I have written to you many times before after having the TURP asking why my bladder was still retaining 20 oz of urine. If you remember it had stored 2 liters when the urologist drained it. Today 11/13/13 I got a second opinion. This urologist says I have a neurogenic bladder. I have looked up the causes which are below:
What causes neurogenic bladder?
Several disorders can cause neurogenic bladder, including the following:
spinal cord injuries
diseases that affect the nervous system
central nervous system tumors
spinal congenital (present at birth) abnormalities
heavy metal poisoning
I have had none of these causes. I have had to my knowledge no nerve damage. This urologist says I have scar tissue AKA bladder wall thickening and the muscle is just to weak to push out all the urine.
So once again I do not understand. Neurogenic bladder is about nerves. How can I have that when I have not had any cause of nerve damage? This urologist also says the muscle is too weak.
Can you reconcile neurogenic bladder and muscle weakness? could it be the trauma from the urine retention of 2 liters?
If you can remember you told me there may be additional obstructive tissue after the TURP that was causing the urine retention. This urologist says that does not appear to be the case. No more TUR of TURP are going to help a weakened scar tissue bladder.
Please try to explain this. Thanks
Right now I can urinate but only after my bladder holds 20 ounces.I can put out 30 or more ounces daily. IT does no good to delay to catheter because the 20 ounces retained are a breeding ground for infection which I currently have.
Please let me know what I am to expect over the next 6 months. I have to now catheter more frequently and will no know what my bladder is capable of doing. I am so frustrated.
You need to ask the physician who diagnosed you with neurogenic bladder to account for his diagnosis. Without some clear underlying neurological problem, the only way to correctly diagnose a neurogenic bladder is by special testing of the bladder muscle looking for denervation sensitivity. A nerve supply depleted bladder muscle reponds disproportionately strongly when given a drug that mimics the usual nerve signal. This response can then be measured and used to help diagnose nerve impairment. Bladder muscle weakness can be due to neurogenic causes or bladder damage from other causes such as diabetes, overstretching and outlet obstruction among others.
Urinary retention of 2 liters can damage the bladder muscle. It depends how long this lasted and what caused it. If chronic, there could be permanent bladder muscle damage.
It sounds like they have checked and determined that there is no significant obstruction remaining. In these cases, intermittent self catheterization or permanent catheters are needed.
I cannot determine what you can expect over the next 6 months as I do not have sufficient information about your case, but your local physicians should be able to answer this for you.