3 replies to this topic

[Lucydog]

This might seem a really stupid question, but why does it matter if your bladder shrinks and you have less capacity? Apart from being an en route stop from the kidneys to the loo does the bladder have any other necessary function? After all I dont suppose any of us are really using our bladders much these days, so it seems to be as about as redundant as the appendix. When discussing these things, I know ISC is the prefered method (I do know all the risks of the others) but having said that, why does it matter tht we should keep bladder capacity? Id have thought that as long as pee wasnt backing up into the kidneys that was the main thing.

One more point, has anyone noticed that there seems to be quite a difference in accepted treatment for bladder problems between the UK and US? Well I think there is anyway.

thanks for your input and hope it wasnt too stupid a question.

cheers

[Autonomic]

Hello there,

Not a stupid question at all. As far as I know... as bladder capacity decreases, the pressure build-up within the bladder can increase. For example, as I have a neurogenic bladder, I'm prone to lots of spasticity throughout the day. Like any muscle, after much use, it will build. The extra lining created on the bladder walls from this extraneous use makes the bladder walls much thicker, therefore not nearly as eslastic - which will cause increased pressure.

This can can cause increase in frequency of voiding (because of lack of capacitiy), stronger spasms (which simply keeps the cycle of build-up going), and can become painful (causing lots of autonomic dysreflexia). And you're right too, the build-up into the kidneys (reflux) is dangerous.

So, bladder capacity is important as it allows for a lower-pressure system of urine release from the body. It's also important for folks like us, as the least amount of times you have to catheterize yourself will help reduce infections and micro-tearing from the friction of the catheter (ouch).

This is all what my urologist explained to me earlier this year =) Hope this helps!

[Izziwhizzi]

Lucydog, on Oct 13 2007, 07:11 PM, said:

This might seem a really stupid question, but why does it matter if your bladder shrinks and you have less capacity? Id have thought that as long as pee wasnt backing up into the kidneys that was the main thing.

One more point, has anyone noticed that there seems to be quite a difference in accepted treatment for bladder problems between the UK and US? Well I think there is anyway.

thanks for your input and hope it wasnt too stupid a question.

cheers

Yes a small bladder can be seen as just another part of tubing, as pee drains into a bag.

Thats the problem, theres no overflow, so when your bladder is as small as ours get then you get a lot of build up of wee very quickly which for me fortunately ends up in weeing myself and hopefully not too much reflux into the kidneys. I mean I can sometimes only get 5 seconds notice that I have a full bag before I pee. And think as much as you'd like it would be easy to notice when your bag is full, a couple of cups of tea and leaning over to check a full bag is enough to put pressure on to pee.

With a small bladder you get a lot or irritation from the catheter balloon causing bladder spasm, which can cause rejection. Peeing during sex isn't good either for either side, and with a small bladder this happens either from rejection or if you remove it first I can't last for a minute without peeing. Hope that bit makes sense.

But I am having a very negative thing on indwellings at the moment. I think I have uretha damage (probably from rejections) causing even more frequent rejections - I can't sit up in bed any more without it rejecting.

I have had 25 years of only needing to find a drain to pee into so I guess I've had the best option for me. But don't be misguided in thinking an indwelling is an easier option to always keeping you dry. It may be at the start but this changes a few years down the line.

I agree there is so much difference over here to the US - thats very visible on the web. Sometimes I sceptically think they like the mitrafanoff just because its another operation they can charge for privately. Or on the more positive side the larger numbers of sci people give them a better insight on scale.

[lune14]

Lucy,

Excellent question to bring up. I think a great many of us were told what to do but never educated as to the underlying reasons. Or maybe we were told but we had so much info to process, our brains selectively weeded out only what we needed to get through the day. What a great refresher course this is for a lot of us though, I'm sure.

Best to you with the cath issues!