Trained and now have retention?

[Veg]

At 6 months now of my untraining journey! But this last 2 weeks or so there's been a problem, I think ive developed urinary retention, i can pee a little but not everything comes out, i'm honestly confused as what tk do moving forward since its the opposite of what I want.

Should I just go with it? Try holding until i physically cant anymore and loose control that way?

Im really confused

[oznl]

I strongly suspect I have something similar.  I pee a bit a few times every hour but these pees seem to be broken into installments and during the day, I often feel like that I am not completely empty although nothing further is happening.

I've had nothing resembling a UTI or kidney pain though.  So far it's just been a benign thing that I've noticed.  It's almost like I've forgotten how to have a "proper" pee but I always seem to be wet to some extent down there.

A bit over 3 years of 24/7 in...

[DiapergirlWB]

After time you stop having normal wetting and just dribble.  You won't have a stream much.

[PuraVidaDip]

Zombie topics! I've seen a bunch of comments on this topic, but not from anyone with first hand experience. Does anyone have first hand experience with seeing retention issues with the bladder after years of incontinence/bladder disuse? I have been dealing with urinary incontinence but am concerned if I just let go and give up on the remaining control, I will have bladder retention issues, forcing a use of a catheter to expel the bladder later in life. I need diapers either way, but just didn't know if there was any reason just to not let nature take it's course here...

[DiapergirlWB]

5 hours ago, PuraVidaDip said:

Zombie topics! I've seen a bunch of comments on this topic, but not from anyone with first hand experience. Does anyone have first hand experience with seeing retention issues with the bladder after years of incontinence/bladder disuse? I have been dealing with urinary incontinence but am concerned if I just let go and give up on the remaining control, I will have bladder retention issues, forcing a use of a catheter to expel the bladder later in life. I need diapers either way, but just didn't know if there was any reason just to not let nature take it's course here...

Maybe you should consult a medical professional instead of a random message board if you are looking for actual fact filled answers instead of belittling people that are answering?

 

[Enthusi]

Obviously I can only speak for myself but I raised this concern with my urologist.   He says that if my bladder capacity shrinks the same time my sphincter strength deteriorates then it wouldn’t cause urinary retention. Although he did point out that if this is a concern he can schedule urologic testing to find out. 

Again, I can only speak for myself, but as my control has waned I sometimes have the sensation that a couple of drops of pee are stuck in the urethra.  When this happens it feels like I’m dribbling a lot but the diaper is only slightly damp.  Also more and more peeing is becoming more of an “event”.  I will wet a decent amount and think I’m done and good to go, and 15 minutes later I feel a sudden urge to go immediately followed by wetting, and then again 15 minutes later.   Though I usually feel “empty” between each burst of wetting.    

 

[Diapered Dave]

I think there's two possibilities here... 

1. You pee a little bit, then your sphincters close, while there's still urine in your bladder. (Urine retention.)

2. Your bladder has shrunken, so you get the urge to pee when there's not much urine in your bladder. You pee a little, then a short time later, you get another urge to pee, but again, only pee a little bit. 

So how to find out which one it is?? I'm not a medical person, but I would think that if you used an intermittent catheter right after you urinated, you'd be able to tell. If a fair amount of urine came out, I'd think that would be a sign of urine retention. If barely anything came out, I'd think that would show signs of a shrunken bladder.

Just my thoughts... No medical education here. 

[zzyzx]

10 hours ago, PuraVidaDip said:

Zombie topics! I've seen a bunch of comments on this topic, but not from anyone with first hand experience. Does anyone have first hand experience with seeing retention issues with the bladder after years of incontinence/bladder disuse? I have been dealing with urinary incontinence but am concerned if I just let go and give up on the remaining control, I will have bladder retention issues, forcing a use of a catheter to expel the bladder later in life. I need diapers either way, but just didn't know if there was any reason just to not let nature take it's course here...

First, see and talk to your Urologist on this subject....

As someone that has issues in part as the result of early onset of BPH and using the "watch and wait" approach, and later needing and receiving the Rezūm procedure (ref: https://www.rezum.com/home.html ), I need to watch what I say in the this specific forum.

One issue I have from the "watch and wait" protocol is I didn't recognize early enough that the bladder was becoming less compliant, resulting in decreased storage capacity.  One thing my current Urologist has checked on every appointment is retention, using a local ultrasound type scan to see how much is left in the bladder after emptying.  So far, I don't have a retention issue.  I'm not sure the specifics behind why the retention check is done every time, but it is.  So, obviously there is a concern that for what ever my combination of issues are that retention could become an issue.

