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    Flomax for BSD

    Can anyone comment on the use of flomax to help increase urine flow for those with bladder sphincter dyssynergia? Has anyone had success with this treatment?

    #2
    Flomax can be used successfully in treating this problem in people with SCI. Like any medication, it has it's risks and benefits. I am sure you went over these with your prescriber. If not, check out afloat on line.I will leave the rest up to people who have used the medication.CKF
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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      #3
      Thanks for the reply. I was initially prescribed it to relax the sphincter for IC but it was discontinued as it was unsuccessful in that regard and I decided on an SP. However, it's been almost 3 years since then and I saw a neurologist who suggested that one day I may be able to void using the 'tapping method.'

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        #4
        No when you had the SPTube put in, it was a long term committment. It can be reversed but the bladder shrinks and whatever the reason you put it in for then, it is probably not better and probably worse as in capacity is decreased etc.. And we really don't recommend the Tapping method for most now. Because you have to keep tapping forever because your bladder doesn't empty.And you need to have UDS testing to see what your voiding pressure was. A lot of times with NDO neurogenic detrusor overactivity( contraction comes early and smaller than normal capacity) there is a high voiding pressure.- And DSD- detrusor sphincter dysnergy- the sphincter is spasmsing and you need to sto the spasms. Unfortunately Tamsulosin doesn't usually work on the external sphincter. Tamsulosin can help this but usually it is the external sphincter and it doesn't because Tamsulosin is an alpha blocker and that sphincter doesn't relie on alpha for its contraction or relaxation but it is worth a try. # or so years ago renal issues were the #1 cause of death and or many SCI persons were on renal dialysis 3 x a week -6 to 8 hours each time. Because we do UDS and check these pressures and stopped all the tapping, crede'., valsalva etc... there is less kidney damage, death and dialysis now. Kindly advise your neurologist to look in to this and update his knowledge on current SCI management. The #1 goal in SCI bladder management is keeping the kidney safe and functioning!

        However, we do use Tamsulosin a lot and it does help relax musles, decrease prostate size and decrease pressure mildly and it is one of the first drugs we try in males- and also in females!
        CWO
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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          #5
          You're assuming I have a leg bag attached to the catheter at all times which isn't the case. My SPC is capped off for the entire day and I only use a leg bag at night. Ultimately the plan is to try increase my bladder capacity (through botox injections) enough that IC is feasible.


          I'm not expecting any miracles but I have recovered pretty significantly in other areas so I think it would be worth a try.

          I appreciate the your insight, thanks very much.

          Comment


            #6
            Can you feel your bladder at all? If not capping off the s/p is not a good idea as you may be building up excess pressures and cause long term kidney damage. You may want to get a simple xray to check to see if your ureters are distended at all, if so you need to be on another bladder program or you will end up with kidney problems as the nurse outlined above. I do use the crede and tapping method, but for me it's different as I have practically zero sphincter pressure as I had a very aggressive operation done for the both the inner and outer sphincter so even if I lean back and the bladder is at all full I start to pee.
            "Life is about how you
            respond to not only the
            challenges you're dealt but
            the challenges you seek...If
            you have no goals, no
            mountains to climb, your
            soul dies".~Liz Fordred

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              #7
              Urodynamics testing with fluoroscopy can also tell you your capacity, pressures and if there is backing up at a specific volume and the safety of what you describe. You let the SPtube empty your bladder every 3-4 hours?
              CWO
              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

              Comment


                #8
                Originally posted by Curt Leatherbee View Post
                Can you feel your bladder at all? If not capping off the s/p is not a good idea as you may be building up excess pressures and cause long term kidney damage. You may want to get a simple xray to check to see if your ureters are distended at all, if so you need to be on another bladder program or you will end up with kidney problems as the nurse outlined above. I do use the crede and tapping method, but for me it's different as I have practically zero sphincter pressure as I had a very aggressive operation done for the both the inner and outer sphincter so even if I lean back and the bladder is at all full I start to pee.
                Yes I can feel when I need to piss- I just can't do it! Have had a urodynamics test done etc. Urologist felt that cycling the bladder would keep it in the best shape and I love not having to wear a leg bag 24/7.

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                  #9
                  Originally posted by SCI-Nurse View Post
                  Urodynamics testing with fluoroscopy can also tell you your capacity, pressures and if there is backing up at a specific volume and the safety of what you describe. You let the SPtube empty your bladder every 3-4 hours?
                  CWO
                  It really depends on how hydrated I am. I can only hold a little over 400ml so some times it's almost every hour, other times it might be around 4 hours. Dr. thinks more botox will (might) improve the situation.

                  Comment


                    #10
                    I find it strange that a urologist would be recommending Botox if your volume is 400 ml. My docs have all wanted me to aim for ~300 ml per cath.
                    Don - Grad Student Emeritus
                    T3 ASIA A 27 years post injury

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                      #11
                      how often are you cathing at that? At 2000ml of water only per day that's like 8x day!

                      Comment


                        #12
                        Originally posted by cripwalk View Post
                        how often are you cathing at that? At 2000ml of water only per day that's like 8x day!
                        You don't put out urine = to the amount you take in. Your body looses water through your breathing, sweat, and metabolism as well. We also recommend never having more than 425-450 cc. in your bladder at a time. Higher amounts increase the risk of UTI (by decreasing blood flow to the bladder lining) and increase the risks for reflux. Most people who drink 2400 cc. daily can cath 5-6X daily and achieve this.

                        (KLD)
                        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                        Comment


                          #13
                          Thanks KLD.

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