Can L5-S1 Slippage Cause Incomplete Urination or Incontinence? - Urology

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L5-S1 slippage, commonly referred to as spondylolisthesis, can indeed contribute to urinary issues such as incomplete urination or incontinence. The lumbar spine, particularly the L5-S1 region, plays a crucial role in the function of the lower body, including the bladder and urinary tract. The nerves that control bladder function originate from the spinal cord and travel through the lumbar and sacral regions. When there is slippage at the L5-S1 level, it can potentially compress these nerves, leading to various urinary symptoms.

In your case, the fact that you are experiencing incomplete urination and occasional dribbling could be related to nerve compression or irritation caused by the slippage. While your neurosurgeon has indicated that there is no cauda equina syndrome (a serious condition that requires immediate attention), it is still possible for other forms of nerve compression to affect bladder control. This can manifest as urgency, frequency, or incontinence, especially if the nerves that innervate the bladder are impacted.

Additionally, psychological factors can also play a significant role in urinary symptoms. Stress and anxiety can lead to increased muscle tension, which may affect the pelvic floor muscles and bladder function. If you are experiencing significant psychological stress, it could exacerbate your urinary issues.
Regarding your concerns about the wetness in your underwear upon waking, it is essential to differentiate between urinary incontinence and other potential causes such as sweating or nocturnal emissions. If you are unsure whether the wetness is due to urine or sweat, consider keeping a diary of your symptoms, noting when they occur and any associated activities or feelings. This information can be helpful for your healthcare provider in determining the underlying cause.

As for the issue of not being circumcised, while it may contribute to discomfort or hygiene challenges, it is less likely to be directly related to your urinary symptoms. However, if you experience discomfort during erections or have difficulty cleaning the area properly, it could lead to irritation or infection, which may indirectly affect bladder function.

In summary, L5-S1 slippage can potentially cause urinary issues due to nerve compression. It is essential to continue monitoring your symptoms and communicate openly with your healthcare provider about any changes. They may recommend further evaluation, such as urodynamic studies, to assess bladder function more comprehensively. Additionally, addressing any psychological stressors and ensuring proper hygiene can also be beneficial. If symptoms persist or worsen, further imaging or intervention may be necessary to alleviate any nerve compression and improve your quality of life.