Bladder Elasticity Issues: A Journey Through Urinary Challenges

Q: Bladder Elasticity Issues: A Journey Through Urinary Challenges

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 be no issues, but long-term medical care is essential. <br>Wishing you good health.

Poor bladder elasticity?

Since elementary school through high school and into college, I have been unable to urinate in public restrooms when others are nearby.
This has led to a pathological urge to hold my urine, waiting until the restroom is empty before I feel safe to go.
Due to the frequent presence of others in restrooms, I have often experienced severe urinary retention.
I only realized in my late twenties that this chronic retention from childhood through college could ruin my life.
Now, I am able to use public restrooms, but I suffer from symptoms such as frequent urination, difficulty urinating that requires abdominal pressure, urgency, and a sensation of incomplete emptying.
On January 30, 2013, I had a uroflowmetry report which showed the following results: peak flow rate of 6 ml/s, time to peak flow of 110 seconds, voided volume of 186 ml, flow time of 112 seconds, voiding time of 222 seconds, average flow rate of 2 ml/s, and residual urine of 40 ml.
A cystoscopy biopsy report from December 1, 2011, diagnosed me with cystitis glandularis in the urinary bladder neck.
The specimen submitted consisted of two pieces of mucosal tissue measuring up to 0.3 cm in greatest dimension.
The physician indicated that these biopsy findings 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 doctor stated that my uroflowmetry and urodynamics tests showed that I was using abdominal pressure to urinate, my bladder elasticity was poor, bladder contractions were weak, and my bladder capacity had decreased.
The doctor explained that long-term retention had caused damage, resulting in the residual urine of 50 cc.
1.
The doctor prescribed urology medications: tamsulosin 0.2 mg to be taken twice daily and baclofen 5 mg to be taken twice daily.
What are the long-term side effects of taking baclofen 5 mg? Will long-term use of this medication lead to irreversible weakening of bladder contractions, or is that not the case?
2.
Will I need to self-catheterize 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.
For my long-term medications, I am also taking psychiatric medications: at bedtime, I take Leeyo (escitalopram) 10 mg (two tablets), Lendormin 0.25 mg (two tablets), Eurodin 2 mg (two tablets), and lorazepam 0.5 mg (four tablets).
For dermatology, I take doxepin 25 mg (two tablets) and pregabalin (Lyrica) 75 mg (two tablets) at bedtime for severe itching that disrupts my sleep.
For metabolic issues, I take metformin HCL 850 mg.
For urology, I take tamsulosin 0.2 mg, and for gastroenterology, I take lansoprazole 30 mg before breakfast and promethazine 3.84 mg after meals.

lov15788, 30~39 year old female. Ask Date: 2020/08/10

Dr. Du Shixi 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 be no issues, but long-term medical care is essential.
Wishing you good health.

Reply Date: 2020/08/10

More Info

Understanding bladder elasticity issues and the challenges associated with urinary health can be a complex journey, especially for individuals who have experienced long-term urinary retention and related complications. Your history of pathological urinary retention, stemming from anxiety about urinating in public, has likely contributed to the current state of your bladder health.
From your description, it appears that you have been diagnosed with conditions such as cystitis glandularis and have undergone various tests, including uroflowmetry and cystoscopy. The results indicate that you have a significantly reduced peak flow rate and residual urine, which are common indicators of bladder dysfunction. The long-term effects of holding urine can lead to bladder overactivity, decreased elasticity, and even changes in the bladder wall that can affect its ability to contract effectively.

The medications prescribed to you, such as tamsulosin and baclofen, are intended to help manage your symptoms. Tamsulosin is an alpha-blocker that helps relax the muscles in the bladder neck and prostate, making it easier to urinate. Baclofen, on the other hand, is a muscle relaxant that can help reduce bladder spasms. However, it is important to be aware of the potential side effects of long-term use of these medications. Baclofen, in particular, can lead to muscle weakness and may affect bladder contractility if used over an extended period. It is crucial to have regular follow-ups with your healthcare provider to monitor your response to these medications and adjust the treatment plan as necessary.

Regarding your concern about the need for self-catheterization, it is difficult to predict exactly when you might need to start this practice. The presence of residual urine (50cc in your case) suggests that your bladder may not be emptying completely, which can lead to urinary tract infections and other complications. If your bladder function continues to decline, self-catheterization may become necessary to ensure complete bladder emptying and to prevent further complications. It is advisable to discuss this possibility with your urologist, who can provide guidance based on your ongoing assessments and bladder function tests.

In terms of psychological impact, it is understandable to feel overwhelmed by the situation. The journey through urinary challenges can be emotionally taxing, especially when it feels like your quality of life is affected. It may be beneficial to seek support from mental health professionals who can help you cope with the anxiety and stress related to your urinary issues.
Lastly, it is essential to maintain open communication with your healthcare team. Regular check-ups, medication reviews, and discussions about your symptoms and concerns can help you manage your condition more effectively. Remember that you are not alone in this journey, and there are resources and support systems available to help you navigate these challenges.
In summary, while the path ahead may seem daunting, proactive management of your bladder health, adherence to prescribed treatments, and seeking psychological support can significantly improve your quality of life. Stay engaged with your healthcare providers, and don't hesitate to voice your concerns and questions as you continue on this journey.

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