Note concerning Rezūm procedure:  This is not for everyone.  If you have a high risk of prostate cancer this procedure will NOT provide tissue for a biopsy, so may not be appropriate in your case.  In my case it was appropriate, and I consider it a significantly better option than a TURP or some of the other available procedures.  Consult a Urologist.

[PuraVidaDip]

6 hours ago, DiapergirlWB said:

Maybe you should consult a medical professional instead of a random message board if you are looking for actual fact filled answers instead of belittling people that are answering?

 

That’s a fair point. I wouldn’t call asking for references belittling but I could see it taken that way now that you’ve called me out. I’ve consulted my urologist 3 weeks ago in person and have a follow up in a week. I’ve been screwed over by medical professionals before who were truly trying to do the right thing so I’m skeptical now from just taking the opinion from just one person. Also the people on this forum have actual first hand experience so thats why I ask here. 

4 hours ago, Enthusi said:

Obviously I can only speak for myself but I raised this concern with my urologist.   He says that if my bladder capacity shrinks the same time my sphincter strength deteriorates then it wouldn’t cause urinary retention. Although he did point out that if this is a concern he can schedule urologic testing to find out. 

Again, I can only speak for myself, but as my control has waned I sometimes have the sensation that a couple of drops of pee are stuck in the urethra.  When this happens it feels like I’m dribbling a lot but the diaper is only slightly damp.  Also more and more peeing is becoming more of an “event”.  I will wet a decent amount and think I’m done and good to go, and 15 minutes later I feel a sudden urge to go immediately followed by wetting, and then again 15 minutes later.   Though I usually feel “empty” between each burst of wetting.    

 

Ok thank you, that makes sense. It’s good to hear it from a urologist, even if second hand. I guess I shouldn’t be so worried as I can always have checkups done. 

I’m peeing 15-30 minutes apart unless I’m in a weird position but get a sense of what you are describing now. Definitely nice to hear a specialist has no grave concern over it. 

3 hours ago, Diapered Dave said:

I think there's two possibilities here... 

1. You pee a little bit, then your sphincters close, while there's still urine in your bladder. (Urine retention.)

2. Your bladder has shrunken, so you get the urge to pee when there's not much urine in your bladder. You pee a little, then a short time later, you get another urge to pee, but again, only pee a little bit. 

So how to find out which one it is?? I'm not a medical person, but I would think that if you used an intermittent catheter right after you urinated, you'd be able to tell. If a fair amount of urine came out, I'd think that would be a sign of urine retention. If barely anything came out, I'd think that would show signs of a shrunken bladder.

Just my thoughts... No medical education here. 

I appreciate your thoughts. I actually had an expensive in hospital / ER test on my bladder done about 10 months ago and they said they didn’t see any retention. At my urologist visit 3 weeks ago they did a lighter version with the same result. I’m not having retention now, nor have I but just concerns about it down the road. 

[PuraVidaDip]

1 hour ago, zzyzx said:

First, see and talk to your Urologist on this subject....

As someone that has issues in part as the result of early onset of BPH and using the "watch and wait" approach, and later needing and receiving the Rezūm procedure (ref: https://www.rezum.com/home.html ), I need to watch what I say in the this specific forum.

One issue I have from the "watch and wait" protocol is I didn't recognize early enough that the bladder was becoming less compliant, resulting in decreased storage capacity.  One thing my current Urologist has checked on every appointment is retention, using a local ultrasound type scan to see how much is left in the bladder after emptying.  So far, I don't have a retention issue.  I'm not sure the specifics behind why the retention check is done every time, but it is.  So, obviously there is a concern that for what ever my combination of issues are that retention could become an issue.

Note concerning Rezūm procedure:  This is not for everyone.  If you have a high risk of prostate cancer this procedure will NOT provide tissue for a biopsy, so may not be appropriate in your case.  In my case it was appropriate, and I consider it a significantly better option than a TURP or some of the other available procedures.  Consult a Urologist.

Thank you for your reply. I’ve had two urology visits in the past year. I did not specifically ask about retention but got tested for it. I guess at the end of the day everybody is different and everyone’s bodies are different so what one is experiencing might not be what another does. I’ll look more into those procedures. Thank you. 

[PuraVidaDip]

Here is some sourcing with examples on both sides of the coin. I don't see any evidence of retention issues but hey I’ve been wrong before. 

1

Here's some data on retention. Bold and italics below are for emphasis. It only mentions sphincterotomy though.

Source: https://sci.washington.edu/info/forums/reports/urinary_problems.asp

Bladder emptying for males: Open the sphincter

There are a few methods for keeping the sphincter open so urine can flow freely from the bladder into a condom catheter.

