Bladder Elasticity Issues: Long-Term Effects of Urinary Retention

Q: Bladder Elasticity Issues: Long-Term Effects of Urinary Retention

Hello： 1) BACLOFEN 5mg should not have side effects, but you should consult your physician for an evaluation. <br>2) In the short term, there should not be any issues, but it is important to seek long-term medical care. <br>Wishing you good health.

Poor bladder elasticity?

Since elementary school, through middle school and college, I have been unable to urinate in public restrooms when others are nearby.
This has led to a pathological condition of holding in urine, where I would only urinate when the restroom was empty.
Due to the frequent presence of others in restrooms, I often experienced severe urinary retention.
I only realized at the age of 28 that this long-term holding of urine throughout my life would severely impact my future.
Now, I can urinate in public, but I experience symptoms such as frequent urination, difficulty urinating requiring abdominal pressure, urgency, and a feeling of incomplete emptying.
On January 30, 2013, I had a report of uroflow results: peak flow rate 6 ml/s, time to peak flow 110 seconds, voided volume 186 ml, flow time 112 seconds, voiding time 222 seconds, average flow rate 2 ml/s, and residual urine 40 ml.
On December 1, 2011, a bladder biopsy report indicated a diagnosis of urinary bladder (neck), transurethral biopsy, cystitis glandularis.
The specimen submitted consisted of two pieces of mucosal tissue measuring up to 0.3 cm in greatest dimension.
The physician noted that these biopsy results were due to long-term pathological urinary retention.
In my most recent report from the hospital, I had a residual urine volume of 50 cc.
The physician stated that my uroflowmetry and urodynamics tests showed that I was using abdominal pressure to urinate, had poor bladder elasticity, weak bladder contractions, and reduced bladder capacity.
The doctor explained that long-term urinary retention has caused damage, resulting in the 50 cc of residual urine.
1.
The urologist prescribed tamsulosin 0.2 mg, one capsule twice daily, and baclofen 5 mg, one capsule twice daily.
What are the long-term side effects of taking baclofen 5 mg? Will long-term use of this medication lead to more irreversible and permanent weakening of bladder contractions?
2.
Will I need to perform self-catheterization for the rest of my life? Given that I already have 50 cc of residual urine, how long—months or years—before I might need to start catheterization? I want to mentally prepare myself for the possibility that I have ruined my life.
I am also taking the following long-term medications:
- Psychiatry:
- Leeyo (escitalopram) 10 mg, two tablets at bedtime
- Lendormin 0.25 mg, two tablets at bedtime
- Eurodin 2 mg, two tablets at bedtime
- Lorazepam 0.5 mg, four tablets at bedtime
- Dermatology:
- Doxepin 25 mg, two tablets at bedtime
- Lyrica (pregabalin) 75 mg, two tablets at bedtime
- Xyzal 5 mg (for severe itching)
- Metabolism:
- Metformin HCL 850 mg
- Urology:
- Tamsulosin 0.2 mg
- Gastroenterology:
- Lansoprazole 30 mg before breakfast
- Promethazine 3.84 mg (for gastric issues)
- KASCOAL after meals.

lov15788, 30~39 year old female. Ask Date: 2020/08/08

Dr. Liu Mingyue reply Urology

Hello: 1) BACLOFEN 5mg should not have side effects, but you should consult your physician for an evaluation.
2) In the short term, there should not be any issues, but it is important to seek long-term medical care.
Wishing you good health.

Reply Date: 2020/08/08

More Info

Understanding bladder elasticity issues and the long-term effects of urinary retention is crucial, especially for individuals who have experienced chronic urinary problems. Your history of pathological urinary retention, stemming from a fear of urinating in public, has likely contributed to the bladder dysfunction you are currently experiencing.
Chronic urinary retention can lead to several complications, including bladder overdistension, decreased bladder elasticity, and detrusor muscle dysfunction. The detrusor muscle is responsible for bladder contraction during urination. When the bladder is consistently overfilled due to prolonged retention, the muscle can become weakened, leading to a reduced ability to contract effectively. This can result in symptoms such as difficulty initiating urination, a weak urine stream, and a sensation of incomplete bladder emptying, which you have described as residual urine.

Your uroflowmetry results indicate a significantly low peak flow rate and prolonged time to peak flow, which are consistent with bladder outlet obstruction or detrusor underactivity. The presence of residual urine (50cc) suggests that your bladder is not emptying completely, which can lead to urinary tract infections and further complications.

The medications prescribed to you, tamsulosin and baclofen, serve different purposes. Tamsulosin is an alpha-blocker that helps relax the muscles in the prostate and bladder neck, improving urine flow. Baclofen, on the other hand, is a muscle relaxant that can help reduce bladder spasms. While baclofen can be effective, long-term use may lead to tolerance or dependence, and it is essential to monitor its effects on bladder function closely. There is a concern that prolonged use of baclofen could potentially exacerbate detrusor muscle weakness, but this varies from person to person. Regular follow-ups with your urologist are crucial to assess the ongoing effectiveness of these medications and to make necessary adjustments.

Regarding the possibility of needing self-catheterization in the future, it is difficult to predict an exact timeline. Factors such as your current bladder function, response to medications, and any changes in your symptoms will influence this decision. Self-catheterization may become necessary if your bladder continues to retain urine and if you experience worsening symptoms or complications. It is advisable to prepare mentally for this possibility, but also to remain hopeful that with appropriate management, you may be able to maintain some level of bladder function.

In conclusion, your situation highlights the importance of addressing urinary retention early and effectively. Engaging in regular follow-ups with your healthcare providers, adhering to prescribed medications, and possibly exploring additional therapeutic options such as bladder training or pelvic floor exercises may help improve your bladder function over time. It is also essential to maintain open communication with your healthcare team about any new symptoms or concerns that arise. By taking proactive steps, you can work towards improving your quality of life and managing your urinary health effectively.

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