Hiatal Hernia and Bladder function.

[tank64]

I am at my wits end on this issue. I hope someone here can help.

Several years ago, I went in to have weight reduction surgery performed (gastric bypass). The surgeons couldn't complete the surgery due to the large hiatal hernia I already had. The surgeons instead changed mid-course, and performed a surgey called a vertical gastrectomy. They ended up taking out most of my stomach as it was highly herniated. I did lose quite a bit of weight, and am relatively healthy since then.

Since the surgery, I have developed a problem with difficulty in urination. I have gone to the urologist several times for this problem. I have tried all of the prostate meds, and none have worked. I do not have BPH, any cancer, or any infection. I also had a cystoscopy performed and the urologist said he can see strait into my bladder no problem, so there is no obstruction. There is some pain when I do urinate.

My questions are: Could my bladder be also hernaited along with my stomach? Could this be the reason I have to strain so much when I urinate? I have looked at medical diagrams of our internal organs, and where they are generally located. If a stomach can be herniated, why couldn't the bladder also be? If a bladder becomes herniated, isn't it logical that it could also lose the natural pressure that assists it in eliminating urine? To compensate for that loss of pressure, wouldn't a person have to strain to eliminate urine?

I actually have to sit to urinate (Male 46 by the way), and sometimes I really have to bear down and strain. I almost always have to strain like passing a very hard stool. Yes, it is that bad. I am hoping someone here will have some answer for me. I have asked my urologist, but don't have any definitive answer.

Thanks,

FLG

[tank64]

Thank you so much for the reply. I am going to consult with another urologist. I have actually only talked with the urologist once, or possibly twice. I always meet with the PA in his office. I actually really like the PA, but since my issue seems to be NOT going away, I would think the urologist would want to meet with me. Honestly, the guy is a bit arrogant for my liking. Time to seek some other advice.

Thanks again,

FLG

[Dr. Kokil Mathur]

Hi
Welcome to the MedHelp forum!
Well, the symptoms do not look like bladder herniation. More like a problem of initiating urine. Prostatitis or inflammation or infection of prostate is a major cause. It can also be benign hypertrophy of prostate—and hesitancy is one of the major symptoms irrespective of the size of the prostate. It can be shy bladder syndrome or it can also be extreme anxiety.
There are medications which contract the bladder musculature and relax the bladder neck which can be tried. Please discuss with a urologist. Take care!