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Episodes of acute urinary retension. normal urodynamic and nerve studies. - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Kidney Conditions
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1742 Questions
User :   I am 43 year old woman whom goes in to acute urine retention, each time it happens its getting worse and am retaining over 2 1/2 litres of urine I have collapsed and pased out out for a good 15 to 20 mins, before hand my legs were like jelly and couldn't self catherterise my self so ended up in a&e with a catherter put in doesed up with morphine for the acute pain,after having nearly two cylinders of gas and air in ambulance,have been to see prof fowler, ms and fowlers syndrrom has been ruled out
Doctor :   hi
Doctor :  
please give me sometime to read through what you have typed.
User :   hi
Doctor :  
do you have diabetes, hypertension, high cholesterol problems?
Doctor :  
was there any history of previous injury to pelvic area?
User :   No to both questions it has just built up over time
Doctor :  
is there any previous history of urethral stricture?
Doctor :   is there any previous history of stones or calculi in urinary tract?
User :   no
Doctor :  
what investigations have been done for this problem?
Doctor :   was cystoscopy/ureteroscopy done done for you?
Doctor :  
was micturating cystourethrogram done for you?
Doctor :  
these tests are collectively known as urodynamic studies to study what the exact problem could be there.
Doctor :  
was there any previous injury to low back?or to lumbar spine?
User :   uro dynamics and nerve ending test and yes to your answer and nothing came up from all test, no injery to spine
Doctor :  
ok.
Doctor :  
do you have any symptoms of anxiety, depression, mood changes?
Doctor :  
are you on any medications?
User :   All I can say pain is more and more acute each time it happens and answer to question is no
Doctor :  
how many times has this happened since the first time it started happening?
Doctor :  
was any gynecological procedure done before all this started?
User :   A bout five or six, the amount of urine retained is getting more and more each time even though I'm self catherterising
Doctor :  
are you married? do you have children?
User :   Yes with three children gyny checks have been done as well
Doctor :   when does this problem occur? is it when you are stressed with any situation or anything?
Doctor :   are you fine in between these episodes?
User :   Not as far as I know
Doctor :  
when was the last childbirth? and what was the mode of last childbirth?
User :   7 years ago all nat del
Doctor :   are you able to pass urine more easily in your home than in any public places or away from your home?
User :   Both the same
Doctor :  
are you fine in between these episodes of acute urine retention?are you able to pass urine normally during these periods?
User :   yes
Doctor :   ok
Doctor :  
since your urodynamic studies have come back normal, and yu are fine in betweenthe acute episodes
Doctor :  
the problem could be multifactorial and a multidisciplinary approach would help you overcome this problem.
Doctor :  
usually an multidisciplinary approach involving urology, neurology and psychology departments would prove beneficial
Doctor :  
for treating it in combined way using bladder training, behavior training and exercises.
Doctor :  
do you consume alcohol?
Doctor :  
have you followed what i have said?
User :   Not much 1 glass of wine on a weekend
Doctor :  
ok
User :   Answer to question Yes
Doctor :  
the factors that could precipitate an acute urinary retention are as follows
Doctor :  
1)alcohol use
Doctor :  
2)cold weather
Doctor :  
3)any kind of stress, anxiety
Doctor :  
4)repeated urinary catheterisation
Doctor :  
5)any acute infection with possible uretheral stricture
Doctor :  
6)excess water consumption after 6PM in evening
Doctor :  
so try to minimise these risk factors
User :   when it has happened it has been any time of day both in summer and winter and dont usualy get to drink that much in th evenig due to running around after three boys and a husband
Doctor :  
ok
Doctor :  
these were the possibilities i could think of, and also the suggested multidisciplinary approach to solve your problem
Doctor :  
so you could discuss the possibility of taking a multidisciplinary approach with your treating doctor
Doctor :  
or consult our panel specialists regarding the problem for a second opinion
Doctor :  
and about how further go about with the treatment and relief of the symptoms
Doctor :  
WWW.WWWW.WW WWW.WWWW.WW WWW.WWWW.WW User :   what does multidiciplinary involve
Doctor :  
these are the links that you can visit to discuss the problem and further treatment
Doctor :  
multidisciplinary approach involving urology, neurology and psychology departments would prove beneficial for treating the problem
Doctor :  
have you followed what i have said?
Doctor :  
Is there any thing else I can help you with?
Doctor :   are you there?
Doctor :  
I have to close the window as you are not responding. Please chat with our doctors 24/7 for medical queries.
Doctor :   Hi
Doctor :  
Are you back?
User :   yes
Doctor :   Ok

Doctor :   Can you proceed with the answers?
User :   When I was tested for fowlers The neuro side said more than likily going on for years as a bad voider and left to that and was told we are going to say there is no reason to say by for know until the next time it happens why Im so frightend is that last time this happened I ended up in resus as my body went in to complete shock
Doctor :   Ok

Doctor :  
As there is no structural problem detected
Doctor :  
it could be of psychological origin as well
User :   how
Doctor :   That is the next possbility

Doctor :  
Psychological the voiding shall not be promoted
Doctor :  
and hence it happens
User :   Why
Doctor :  
Psychological factors cannot be reasoned out
Doctor :  
it could be suspected in your case
Doctor :   I would suggest you to consult our Urologist once

Doctor :  
for better guidance on this
Doctor :  
as it is not a common case
Doctor :  
and needs specialist opinion
Doctor :   WWW.WWWW.WW

Doctor :   You can use the above link for the same
User :   But how can I stop then as the last thing I want is to be stuck up in hospital with my bp shooting though the roof last time it happened it went up 170/110
Doctor :   Ok

Doctor :  
With urinary retention BP does increase
Doctor :  
but you can take the necessary steps now
Doctor :  
Consult our Urologist
Doctor :  
and he shall be helpful to you
User :   Yes one hell of a lot
Doctor :  
Do not loose hope
Doctor :  
it can be handled
Doctor :  
and our Urologist shall help you
User :   I hope so because I'm afraid
Doctor :  
Need not be
Doctor :  
you should be bold enough and surely can find a solution
Doctor :  
Is there any thing else I can help you with?
User :   YES
Doctor :   Ok
Doctor :  
Proceed with it
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