuations in urination. Sarting and stopping. Between 1995 and 2003 I used to come down with infections every 3 to 4 months.

After my urodynamics test in 2003 it was suggested by a urologist who was treating me for erectile dysfunction, that I should self cath several times a day. I had noticed that this made a big difference in the infection rate and dyscomfort. Just recently I have come up with complications from self catheterization. I have had a catheter in for the last 3 years.

Teaching yourself how to urinate might be very difficult. It would be the oposite of doing kegal exercises. It is possible that you unknowingly have started and stopping urination un controled.

I too have abdominal pain and cramping, due to my situation this is controled through pain meds. Exept for the urinary fluctuations, you don't seem to have anything that points out a specific problem.

You should ask your doctor specificaly what sort of exercises you could do to improve your condition.

All the best.
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