Question: I was born with severe scoliosis. At age 13 I had two back surgeries a week apart. During that week I was sedated and had a catheter. One night a nurse was turning me and got tangled with the catheter and pulled it clear out. (Although sedated I remember it clearly!) Right after the second surgery I started having some troubles with incontinence, mostly urge type. As a teenager I dealt with it the best I could, but by the time I was 21, scar tissue had become so bad that I had to have an uroplasty. (Urinary track replacement) Afterwards I still had trouble with urgency that required me to wear protection of some sort. The urologist did some sort of test by placing a type of catheter in the urethra that I guess created some sort of pressure to see if things worked correctly. He stated that whatever test he did, that he didn't know the reason for the trouble. I am now 52 years old and still have issues. I have had seven more major back surgeries, the last in 2011. Recently I saw an urologist after all these years. I was wondering if he could help resolve the trouble I have had. He again performed a similar test to what I had thirty years earlier and simply said he wasn't sure either. He tried me on two different medications that failed to help, but caused some nausea. I have mentioned the back surgeries because I am wondering if anything could have happened to create a sense of urgency. When I mean urgency, it's like I am feeling the need to go, but within a few seconds I can't seem to stop it. At times I can feel the bladder is full and get to the restroom, but the amount voided can be very little to a quite a bit. My question is if you can give me any insight to what might be going on. When I was first dealing with it as a young teen I guess I was to embarrassed to tell the doctors that did the back surgeries about it, and did the best I could to hide the issue. Please let me know if you have any questions that can help you make a diagnosis.

I need to clarify a few points you missed in my original post. I began to have problems with continence right after my first two back surgeries and the trauma from the catheter being yanked out. I don't strain passing urine. The frequency is the same night or day. I try to really limit fluid intake at night, but still have occasional problems with wetting if I don't sense the urge to go soon enough. My urine stream is normal, and after the surgery the occurrence of UTI's went way down. I may get an infection twice a year . I have not had an uroflometry study done. My prostrate is normal size and not an issue in this problem, especially since I have had it since a young age. I have been on Darifenacin and stopped after about three weeks. It was not making a difference for me and it was causing problems with nausea. Since the original back surgeries I have two numb, or areas of little feeling, in my groin area. I am wondering if you think there can be any relationship to a nerve issue in my back that can cause the incontinence problem? I know after my second surgery the doctors were very relieved when afterwards I had normal feeling in my legs. They had told my parents that they had been extremely concerned that they may have compromised a nerve, or nerves, during surgery. I don't have any loss of sensation in my legs, but I do have pain that sometimes shoots part way down either leg. I realize this all is somewhat vague. The typical causes, and tests done have not revealed exactly what is going on. I had hoped that given the years since I had first seen an urologist that maybe some other technology has been developed to test further. The recent urologist I saw used a scope to look up the urinary track into the bladder. I also believe he also filled the bladder with water at the time to check sphincter reaction, but I'm not positive about this. Just that he reported nothing amiss at the time. I also don't have any problems with ED. I'm not sure if that information is pertinent to any possible causes you can come up with. Thanks for your review of this problem. Please try to consider possibilities that aren't what you would first look at. I am tired of dealing with this for so many years without a good reason given for it. This is hard to talk about, even though I am speaking to physicians. XXXX

Thank you for your answer. If the studies were to find an issue with nerve trauma as a cause, is there a treatment that would help? I have practiced kegel exercise and it has helped a little, but not as much as I would like. After thinking about your answers, I am wondering if perhaps my trouble could be a result of more than one of the factors that we have discussed. I think the studies you suggested could answer this, but I am just wondering what your thoughts are regarding the possibility of more than one cause. Thanks, XXXX