Urinary questions

[biowham]

I should know this kind of thing because I did my postdoc in urology, but that was PEDIATRIC urology and I'm...old (er).

So....these urinary things. Does this sound familiar to anyone: Feel urgency, go, hardly anything there. Sometimes, go without feeling any urgency at all and, pardon the expression, output is elephant-like. Sometimes, nothing left but still feel need to go.

I don't have a UTI.

Thanks,
E

[sllowe]

Very familiar, although, I'm not sure if my issues are related to the MS, or delivering children. . .
I thought you'd find this informative:
_____________________________

http://www.unitedspinal.org/publications/msqr/2007/08/17/understanding-and-managing-the-bladder-problems-that-accompany-ms/

Let’s take a closer look at the actual locations of the command and control centers both in the spinal cord and in the brain. This knowledge will provide the framework to better understand what can go wrong at these centers.

Within the spinal cord there are two key areas involved in the control of bladder function. The first is located in the lowest two thoracic segments of the cord and the upper two lumbar segments of the cord (T-11–L-2). This area is important because of the nerves that originate at these levels (called sympathetic nerves) that inhibit the bladder muscle from contracting and also tell the bladder outlet (urethral sphincter) to contract. This center sends a clear message to the bladder to store urine. In a normally functioning system, this message is continuously being sent to the bladder. To override it, other strong signals have to tell this center to quiet down (and allow voiding to occur).

Our second area of interest is located in the lowest aspect of spinal cord (sacral cord levels 2–4). Nerves originating from this level go to the bladder muscle and tell it to contract. The chemical messenger that these nerves respond to is acetylcholine. This is important to know because as we will see later, one way to treat urgency and incontinence due to over-activity in these “cholinergic” nerves is to give medications called anticholinergics that would block this “contract” message to the bladder. . . . . . .

[essdipity]

The Hopkins neuro quizzed me about this. I said I hadn't had any problems, but he sort of pressed, and then it came to me that sometimes the time between the need to go and the wild need to go right this minute or it's all over can be very short. I had just chalked it  up to aging (hardly a spring chicken), but he turned to the resident and said, "Note: micturition urgency."

Interesting that these signals are from the spine. He doesn't seem concerned with my spine.

ess

[AMO]

hi girls,

don't forget the concious area of urinary process. That begins in the the frontal lobes . think about potty trainning, the steps on learning come from there .
Then it goes sto the brain stem, pons. So if someone with a neurologic illneess has an y damage to either those areas. Those areas rely to the spinall areas, then the bladdder. So damage anywhere downn the line would havve recoarse. Here is a little info....

http://www.jstage.jst.go.jp/article/jsmr/41/3/41_117/_article

i actually tried an InterStim therapy trial, my wondeerful uro was very brave to give me a chance with it. UNfortunately it was not sucessful, since i have damage in my sacral. nerves.

[Quixotic1]

The process of peeing is actually very complicated and involves the brain, brainstem and spine, as that very good article shows.  An interruption at any point can cause tremendous problems.  E, your symptoms are not typical of the older woman (>40, lol) who has had kids)

A high spinal cord lesion  (above T6) can cause a person to demonstrate symptoms of urinary frequency, urgency, and urge incontinence but will be unable to empty his or her bladder completely. This occurs because the urinary bladder and the sphincter are both overactive, a condition termed detrusor sphincter dyssynergia with detrusor hyperreflexia (DSD-DH).

E - this is a good article

http://www.medhelp.org/posts/show/428586

MS is caused by focal demyelinating lesions of the central nervous system. It most commonly involves the posterior and lateral columns of the cervical spinal cord. Usually, poor correlation exists between the clinical symptoms and urodynamic findings. Thus, using urodynamic studies to evaluate patients with MS is critical.

The most common urodynamic finding is detrusor hyperreflexia (bladder contracts too often and too forcefully), occurring in as many as 50-90% of patients with MS. As many as 50% of patients will demonstrate DSD-DH (Bladder contracts, but sphincter spasms shut not allowing the urine to pass). Detrusor areflexia (bladder muscles are weak, casuing retention and inability to empty fully) occurs in 20-30% of cases. The optimum therapy for a patient with MS and incontinence must be individualized and based on the urodynamic findings.

50% to 90% is a large chunk of us!

Quix

[biowham]

Thanks for the feedback and info. You'd think I'd know things like "innervation from T and L spine," but I don't, really. That's what comes of focusing too much on the trees and forgetting about the forest.

Gracias--
E

[jensequitur]

As for relief from these symptoms...  My neurologist has told me that without a serious incontinence problem, he's not going to prescribe anything for me.  And I don't - I have some serious urgency, but if I get there in time, no problem.  It's just the coughing, sneezing, and laughing I have to watch out for.  (Was it Loudon Wainwright?  "Don't fart, don't laugh, and don't sneeze!")

What I do for the bloating and bladder cramps is take Midol.  It seems to help a little.  And I don't wait any longer.  When I have to go, I get into the little room and go.  After a couple of mini-accidents, I decided it wasn't worth it.