Urgency With Severe Hesitancy
Spastic legs tire easily and refuse to walk properly on command. Spastic Bladders never tire, but often refuse to urinate on command.
As the normal Bladder wall contracts to begin urination, muscles at the Bladder Neck relax, allowing urine to leave the Bladder and enter the Uretha.
In MS Bladders, the muscles around the Bladder Neck may not recieve the impulse from the Brain to relax when they should; obstructing the flow of urine at the very moment of worst urgency.
It may take 20 minutes of trying, before the Bladder neck muscle finally relaxes and urination can occur. This is called Detrusor-Sphincter DysSynergia (Bladder Wall muscle-Bladder Neck muscle incoordination).
The DysSynergia dysrupts a pleasant day. It is dysagreeable, dysadvantageous and dyscouraging. It makes MSers dysconsolate, dysgruntled and dyscommoded. It is a major nuisance.
The cause of Detrusor-Sphincter DysSynergia is Spasm of muscle at the Bladder Neck.
Dibenzyline prevents Spasm of Bladder Neck muscles, decreases hesitancy improves urinary stream and helps to reduce residual urine volume.
The major symptom is tremendous urgency, coupled with inability to urinate. Seek the cause by requesting Urodynamic Studies; or ask for a prescription of Dibenzyline to determine whether it can provide relief.
The worst side effect of Dibenzyline is dizziness, sometimes worsened by getting up from sitting or lying down.
When To Change From Spasticity To Flaccidity Management
I have trouble advising MSers as they emerge from successful management of a spastic Bladder, and discover to their dismay that this week Ditropan makes things worse.
My first assumption is the Bladder is overdosed, so we stop the pills. This usually improves Bladder function.
If the Bladder has become more flaccid a limited use of Ditropan several days later may again cause incontinence.
For MSers who know self-cath the problem is easier. When Ditropan fails, we check the residual urine volume immediately. If the person has kept records, we then know how the residual urine volume has changed.
Usually we stop Ditropan and return to self-cath. Once the residual falls again, Ditropan might again be useful.
If Ditropan failed because MS caused more Bladder flaccidity, it cannot again be the sole mode of management untill MS again adds Spasticity to Bladder function.
p127Successful MSers develop a combination of management techniques that help them adjust to change. This requires vigilance and occasional re-assessment of Bladder function.
If you develop expertise, you may be able to do most of this at home. A limited number of techniques emcompass all of Bladder management. Keep a record of successes and failures.
Learn from your doctor and keep the professionals in your life informed. Your aggressive decision to take charge will improve your life in future years.
Master the few techniques of Bladder management so you can continue your life without losing your urine or your composure. You can avoid or manage almost all emergencies.
Individual procedures sound hard, but once they have been mastered they are straightforward and simple. Choose proper management over complications.
Persevere through hard times, because excellent Bladder management for the rest of your life is worth far more, than the limited effort you must invest now.