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Urology/Underactive bladder


I think that I have some signs of underactive bladder. I was recently diagnosed with multiple sclerosis and my neurologist asked me about bladder problems. I told him that I didn't have any difficulties, but later I realized that I do. I've just been dealing with them for so long that I don't think about it anymore, and before my diagnosis, I had just blamed my problems on having had children.

Anyway, for the last couple of years, I've had a problem with urgency. It seems to me like I don't feel the urge to go until it's nearly too late and when the urge strikes, it is intense & I have to go NOW. Since I've been paying more attention, I've noticed that I can often go a full work day without feeling the urge to go - despite drinking water on breaks, having something to drink with lunch, etc. If I do feel like I need to go, it is usually only once during the work day. It seems like a long time to go without feeling the urge. I've always tried to head off the urgency by remembering to plan regular trips to the bathroom even if I don't feel the urge, and I've never thought much about it. Now, I'm starting to worry more about it. Is that an abnormally long time to go without feeling the urge? Do I need to ask my neuro to refer me to a urologist? I've had some leakage here & there (again, I always blamed childbirth) and have had occasions when I felt like I wasn't emptying all the way (stopping and starting multiple times, or needing to again very shortly after). Do I need to get it checked out? In cases of underactive bladder, what are the treatment options? Is self-catheterization the only option?


You need to see a urologist to determine what damage, if any, has already been done to your bladder and bladder nerves.  Clearly, going all day and only voiding once is not quite normal but the reason isn't clear at this point.  

In some cases, underactive or hypotonic bladder can be treated with medications like bethanecol, but often this is not adequate and intermittent self catheterization then becomes the best option to keep the kidneys healthy.  That's why you need to see a urologist.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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