What to do

[dennis]

I need some suggestions. Yesterday at my last urology appointment my prevoid was 435ml, and post void 365ml. The urologist has me on a 3 week use of vesicare. I'm not sure I'm going to like this if I already have that much retention. I do have bladder diverticula that is only treated by surgery. I understand that surgery may make my control worse then it is now. If I have current control issues, why would I want to risk making them worse. Should I continue to manage my issues with diapers until something more serious occurs? Any advice on this matter would be appreciated. Thanks in advance.

[Inconinmiss]

The inability to completely empty your bladder (which is what I think you are describing) is a potentially very serious medical problem. It is often associated with frequent urinary tract infections and with reflux of urine back into the kidneys, which can cause kidney failure. One reason why you might consider surgery for your condition, if that's what your urologist recommends, is to protect your kidneys and thereby prolong your life. IMHO, staying healthy and alive is important enough that you might well be willing to udergo a recommended medical procedure even if it worsened your incontinence.

[wheels5894]

I'm quite surprised, Dennis, that you haven't been told to self-catheterise with that level of retention. Urinary retention means your bladder is open to infection - and urinary tract infections are nasty! Oddly, draining the bladder by self-cathing reduces the chance of leaks as the bladder has to have more than the retained volume before it leaks.

As to surgery, well I suspect infection risk is even higher with that condition and that risks damage to your kidneys which can be terminal. Go for surgery even if you end up incontinent - its better than kidney failure.

[SeattleDoug]

Vesicare may help relax your bladder, but it is not going to empty your bladder. It is actually designed and marketed to keep the bladder from leaking but relaxing the smooth muscle. That as a side effect can cause your bladder not to empty at all if you have nerve damage that causes your incontinence.

Self cathing is the best thing you can do to protect yourself from residual urine. In the hospital they would cath me if I had anywhere near 400 ml post void. One time I had 999 ml PRV. It was more than the scanner could read so it maxed out the display. After draining 900 ml I still had almost 300 ml residual. That was after a new medication was added to "help" with leakage. Needless to say I stopped taking the new med that day.

Meds aren't always the answer for the patient, even though it is income for the doctor to prescribe them. Weigh the pro and cons for yourself and don't let the doctor push you into it if you decide against it.

[Don]

I'm with Doug. I tried a number of bladder relaxing meds for my OAB and urge incontinence. I couldn't deal with the side effects. I tried though. Many medications I take effect my central nervous system, including my psychotropic meds which cause my incontinence. I have been wearing diapers for 5 years. Bladder Meds just weren't working for me. So I gave in.

[dennis]

After talking with the urologist, it was advised to stop taking vesicare. I have an appointment on June 12 to see what the next course of action may be. I'm hoping he will suggest that I wait a bit before anything too drastic is done. I will be going to Italy for 3 weeks in Sept. with my wife and another couple. Maybe after we are back if things haven't improved, I will consider some kind of surgical procedure. I worry a little about packing 3 weeks worth of diapers, however. Thanks for the advice everyone. I will keep you posted if anything changes.

[SeattleDoug]

I have heard from several people the incontinence products in Europe are much better than we can buy in retail stores in the US. I would pack enough for half your trip and ask at your hotel about a chemist or medical supplies shop. That is where you will find the good supplies.