Urinary retention versus overactive bladder

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Hi, it’s me again. I have a question. I’ve been to a few urologist because I’m leaking urine almost every five minutes if not more. And it’s very small amounts.

The doctor that ran the cystoscopy and urinary dialysis. Has concluded I have urinary retention. And believes Medtronic neurostim stem would be my best bet.

However, I visit another urologist for a second opinion. And he said I empty my bladder fine. And would put me on medication for overactive bladder, as well as Flomax.

These diagnoses seem to be conflicting. And it’s my understanding that if you have urinary retention, you really shouldn’t be taking medication for overactive bladder. As it will make your bladder store more urine.

Anyway, I’m curious if anyone in the group has had the scenario where one doctor is claiming urinary retention and another is claiming overactive bladder?

Thanks, Michael

 

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For what I can add:

15 years ago I had problems with over active bladder (femal, three births, age 63) went to a bladder PT. Did a bladder journal (measurements with comments) and was told I should not be urinating so frequently. Tried drugs. Did not work. Went to a PT for training. Kegels, etc. Use of light weight pads. Finally tired of fear of major leakage, accidents. And Such. Three weeks ago I started a STIM program. What a huge difference. I can now go long periods of time without needing to urinate. And now l I get is there a “key in they door” urge to immediately urinate upon walking in the front door. This had been a life saving( i.e. lack of fear of leaving home for fear of and “accident” outside of home) change. Try it. It works.

 

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I had a sonagram done of my bladder at the first visit and was asked if my bladder was empty. It felt that way until the test and the pushing made me feel like it was full. The test showed 40% according to the technician. I was then scheduled for a cystoscopy and that showed nothing. I have sudden urges. Caused by running water, walking, movement, cold, or just because. Sometimes and thankfully not often I will void with no warning and will not know it until I feel the wetness somewhere. Flomax did nothing and just wasted money. Myrbetriq gave me better control. I could hold those little urges. Those urges actually feel like lesser pain feelings I had with the cystoscopy when the doctor passed the tube into or out of my bladder. So they may be little leeks. I did the full stim test. It made me feel bad when it was on my left side and higher frequency. My legs were week and I just felt really bad. After they switched to the right side and lower frequency I started feeling better. Most of the test was on the left side. The results were the same in that it worked for a short time and then I had to increase the setting. Just kept going up and up. Stim techs seemed to think they could dial in a program that would work. I was really pretty dry on the test about half the time. It depends on how close I am to the bathroom I am and how quick I am able to void. Most of the time I just spend at home in my underwear as it is quicker to start. Jeans seem to be too slow and by the time I get them unzipped I will start as I am pulling out. The cases of going and not knowing are when I am not able to get to a restroom and keep trying to hold those urges. I cannot really tell if I held the urge or not until I check my pad of TP in my underwear. Myrbetriq gave me better control as my TP pad was drier and I could use less TP. That slowly faded and before all the tests my doctor put me on Alfuzosin. That gave me better control for a very short time and then back to where I was before I started it. It did however help with my frequent nighttime trips to the bathroom. Before I was up every 2 hours. Now I can sleep 3-4 hours before I wake to go to the bathroom. I am lucky as I have a small prostate. My PSA has been inching up the last 5 years. It was just under .5 and is now just under 1. My urges are not as often as you have. I have had a little dribbling before or after voiding as long as I can remember. Not enough to cause anything but very minor dampness. Doc wants to do the permanent stim in June. I am on the schedule, but I am still thinking it over. I have a history of DVT's and will have to start painful shots in my abdomen 5 days prior to surgery when I stop my blood thinners. Instructions say I cannot start blood thinners for a week after surgery and I will be back on the shots for that whole week and then until my blood thinners get me back in range. The shots are 2 a day. They are also expensive. But so is the medication I am taking. It will be worth it if it works. Save me money on meds and TP in the long run. Doc says it is OAB as I have these sudden urges that are difficult to control. I just started Medicare a year ago. That is when the testing started and it seems that my doc can now do the tests and surgery and get paid for it. My private purchased insurance prior hated to pay for anything that was not life threatening.

 

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I have OAB. I only leak a little when the bladder is overly full.

In the beginning the nurse would always have me empty my bladder and then do an ultrasound to check for retention; always empty.

After that, I had several cystoscopies with dilation treatments.

I was prescribed Tamsulosin/Flomax.
NOTE: Be aware that this drug can cause complications during cataract eye surgery - even if only taken once years ago. So, never forget that you have taken this drug, and tell your eye surgeon.

Then, I had the Urodynamics test. Hated that one!

I had the Medtronic Interstim implanted. (I am on my third device now.)

To improve my stream, I had the REZUM procedure to reduce the size of my prostate.

 

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I advise caution. If you actually do have retention, medicine for an overactive bladder can make it worse.