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Suggest Treatment For Overactive Bladder
Question: I am a paruretic since last 3 years and also suffering from Overactive Bladder at the same time. I urinate almost 20-25 times in a day and even more upto 30 times if the weather is cold or wet, in spite of drinking less amount of water or completely avoiding fluid intake. I've consulted regarding this two issues with an urologist and taken the medication prescribed by him. But, nothing worked.
***When urination becomes frequent it becomes less in volume and watery in color and also gives a feeling of incomplete urination***
He prescribed me, Tropan 2.5 and Fludac 20mg and also prescribed me to undergo through the following tests:
1. USG of KUB & Prostate
2. Routine and Culture Examination of Urine
3. Uroflometry.
I have done 2 of them and the reports were normal. Couldn't able to do uroflometry as there were nurse present in front of me asking me to urinate and as I am paruretic in nature, couldn't able to pass the urine in front of her
I am very much worried about these two conditions specially being a paruretic, I suffer a lot.
I find almost impossible to urinate in moving vehicles like train hence I avoid travelling by train.
I cant able to urinate in urine stalls specially if it lacks proper partition and also If somebody is waiting behind me for his turn...
When, I travel by train and if the train is running I cant able to urinate even if my bladder is uncomfortably full, nomatter how much hard I try.. Then I end up forcing myself to urinate by sitting in train's co-mot and forcing my urine out of the body by applying a huge pressure by holding my breath as if I am having constipation. Then urine passes out from my urethra but it's a very uncomfortable and painful process.
Please help me, I have tried everything that is possible. Even the graduated exposure therapy but nothing worked. I feel commting suicide.
Please I beg you sir/madam. Please give me suggestion.
***When urination becomes frequent it becomes less in volume and watery in color and also gives a feeling of incomplete urination***
He prescribed me, Tropan 2.5 and Fludac 20mg and also prescribed me to undergo through the following tests:
1. USG of KUB & Prostate
2. Routine and Culture Examination of Urine
3. Uroflometry.
I have done 2 of them and the reports were normal. Couldn't able to do uroflometry as there were nurse present in front of me asking me to urinate and as I am paruretic in nature, couldn't able to pass the urine in front of her
I am very much worried about these two conditions specially being a paruretic, I suffer a lot.
I find almost impossible to urinate in moving vehicles like train hence I avoid travelling by train.
I cant able to urinate in urine stalls specially if it lacks proper partition and also If somebody is waiting behind me for his turn...
When, I travel by train and if the train is running I cant able to urinate even if my bladder is uncomfortably full, nomatter how much hard I try.. Then I end up forcing myself to urinate by sitting in train's co-mot and forcing my urine out of the body by applying a huge pressure by holding my breath as if I am having constipation. Then urine passes out from my urethra but it's a very uncomfortable and painful process.
Please help me, I have tried everything that is possible. Even the graduated exposure therapy but nothing worked. I feel commting suicide.
Please I beg you sir/madam. Please give me suggestion.
Brief Answer:
Your condition can be labelled as neurogenic bladder.
Detailed Answer:
Hello Mr XXXX,
Thank you for posting your query here.
I have gone through the details provided by you carefully and understand how difficult it must be for you.
As you have noted in your history, you have been facing these issues since 3 years, that signifies a problem that started around 3 years ago.
What I would like to know is, if you had had any injury to the back, like a sprain or sudden catch while playing 3 years back.
Other cause could be an enlarged prostate, this usually does not happen in young individuals like yourself, however needs to be ruled out.
Uroflowmetry/urodynamics is the investigation of choice for neurogenic bladder hence I suggest you to kindly talk to your urologist and arrange for the test to be done in a manner that is possible.
Please do not give in to thoughts of self harm, I am sure things will work out for you if you keep your follow up with the urologist.
In your case, I would also suggest an MRI scan of the lumbosacral spine to look for any spinal cord injury that might be aggravating your condition.
For the time being, you could request your urologist to teach you self catheterisation, this is important because, longstanding urinary retention can cause kidney failure, so please talk to your urologist again and explain the problem in detail and request him/her to do everything possible to rectify the problem at the earliest.
I am afraid online consultations will be much use to you, however, I would suggest you to write back to me with the details requested and also please upload all the reports you have so that I can get a better picture of what is going on.
Wishing you speedy recovery.
Best regards
Your condition can be labelled as neurogenic bladder.
Detailed Answer:
Hello Mr XXXX,
Thank you for posting your query here.
I have gone through the details provided by you carefully and understand how difficult it must be for you.
As you have noted in your history, you have been facing these issues since 3 years, that signifies a problem that started around 3 years ago.
What I would like to know is, if you had had any injury to the back, like a sprain or sudden catch while playing 3 years back.
Other cause could be an enlarged prostate, this usually does not happen in young individuals like yourself, however needs to be ruled out.
Uroflowmetry/urodynamics is the investigation of choice for neurogenic bladder hence I suggest you to kindly talk to your urologist and arrange for the test to be done in a manner that is possible.
Please do not give in to thoughts of self harm, I am sure things will work out for you if you keep your follow up with the urologist.
In your case, I would also suggest an MRI scan of the lumbosacral spine to look for any spinal cord injury that might be aggravating your condition.
For the time being, you could request your urologist to teach you self catheterisation, this is important because, longstanding urinary retention can cause kidney failure, so please talk to your urologist again and explain the problem in detail and request him/her to do everything possible to rectify the problem at the earliest.
