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Neurogenic bladder condition. had cystolitholapaxy surgery for removal of gall stones. spinal lumbar found no nerve damage. Laser the cause of damage to bladder ?

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During my cystolitholapaxy, if a 1000 micrometer laser fiber on a setting of 1.5 kilojoules and at a rate of 15 inadvertently against all odds missed the bladder stone and struck my bladder's mucosa, could nerve damage be done impacting the emptying functioning of my bladder depending on where the laser hit my mucosa? Age 66. 5'10". 220lbs. In XXXXXXX 2010, I had a cystolitholopaxy to remove 8 bladder stones. Since I've developed a partial neurogenic bladder. I now self-catheterize 4Xs a day for the rest of my life. I've adjust super well.Partial in that I cannot urinate, though I can "feel" when my bladder is full at 650+ ml of urine. My urologist said, "I'm not interested in its cause." According, he treats my partial neurogenic bladder but has done nothing to identify its causes. My family physician ordered a spinal lumbar MR, which found no nerve damage that could cause my neurogenic bladder condition. I've no spinal cord injuries, no history of diabetes, no MS, no Parkinson's Disease. Though it may not be found, we know there must be a cause of my neurogenic bladder. So, I'm just wondering if it's a miniscule possibility during my cystolitholapxy if the laser inadvertently struck my bladder's mucosa, depending where it stuck, could that laser do any nerve damage in the mucosa to negatively affect my bladder's ability to urinate? Thank you.
Posted Thu, 26 Apr 2012 in Urinary and Bladder Problems
Answered by Dr. Rajiv goel 3 hours later

Thanks for your query.

Even if the laser fiber hits the bladder mucosa, it will just burn the tissue locally. Beyond that it shall not cause any thing and there shall be no long term consequences. Hence, your cystolitholapaxy with laser fiber cannot cause neurogenic bladder.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Above answer was peer-reviewed by
Follow-up: Neurogenic bladder condition. had cystolitholapaxy surgery for removal of gall stones. spinal lumbar found no nerve damage. Laser the cause of damage to bladder ? 23 hours later
Thank you, Dr. XXXXXXX goel, for your reply that a cystolitholapxy with laser fiber cannot cause neurogenic bladder. I accept your answer. Please allow a short medical history background that will lead up to my second specific question for you.

I'm searching for possible cause to why I developed a partial neurogenic bladder. My urologist has told me, and I quote, "I am not interested in finding the cause". This is why I'm asking a specialist like yourself questions.

Now, partial means I cannot pee, yet I can "feel" my bladder full consistently when it has 650+ ml of urine. I self-catheterize 4Xs a day, so I measure my urine and can co-relate my bladder "feeling" full when measured urine says it is full.

I have no spinal cord injury; no diabetes, no MS, no Parkinson's Disease. I've had no strokes; no major surgery involving my pelvis; no injuries involving my brain or spine. Since I had a herniated disk problem, my family doctor (not my urologist) ordered a Spinal Lumbar MRI. It showed no nerve damage to my Cauda Equina. I had Brain MRIs in 2007 and 2008 that show no signs of a tumor or brain cancer.

The Brain MRI in 2007 identified Asymptomatic Sub-cortical Small Vessel Disease with no impact on my health. The numerous ischematic changes were identified and interpreted by my neurologist as alive pink scare tissue, not white dead tissue.

But,the MRIs identified a 6-to-4mm capillary telangiectasia in my pons. Barrington's Nucleus is in the pons and as you know is the Pontine Micturition Center.

This is my question, Dr. XXXXXXX goel:"Could a single focus T2* shortening in the central pontine tegmentum in a pons caused by a capillary telangiectasia of 6mm to 4 mm with its increased blood-flow negatively impact how Barrington’s Nucleus sends or receives micturition signals to or from a bladder?"

Thank you, Doctor. I appreciate your expertise.

Answered by Dr. Rajiv goel 2 days later
Hi ,

Thanks for writing back.

I really appreciate your knowledge acquired on the issue which could be by an outstanding research you have done here.Well , it made my work easy.

Yes , there are chances where if the Pontine micturition center ( Barrington's Nucleus) received a threat due to the telangiectasia present there could have caused so called partial neurogenic bladder. The action of micturation is a complex one where the afferent impulse from the stretch receptors from the bladder are interpreted and a efferent through Parasympathetic route from the PMC stimulate the contraction and result in urination.

But I am sorry to say that the exact pathophysiology cannot be explained with evidence.Well, theoretically its possible and expected in such affection to the PMC.

Hope I answered your doubt.

Wish you good health.
Above answer was peer-reviewed by
Follow-up: Neurogenic bladder condition. had cystolitholapaxy surgery for removal of gall stones. spinal lumbar found no nerve damage. Laser the cause of damage to bladder ? 6 hours later
Hi, Doctor XXXXXXX Goel. I believe I have one last question I'm allowed to ask. You have been most helpful. I appreciate your insight and expertise, especially your effort on my last question about the effect of a 6 to 4mm capillary telangiectasia on the PMC.

My question is: In your experience of neurogenic bladders and knowledge of the literature, what percentage of neurogenic bladder cases have NO spinal cord injury; NO brain tumor; NO brain cancer; NO spinal disk issue; NO MS; NO Parkinson's; NO stroke; NO dementia; NO diabetes or NO apparent cause?

I wish you well in all your endeavors,
Answered by Dr. Rajiv goel 6 hours later

Thank you again for writing back to me.

In my personal experience, of approximately 40-50 patients with similar complaints. 5 of the patients had no identifiable cause for neurogenic bladder.

Wishing you a speedy recovery from this disturbing condition.

Take care.


Dr. Rajiv Goel.
Above answer was peer-reviewed by
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