Urinary Issues: Bladder Surgery and Menstrual Irregularities - Urology

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Understanding urinary issues, especially after undergoing bladder surgery, can be complex and multifaceted. In your case, it seems that you have experienced significant changes in your urinary function and menstrual cycle following a bladder neck incision surgery performed over a year ago.
Firstly, bladder neck surgery is typically performed to alleviate urinary retention or obstruction. While this procedure can be effective in improving urinary flow, it may also lead to unintended side effects, including changes in bladder sensitivity and function. The sensation you describe in your lower back when you need to urinate could be related to altered nerve signaling in the pelvic region following your surgery. The bladder and surrounding structures, including nerves, can be affected by surgical interventions, leading to sensations that may not have been present before.

Moreover, the relationship between urinary issues and menstrual irregularities is not uncommon. The pelvic region is interconnected, and changes in one area can influence another. Hormonal fluctuations, which can be exacerbated by medications for mental health conditions such as schizophrenia and anxiety, may also contribute to menstrual irregularities. Antipsychotic medications, for instance, can sometimes affect hormonal levels and menstrual cycles, leading to irregular periods or changes in flow.
Your experience of having your menstrual cycle disrupted, with periods occurring more frequently or irregularly, could be a result of several factors, including hormonal changes due to medication, stress, or the physical impact of your surgery. It is essential to consider that the body often takes time to adjust after surgical procedures, and the interplay of various medications can further complicate this adjustment.

Given your concerns, it is crucial to consult with both your urologist and gynecologist. They can work together to evaluate your urinary symptoms and menstrual irregularities comprehensively. Here are some steps you might consider:
1. Comprehensive Evaluation: Schedule appointments with both your urologist and gynecologist. Discuss your urinary symptoms, including the urgency and any discomfort you experience, as well as your menstrual irregularities.
2. Medication Review: Have a thorough review of all medications you are currently taking, including those for mental health. Your healthcare providers can assess whether these medications might be contributing to your symptoms and discuss potential alternatives or adjustments.

3. Pelvic Floor Assessment: Consider a referral to a pelvic floor specialist. They can evaluate the function of your pelvic muscles and nerves, which may help in addressing both urinary and menstrual issues.

4. Mental Health Support: Since you mentioned taking medication for schizophrenia and anxiety, ensure you have adequate mental health support. Stress and anxiety can significantly impact both urinary function and menstrual cycles.

5. Lifestyle Modifications: Implementing lifestyle changes, such as stress management techniques, regular exercise, and a balanced diet, can also help improve overall well-being and may positively influence both urinary and menstrual health.

In conclusion, the interplay between your bladder surgery, urinary symptoms, and menstrual irregularities is complex and warrants a multidisciplinary approach. By collaborating with your healthcare providers, you can work towards finding effective solutions to improve your quality of life. Remember, it’s essential to communicate openly about all your symptoms and concerns to receive the best possible care.