I am afraid online consultations will be much use to you, however, I would suggest you to write back to me with the details requested and also please upload all the reports you have so that I can get a better picture of what is going on.
Wishing you speedy recovery.
Best regards
Above answer was peer-reviewed by :
Dr. Yogesh D
Unfortunately, I don't have those reports right now as I just recently shifted to my new house and also I don't remember having any spinal cord injury or getting injured severely since in last couple of years. It started all of a sudden.
In the home, while I am in a comfort of my house. I can urinate easily without any hassle but while urinating in public gives me a lot of issue. Even with full bladder, the urine doesn't come down to my urethra unless I push the urine forcefully out of my body by holding my breath upto an extreme level. And also, I face this problem of frequent urination occassionally only. Specially if the weather is cold or wet or suppose, If I just drink 1 glass of water by mistake. It makes me urinate 10-12 times within 1 hour with a frequency 2-3 mins and gives me a feeling of incomplete urination. However, during USG of KUB post voidal studies didn't showed any residual urine on my bladder. And till date, I've did this test 3-4 times but reports were always normal.
Can you tell me what this paruresis occurred to me so suddenly?
And, I have this problem of frequent urination since a very long time maybe more than 3 years but got affected with paruresis about 3 years ago. Before that, I was able to pee in public and in train as well.
What is self catheterisation? How to do it? Does it cause any pain?
Please also do note that I was having problem of hypertension since I was 13 and was taking medication for the same (LOSAR 25 then 50 and then ended up with LOSAR A) followed by this problem and asthma. But, I stopped taking medication for hypertension since last two years (without doctor's consent) as I found my BP to be normal, and still now its in normal range (135/80) but I still use Inhalers for my asthma.
And I get severe asthma attacks daily and end up using almost 25-30 puffs of LEVOLIN inhaler in a day combined with Seroflo 250 Inhaler (2 times a day)...
Please tell me doctor, am I going to die soon? Please dont lie to me sir.
In the home, while I am in a comfort of my house. I can urinate easily without any hassle but while urinating in public gives me a lot of issue. Even with full bladder, the urine doesn't come down to my urethra unless I push the urine forcefully out of my body by holding my breath upto an extreme level. And also, I face this problem of frequent urination occassionally only. Specially if the weather is cold or wet or suppose, If I just drink 1 glass of water by mistake. It makes me urinate 10-12 times within 1 hour with a frequency 2-3 mins and gives me a feeling of incomplete urination. However, during USG of KUB post voidal studies didn't showed any residual urine on my bladder. And till date, I've did this test 3-4 times but reports were always normal.
Can you tell me what this paruresis occurred to me so suddenly?
And, I have this problem of frequent urination since a very long time maybe more than 3 years but got affected with paruresis about 3 years ago. Before that, I was able to pee in public and in train as well.
What is self catheterisation? How to do it? Does it cause any pain?
Please also do note that I was having problem of hypertension since I was 13 and was taking medication for the same (LOSAR 25 then 50 and then ended up with LOSAR A) followed by this problem and asthma. But, I stopped taking medication for hypertension since last two years (without doctor's consent) as I found my BP to be normal, and still now its in normal range (135/80) but I still use Inhalers for my asthma.
And I get severe asthma attacks daily and end up using almost 25-30 puffs of LEVOLIN inhaler in a day combined with Seroflo 250 Inhaler (2 times a day)...
Please tell me doctor, am I going to die soon? Please dont lie to me sir.
Brief Answer:
You should go back to your doctor and ask for Gabapentin
Detailed Answer:
Hello Mr XXXX.
First of all.... Relax, you are not going to die.
Paruresis is a psychological disorder, it is classified as a social anxiety disorder.
Before confirming the diagnosis of paruresis, I wanted to make sure that the reason was not organic like spinal cord injury. Now since you have no history of any injury, it leaves with this condition.
The exact reason for this condition is not well understood and there seems to be an underlying genetic predisposition as with most other psychological disorders.
I can understand the difficulty this must be causing you.
One medicine has shown to be effective in treating paruresis and that is "Gabapentin".
Gabapentin is a newer medicine that is shown to have many effects and the early research indicates very good results with this medicine.
I would request you to consult your urologist as well as psychiatrist and talk to them about the problem and you can mention this medicine.
Gabapentin is available on prescription only so please discuss with your treating doctor.
As for high blood pressure and asthma, you need to get yourself checked at least once a month and follow the doctor's advice to the letter, there is no shortcut to health.
I hope this answers your query for now.
Wishing you good health.
Regards
You should go back to your doctor and ask for Gabapentin
Detailed Answer:
Hello Mr XXXX.
First of all.... Relax, you are not going to die.
Paruresis is a psychological disorder, it is classified as a social anxiety disorder.
Before confirming the diagnosis of paruresis, I wanted to make sure that the reason was not organic like spinal cord injury. Now since you have no history of any injury, it leaves with this condition.
The exact reason for this condition is not well understood and there seems to be an underlying genetic predisposition as with most other psychological disorders.
I can understand the difficulty this must be causing you.
One medicine has shown to be effective in treating paruresis and that is "Gabapentin".
Gabapentin is a newer medicine that is shown to have many effects and the early research indicates very good results with this medicine.
I would request you to consult your urologist as well as psychiatrist and talk to them about the problem and you can mention this medicine.
Gabapentin is available on prescription only so please discuss with your treating doctor.
As for high blood pressure and asthma, you need to get yourself checked at least once a month and follow the doctor's advice to the letter, there is no shortcut to health.
I hope this answers your query for now.
Wishing you good health.
Regards
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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