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    Urethral filler

    Had a review with my Psyiatrist and she suggested I see my Urologist about using a Uretheral bulking agent instead of Ditropan. Has anybody used this? I'm 45 T11/12 with Spina Bifida

    #2
    Two different approaches to two different problems. Ditropan or other anticholenergic medications help prevent leakage by decreasing bladder muscle spasm (uninhibited contractions). If you have a flaccid bladder already (common in SB), there is no point in using Ditropan, as it has no effect on the external urinary sphincter muscle (which is striated or voluntary muscle, not smooth muscle like the bladder itself).

    Bulking the urethra with injections can be done, as can the surgical placement of an artificial sphincter device if the bladder itself is truly flaccid, and leakage is due to an incompetent (non-contracting) external urinary sphincter. Emptying the bladder may need to be done with intermittent catheterization after such a procedure (straining or valsalva or crede may no longer be possible or safe). Also it is generally advised not to do this if you still have bladder tone or spasm (a reflex, not a flaccid, bladder). You should have a discussion about these options with your urologist, and urodynamics should be part of the studies done to help make this decision.

    (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.

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      #3
      Thank you KLD, I didnt realize with a Flaccid bladder and incompetent external sphincter that the medication would have no effect. No wonder my Dr. has made no further push on medications.

      He (Dr.) also told me not to push at all, let the straight catheter empty the bladder. So I merely have dribbling now.

      And I felt the push towards a Foley.

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        #4
        Thanks KLD, see the urologist on the 11th to discuss this further. Internet Explorer hasn't been working well for me in accessing cc so that's why it took so long to reply

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