Sudden Urination

[MikeC]

First a little background. I intermittent cath 6 times a day. About a month ago I started having groin pain. Went to the doctor this week (Monday) and he checked for hernia and UTI - both negative. He was able to recreate the pain by having me lay on my back and spread my legs. He figured I had inflammed something even though the pain was intermittent so gave me a prescription for naproxen. A few weeks ago I started having constipation problems. I take fiber, stool softener, and prunes daily. Constipation is getting worse so Wed I started taking Dulcolax at night. This morning I was getting ready for breakfast and I peed myself. My bladder didn't empty but there was enough urine to run down my leg and onto the floor.

Does anybody have any idea of what can be causing this? I've had a little urine leakage in the past if my bladder is overfull but never had it release like this. I don't know if everything (constipation, groin pain, etc) is connected so thought I'd provide all of the details.

[SCI-Nurse]

Prostate problems? Did your doctor do a prostate exam? Was it your urologist who did the exam or some other physician? Was a PSA done?

(KLD)

[MikeC]

Thanks for answering KLD. My primary care doctor did the exam and digitally checked my prostate. A PSA wasn't done. Can prostate problems cause urination? The laxative I took finally worked and I had a huge bowel movement this morning. Can constipation cause sudden urination?

[SCI-Nurse]

Constipation can interfere with urination (retention); less likely to cause urinary incontinence.

The prostate is right above the external urinary sphincter, and in theory, inflammation there could effect the integrity of the sphincter. If you have not had a PSA done in the last several months, I would recommend getting one done if this pain continues. It can be elevated due to prostatitis as well as prostate cancer.

(KLD)

[MikeC]

Thanks again. Sometimes when I cath I feel like the catheter is pushing against something. It’s a hard feeling to describe but its like something inside is being pushed aside not like I’m pushing it in. I have been having problems inserting the cath so had a cysto in October and it was clear

[SCI-Nurse]

Just a shot in the dark, but hip fractures can cause referred pain to the groin in men and the labia in women. Any chance you could have a hip fracture or dislocation?

(KLD)

[MikeC]

Thanks, I don't think I have a hip fracture - I haven't fallen or anyway hurt my hip. I just had a bowel accident. I didn't think that the laxative would keep working after the initial clean out. I took 2 imodium. Do you think that's okay - to take imodium until the accidents stop?

[crags]

An enlarged prostate can give one the feeling of running up against a hard blockage when inserting a catheter, especially if the blockages encountered about 2/3 to 3/4 of the way in. You may want to try using a Coude catheter and if that helps reduce the difficulty, it may be further indication that it is a prostate problem. I would often encounter this and then when I gave up and withdrew the catheter the tip was bloody from the tissue trauma. Chronic colonization and infection can lead to infection of the prostate are the very least chronic low-grade inflammation/prostatitis, hard to diagnose and hard to treat.

I had a high PSA as well and the doctor sent me for an MRI revealed suspicious nodules on the prostate which were then biopsied using the data fusion ultrasound/MRI machine for more accurate biopsy. Thankfully, all biopsies came back negative. I have been on finasteride for quite a while now and my PSA is well within normal limits. In addition I was bleeding out the urethra when my aid would do digital removal of stool during my bowel routine. This motion, similar to a digital exam must have been irritating to an enlarged prostate. This bleeding too has stopped.

As a matter of practice I cath through my umbilical stoma into my augmented bladder, though I thought it may have been good to cath through the penis just to make sure the channel remained open. However, after seeing the bleeding even after everything came back normal, my doctor said to stop it.

Curiously, whenever I had a cystoscope for Botox or otherwise, the physician didn't have too much trouble inserting the instrument, though after the Botox I did bleed a bit. In addition to the blood from the procedure, which traumatizes the bladder lining, it was also bright red blood dripping out of my urethra from the trauma of the scope passing the prostate.

Some people just have an anatomically very sharp angle where the urethra curves around the prostate.

[MikeC]

Thanks for the post crags. I’ve been using coude caths and finasteride since my accident. I had blood on my cath a few weeks ago. I hope the constipation doesn’t come back. Don’t want to take more laxatives.

[crags]

I thought I had developed what is known as a false channel when the catheter creates its own offramp so to speak off the main urethra, but the urologist said I didn't have one.

[MikeC]

I worry about a false passage also. I was having a very hard time cathing last Sept/Oct and the urologist said I don't have one either. He dilated the opening but it seems to be closing again. Do you ever feel pressure in a testicle when cathing? I sometimes feel that - one of the things that made me think I had a false channel.

[Donno]

In the past when I felt that it was difficult to get the catheter all of the way in, I would put in a foley and leave it in for a couple of days. It seemed to help.

[MikeC]

I don't use foleys so don't have one to use. However, I do think it would help to not insert caths for a few days. Seems like I've irritated something.

[Art454]

If you are sitting on a roho cushion it can make it hard to install cath. Sometimes have to lift myself up with elbows just to get enough weight off you butt and then it goes right in. If you can't do that lay in bed and you should not have a problem. The longer I sit sometimes I have a harder time with a cath. Seems like things get twisted up for some reason too. Just me I guess.

[drutland]

You may be beyond your issue by now but I thought I would post this in hopes of being of help to you. Dulcolax is a stimulant laxative. It stimulates smooth muscles forcing them to contract more than they normally would. The bladder is also made of smooth muscle and Dulcolax can make it more contractile also. Those small dribbles you have can become a steam if the bladder is more irritable. In normals its not a problem they can send a conscious signal to the external sphincter (Whoa boy, not now) and it can exert more pressure than the bladder is at the moment. for a lot of us we do not have that luxury. For us a lot depends on the amount of tone in our external sphincters. Mine is not so great so when my bladder decides to pounce I get more than a dribble. And that is without taking dulcolax or anything. I can be completley dry for hours and then fill up a depends guard for men in seconds.
Have you tried mirilax? It pulls fluids into the gi tract which causes it to contract more than normal also. The extra fluid makes the stool softer as well. It wont effect the bladder.