Flunked my urodynamic test
Posted , 12 users are following.
Got the results from the urodynamic testing I had done last week, they concluded the bladder is shot and I will need to self catheterize for the rest of my life.....
This is the report.
RETENTION: Pre- CMG PVR 11 mL post self catheteriation, no record of pre-cath residual. Post-CMG PVR 767 mL residual
SENSATION/CAPACITY: *First sensation: 164 mL *First desire 203 mL *Strong desire 497 mL Actual bladder capacity 767 mL PVR
URINE LEAKAGE: No stress urinary incontinence: No leakage with cough or Valsalva at 497 mL fill volume No uninhibited contractions or urge incontinence. PRESSURE flow studies: At 497 mL fill volume, no void, Max pDet 10 cm water pressure, Max pPAbd 1 cm water pressure--no abdominal straining. No classic obstruction and no void with elevated residual
ASSESSMENT/CMG findings: No classic obstruction, no void, positive sensation, large bladder capacity, Elevated post void residual and large bladder capacity with need for bladder decompression with catheter.
PLAN: Instructed him that he is to do regular CIC every 6 hours to keep the urine residual volume down to 300 mL or below and give him an explanation what today's findings were that his bladder does not work and he retains urine he needs to self catheterize indefinitely.
Was a bit disappointed, have been doing self catherization for a year and was thinking things were getting better. Since the testing I started keeping track of the PVR's again and they were running 500+ ..funny didn't feel that full. I guess I have a nuerogenic bladder...as suspected
0 likes, 128 replies
uncklefester jwrhn1951
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frank74205 jwrhn1951
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frank,
jwrhn1951 frank74205
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I'm 67. They say TURP or things like that wont work because the bladder doesn't work. They can do a surgical procedure where I'd end up with a permanent uroostomy coming out of my side but there is no way I'm going to do that. I've gotten used to CIC and have very few problems so I'll keep doing that.
hank1953 jwrhn1951
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frank74205 jwrhn1951
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jwrhn. i agree with you CIC is not that bad.I'm still trying to cut down from 6 times a day.What is a urooostomy?
frank,
oldbuzzard jwrhn1951
Posted
JimJames didn't reply, so I'll summarize his experience. In short, you might be getting better and its possible that you could be off the cath in a year or two. Jimjames was self cathing 100% of the time and had the same dire diagnosis you did. It took a couple of years, but he gradually improved and got to the point that he hasn't used a cath in months.
I hope he'll jump on and provide more details, but either way, test yourself occasionally and be patient. Its not unheard of for someone in your position to rehab your bladder over time via self cathing. There is also a urologist on this forum that has mentioned a pacemaker type device for bladders. I have no idea if you'd qualify, but if your urologist doesn't know about it, you might want to find one that does.
hank1953 oldbuzzard
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laurie23366 jwrhn1951
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hard luck buddy illkeep in contact I feel I will be in the same boat ,,,wondering did u play any sport I'm a mad golfer and play cricket in the overt 65is .did they say u could lead a normal life ..
oldbuzzard laurie23366
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jwrhn1951
Posted
jimjames was very helpful when I first started CIC, took me a couple of months to work through the problems I was having with his help. I imagine he will offer his insight at some point.
I get my care at a large VA medical center affiliated with a well known medical school. They have a lot of experience with guys with SCI so I tend to trust their judgment. I was in a car wreck many years ago and sustained fairly significant brain and cervical injuries that have been slowly getting worse over time. They think the retention is the result of the generalized nuero decline so the results were not unexpected just a little disappointing...
I have no interest in the urostomy so I didn't pay much attention when they explaiined it. Apparently they remove the bladder create a sac from your intestine or colon, attach the urethras from the kidneys to it and make a hole in your side for it to drain. Its usually used for people with bladder cancer or SCI who cannot self cath.
From what I understand the fact that the Max pDet stayed at 10cm throughout the test even when they pumped more than 700ml into the bladder with no void showed both that there no obstruction and it was diagnostic for nuerogenic bladder.
jwrhn1951
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hank1953 jwrhn1951
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jwrhn1951 hank1953
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I didn't have any pain or discomfort at all but it is a bit embarrassing. They put catheters in the urethra and rectum and electrodes in places down there that I've never seen. There was a nurse practitioner who ran the computer and machines and another nurse who did all the "leg" work. They were friendly but professional we chatted and did their job very efficiently. Before they started they said it could take up to two hours but because I was in retention they stopped after about a half hour and gave me a catheter and bottle to void. I did have a blood in the urine the next couple of times I self cathed and leaked a little blood for a few hours after the procedure. I had some soreness for a day or two after while catheterizing but it was not to bad and I didn't pick up any infections.
hank1953 jwrhn1951
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"...to keep the urine residual volume down to 300 mL or below "...
They told you to do this so there must be a chance for rehab, I think. Hank
frank74205 jwrhn1951
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frank,
jwrhn1951 frank74205
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I'm 67.
I didn't have surgery, they were doing this to see if surgery would work for me and they found out it would not.
I can sometimes void when there is only a few hundred mls in the bladder but when the bladder gets to full I have to use the catheter.
oldbuzzard jwrhn1951
Posted
300mls is quite a bit. Why not just make a point of voiding every 2 to 3 hours naturally. Holding too much will definitely make your weakened bladder worse, while sticking to a schedule, going regularly and not letting yourself get too full might rehab it enough that you can function almost all the time without a catheter.
FWIW, there is NO WAY I could hold 700+mls and its quite possible that I (and many others on the forum) would fail the test you took, but I function normally. PT might help too. My guess is that unless you drank a lot of something that you could go 21/2 hours without exceeding 300mls. Set a timer on your phone, make sure you don't get too full and get some PT. There's a decent chance that regimen could wean you off the cathing.