Question: Dear Dr,
Is it possible to cause neurogenic bladder by pressing down on the bladder? I have developed OCD and nervous habit of compressing abdomen to feel if I need to urinate and now it seems like I have a reduced sensation of fullness of my bladder. I have no problems urinating, and no urinary retention, but it seems I need to go quite badly before I need to go, about 500-600ml and even totally full, like 900ml, I can feel but not as sensitively as I used to.

I have had thorough workup with blood tests and bladder ultrasound with no issues and urologist and nephrologist I have seen have told me that as those tests are normal, there is no need for any further testing.

The reason this habit developed is that last year I developed PVC-induced cardiomyopathy. After ablation surgery in December, heart function and size returned to normal. However I had a cardiologist tell me that I would die of fluid retention and I would never be cured. I was never even on diuretics but he told me if I didnt have strong need to urinate at least every two hours, then I was going into heart failure and needed to go to the hospital. Since then, I have nervously pressed on my bladder, desperate to know if the need to urinate was there. It has been about 8 months since this habit started.

Have I done myself permanent damage? If I stop the bladder compression, will sensitivity return? Is it even possible that I have causes nerve damage?

Thank you so much. Test results are attached.

Mia

Thank you Dr XXXXXXX
I am relieved to know that I couldnt have caused myself to have neurogenic bladder. However, I am sure something has happened to make me feel less sensitive to the feeling of my bladder filling. It seems I have to go quite a lot before I can feel it, many hours, so I continue to press on my bladder to see if I need to go. Is not possible to cause less sensitivity in the bladder through this manner? It makes me so nervous that I drink quite large amounts to make sure I am able to feel need to urinate and that I'm urinating enough. I drink about 2.5-2.8 L a day and I do urinate that much too, but it seems like I never feel like need to go.

Also is it quite normal for urine output to be quite variable even if one isnt noticeably sweating more or eating differently? It seems some days I urinate much less for no reason I can see, and even understanding about insensible losses it seems extreme to me. For example I will drink a large herbal tea(26 oz) and sometimes will need to urinate the entire amount within an hour but sometimes even three hours later, it will be less than half that.

I know I should try to forget what my old cardio told me about fluids killing me but it is so hard. I meticulously measure intake and output and live in fear. I do have a therapist and a psychiatrist but so far I am still experiencing great anxiety.

Thank you so much, dr.
Mia

Thank you Dr XXXXXXX I am in therapy and will continue to seek counseling. Are you certain there is no physical reason for me to be concerned?

Thank you,
Mia