Neurogenic bladder

Submitted by mosan on October 7, 2012 - 1:21pm
Body: 

I was diagnosed with a cystocele in April of 2012 by my obgyn. She left it up to me to see a urogyno physician. In June I started with a therapist that has worked in woman's health for years and she started me on all of the kegel routines. I worked diligently and 2 months later she examined me and said it really had not helped and recommended a vaginal weight.
In the mean time, she noticed a rectocele and suggested I see a urogyn. All this time my abdomen is getting larger (I think I am going the way of my mother who has always had a big belly) and it is more and more difficult to empty my bladder. No leaking or incontinence.
So in September the urogyn calls with a cancellation and I take it because for two days I just felt "sloshy" down there. I emptied 1/2 liter and they cathed 2 1/2 liters from my bladder. Needless to say, my belly went away. Apparently I was emptying less and filling more until I had reached this maximum capacity!
I have not been able to empty my bladder naturally since that day. They sent me home with instructions to cath myself and to go a much as I could on my own and cath the residual but I don't even have an urge to urinate.
Had anyone had this problem?
I'm thinking I will give this time and see if the nerves in my bladder regenerate and in the meantime start to practice the WW posture with exercises.
It's been about 4 weeks and I have been angry, devastated, and totally weird. Now I am trying to be hopeful for my bladder function to return and then just try to live with the prolapse.

Forum:

mosan

October 7, 2012 - 1:29pm

I am using estradial troche's, recommended by my therapist, to beef up the flesh so the "kegels" will work. Of course now that I understand the kegels won't help the prolapse, is there any point of continuing with the hormone.
I also think that the hormone is interfering with my sleep.
If the skin is thin between the bladder/rectum and the vaginal wall, could the hormone help. Or does it matter?

Surviving60

October 7, 2012 - 4:36pm

Hi Mosan…..Is it safe to say that you have tried everything to urinate on your own? Down on all fours in the shower or over a basin? I’m not sure what it means when there is no urge to go, and of course we are not medical people here, so hopefully someone with relevant experience can comment. Estrogen is prescribed to build up the tissues, but there are certainly a ton of reasons to avoid hormones and I don’t see how they will address the immediate issues. In my opinion it would be better for your health to concentrate on getting your urination under control and your prolapse to a point of maintenance with WW posture. Good luck and I’m sorry I can’t give a better answer. Use the search box to look for topics. Hope things get better for you - Surviving

KiwiSarahsa

October 7, 2012 - 7:34pm

Hi Mosan, I don't know if this will be relevant for you, but after giving birth to my first child 5 months ago, I could no longer feel when my bladder was full and seemed to have lost any urge sensation too. The only sensation I had was a very faint hot sensation round my uretha, which I only got when I had left emptying too long. It was this sensation that made me realise I couldn't feel my bladder anymore - I thought 'what's that? It's been ages since I peed, better go to the toilet' and sat there for ages emptying a very full bladder!

I think it was from the pregnancy and (vaginal) birth, although the cystocele I suspected could well have contributed? I can now clearly feel the cystocele since my rectocele has been less bulgy for the last two or three weeks - encouraging to see some improvement even though it's made the cystocele more obvious!

But anyway, my bladder sensation has slowly returned, and while I couldn't feel anything, I just made sure to drink plenty of water and green tea (my non-caffeinated hot drink of choice) regularly and go to the toilet regularly too - every two or three hours during the day, just sitting, relaxing and leaning forward to help empty as much as possible. As recommended in Christine's book and on this site, I also would get down on my hands and knees to pee (once a day, in the shower, so nice and warm and relaxing, and no mess ;). I haven't had any UTIs or incontinence, luckily. I practice the WW posture (I have a way to go with the posture but it is becoming part of my 'new normal') and do no kegels. I did kegels for years and throughout my pregnancy and they have not prevented my POPs. Christine's recent blog post about kegels is enlightening. Good luck!

louiseds

October 7, 2012 - 11:34pm

Hi Mosan

You might need to be patient with the return of sensation. It can take several months for tissue to regenerate if it is damaged. The muscular lining of the bladder will have distended greatly. Muscles need their full range of movement (ie filling and emptying) for maximum function. The nerves controlling this muscular bladder wall may have 'gone to sleep' because they weren't getting exercised either.

This would be a bit like a man with a big distended belly. His abdominal muscles will have little range of movement, so they lose tone, and remain stretched. It is almost impossible for him to move them at all.

I think the idea of urinating on all fours, every day, is a good one. It will allow your bladder and urethra to hang free, well forward in your belly.

Let us know how you go.

bad_mirror

October 8, 2012 - 8:43am

Mosan, what is the cause of your neurogenic bladder?

mosan

October 8, 2012 - 5:12pm

Thanks everyone for your comments, I so appreciate your support as I feel very alone in this.
They tell me that over time because I didn't urinate as often as I should have that there was nerve and muscle damage in the bladder.
To me it seemed that after the prolapse it became so difficult to urinate that it was from that point that urine began to collect more and more because I couldn't get it out ..... kinked urethra.
Doc doesn't think the problem is from the spine as I am very healthy otherwise. The option for an MRI is in the wings. It's just wait and see for now.
I can't empty at all on my own. I've tried it all.
I also agree that the kegels won't help for now, but my physical therapist is worried that down the road I could become incontinent and she wants the muscles to be strong to support this possibility.
It feels that my entire day is taken up with kegels, abdominal strengthening and now with the Whole Woman Workout which I very much believe in.

Surviving60

October 9, 2012 - 6:51am

Mosan, WW posture is really an all-the-time thing, so if you are limiting yourself to workouts and not practicing the posture the rest of the time, your results aren't going to be the same. What kinds of abdominal strengthening are you talking about? There is lots of bad stuff out there being passed off as good for prolapse, when it's really just the opposite. I'm including kegels in that statement. I realize your immediate problem is to wake up the bladder and get it going, but don't set back your prolapse work in the process. - Surviving

mosan

October 9, 2012 - 8:20pm

The physical therapist wants me doing four sets of kegels daily along with exercises on a ball and breathing. She has given me some sort of an electric stimulator that is placed in the vagina. She hopes that the bladder might get some of the effects of the contraction work.
I started the WWworkout today and it is really beautiful and I know I will look forward to working with it. It has already begun to make me aware of my posture.
Thank you for your concern.

louiseds

October 9, 2012 - 8:21pm

At the age of five DD had daytime continence problems with bladder and bowel. Doctors eventually gave up on her after a couple of years. A chiropractor had her 90% fixed in six weeks, and never had a major incident again after about 3 months' treatment. It appeared that she did not feel the fullness sensation in either bowel or bladder, so was never prompted by her own sensations to void until she had a massive involuntary empty. When she was sitting on the toilet having a wee or a poo she couldn't even tell me which it was.

Chiropractic sometimes has unexpected answers to questions that stump doctors.

Louise

mosan

October 10, 2012 - 6:55am

Thanks DD,
I'll look in chiropractor. Congratulations on not giving up. I'm so glad she is well.