Back and urological problems

frb1591 · 09-13-2007, 07:20 PM

I have herniations at both L4-5 and L5-S1 with "with inferior migration of the disc fragment to the upper S1 spinal canal, leading to focal broad-based left-sided thecal sac encroachment and displacement of the left S1 nerve root". I previously had a L4 laminotomy with everything appearing o'kay in that area.

My question is: The displacement of the S1 nerve root is said to be "slight" on the MRI results, but does anyone have any experience with bladder dysfunction and a "slight" displacement? I have had an extreme constant urethral spasm since July and really wouldn't be able to urinate without Enablex, Flomax (I'm female), and Lyrica...and even then sometimes I can't urinate. The constant spasm is driving me nuts!

Any thoughts would be greatly appreciated!

Baybreeze · 09-13-2007, 07:38 PM

Hi, I havent your exact issue, but i've had several large herniations and tears, as well as severe lumbar canal stenosis and I have noticed that my bladder gets flares of symptoms when this happens. And when I take steroids (usually in epidurals but a couple times in pill form) my bladder symptoms seem to go away and I urinate normally again. It just so happens it came up during my gyno appt a couple weeks ago and she said some spine issues might afect bladder function but she wanted me checked for interstitial cystitis first. I just had that test done yesterday and the doc who did that test found after it was done I did not have this condition. I explained to him also about what ive noticed regarding it seems to coincinde with either stenosis or herniations and he also said ti could be possible. (though i've not had any large herniations at S1 that I know of, only bulges) So now I have to schedul more tests, to check my bladder capacity and voiding. This doc said that if any nerves from teh spine to the bladder get affected, it can cause problems such as bladder spasms, not completey emptying the bladder, dribbling, even loss of function, and neurogenic bladder (though I think he said some of these symptoms can be classified as part of neurogenic bladder). All of this, in turn, can even end up causing bladder infections (such as if one isnt completely emptying their bladder, the bacteria stay in there & build up, then cause infection)

frb1591 · 09-13-2007, 09:23 PM

Baybreeze, Thanks for your quick reply. What your doc told you is exactly what is happening with me, I think. My neurosurgeon scheduled me for a mylegram followed by a CT and an EMG next week. I originally had a bad spell with my back complete with a bladder infection...As I've never had a bladder infection before, I just assumed that the back pain (radiating into the leg) was due to the bladder infection. I knew I wasn't emptying completely for some time but didn't pay any attention to it. Now I'm putting the pieces together, I hope. After the first round of antibiodics, I was clear of the infection but one day later the urethral spasm hit me and hasn't let up...and that's been since July!

My urologist catherized me twice and told me I have urine retention....duh! He told me not to believe what my mom told me when I was a kid...that it was o'kay to pee in the tub...gave me flomax, enablex and more or less sent me on my way.

My GP prescribed lyrica which has helped somewhat but I'm finding that I'll probably be on the max dosage in a couple of days because the spasm is not responding to the lyrica as it did at first.

My urologist told me that interstitial cystitis is more or less a diagnosis after everything else has been ruled out. If the back tests next week don't show anything, then I'll go to another urologist IF I can't talk the neurosurgeon to take out the piece of disc pressing on the nerve root...I've got a huge gut feeling that's my problem. I was not emptying completely 7 years ago when the other fragment of disc was removed but didn't realize it until after the surgery was over. I remember telling my GP that I could urinate better then and he said that disc problems can cause bladder problems as well.

If all else fails, I'll just get off the meds and go to the emergency room screaming in pain and refuse to leave until somebody finds out what's wrong!

Again, thanks for your reply!

bwitht · 09-14-2007, 12:06 AM

You do not say what caused your herniations, but here if what I found out. My neurosurgeon just about flipped out when she found out that I had bowel and bladder control problems for over 10 months and nothing had been done. She told me that any problems with control, when there has been a back injury, is considered an emergency. I should have gone to the ER & had the surgery immediately. She said that even if the compression is corrected within hours, often the damage is permanent. My control problems are permanent, luckily I do have partial control. Please take this very seriously, do not stand for any delays. Be very persistant with your NS about the retention problems.

Moldova · 09-14-2007, 06:20 AM

My bladder affected by back problems too but in a different way: I run to the bathroom all night long. Drink liquid or not - I'm up every 1/2 hour, sometimes more often. I am so tired; day time I can handle, but night, when I want to sleep and each time I get up -more pain I feel in my back - I run and I run...
And it never feels like it's empty - you just got back to bed, feels I could go again. And nothing they can do about it.
So sorry about your problems, this is very frastruating, I know...