• Sphincterotomy: Surgically cut and open the sphincter. Scarring can occur over time, and the surgery may need to be repeated. It can also worsen erectile dysfunction.
• Botox injected into the sphincter. This needs to be repeated every three to nine months, and as it wears off there is an increased chance for urinary retention.
• Urethral stent (small steel tube) placed in the sphincter. Disadvantage are that the stent can move around or tissue may grow into it and block the flow or urine, requiring corrective surgery.

Methods that keep the sphincter open only work for people whose bladders are able to contract, allowing urine to continuously drain into a collection device like a condom catheter. If your bladder does not contract, the urine won’t drain out, and you are at risk for infection.

The downside of any sphincterotomy method is that the bladder may lose its ability to contract and urinary retention may develop over time. Also, condom catheters are not without problems. They can be hard to keep in place, and some patients will need to have a penile prosthesis put in so there is enough penis for the condom to attach to. And even though the condom catheter does not involve a tube going into the bladder, it does not seem to result in fewer UTIs than indwelling or Foley catheters.

2

Here's another showing intermittent catheritization in women vs using "padding." Showing a 40% complication rate vs 17% for CIC.

https://www.auajournals.org/doi/10.1016/S0022-5347(01)67432-9

3

Diapering as an option https://www.auajournals.org/doi/10.1016/j.juro.2012.09.079

4. OAB is not a disease; it is a symptom complex that generally is not a life-threatening condition. After assessment has been performed to exclude conditions requiring treatment and counseling, no treatment is an acceptable choice made by some patients and caregivers. Expert Opinion

Initiating treatment for OAB presumes that the patient can perceive an improvement in his or her QoL. Patients who cannot perceive symptom improvements may not need any treatment beyond toileting and/or diapering, as treatment may be potentially unsafe and/or futile (eg, in the very elderly or demented patient). It is important for clinicians who treat this problem to recognize this issue and set feasible therapeutic goals with the patient and/or caregiver.

20. Indwelling catheters (including transurethral, suprapubic, etc.) are not recommended as a management strategy for OAB because of the adverse risk/benefit balance except as a last resort in selected patients. Expert Opinion

Management with diapering and absorbent garments is always preferred to indwelling catheterization because of the high risk of indwelling catheter-associated UTIs, urethral erosion/destruction and urolithiasis. Intermittent catheterization may be an option when concomitant incomplete bladder emptying leads to overflow incontinence; however, this approach generally requires either patient willingness and ability or significant caregiver support. As a last resort, an indwelling catheter might be considered when urinary incontinence has resulted in progressive decubiti.

4

This is for spinal cord injuries.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1949036/#app1

Reflex Voiding

Reflex voiding is a method that depends on an intact sacral micturition reflex. As bladder filling begins, sensory afferents begin to feed this information into the sacral cord. Continued bladder filling eventually triggers sacral efferents to cause an uninhibited (involuntary) bladder contraction. But because of the spinal cord injury, coordinated relaxation of the sphincter mechanism is absent; thus, detrusor sphincter dyssynergia is usually present. Despite dyssynergia between the bladder contractions and sphincter relaxation, voiding occurs because the sphincter relaxes intermittently during the bladder contractions. However, detrusor sphincter dyssynergia frequently results in elevated voiding pressures, which can then cause poor drainage and complications to the upper tract. Another problem that commonly occurs in those with detrusor sphincter dyssynergia is poor drainage of the bladder. In those with spinal injuries at T6 and above, autonomic dysreflexia can occur when the bladder contracts against a dyssynergic sphincter. Autonomic dysreflexia can also occur from bladder distention from incomplete bladder emptying.

Because the bladder contractions are involuntary with little or no warning, individuals who reflex void require a collecting device. The presence of detrusor sphincter dyssynergia frequently necessitates other interventions (e.g., suprapubic bladder tapping, alpha-blockers, botulinum toxin injection, urethral stents, or sphincterotomy) to allow the bladder to empty effectively and prevent upper tract complications.

1. Consider using reflex voiding for males who demonstrate post-spinal shock with adequate bladder contractions and have:

• ▪ Sufficient hand skills to put on a condom catheter and empty the leg bag or have a willing caregiver.

• ▪ Poor compliance with fluid restriction.

• ▪ Small bladder capacity.

• ▪ Small post-void residual volumes.

• ▪ Ability to maintain a condom catheter in place.

 

(Scientific evidence–None; Grade of recommendation–None; Strength of panel opinion–Strong)

Rationale: A reflex (uninhibited) bladder contraction adequate for bladder emptying is needed for those who are considering reflex voiding as their method of bladder management. It should be noted that as the bladder develops reflex contractions to keep the bladder from getting distended, the bladder loses its capacity. This will make it very difficult to revert back to intermittent catheterization. Males can use external collecting devices very effectively, but no such device exists for females. In rare instances, reflex voiding may be used in females if they wear incontinence padding. However, incontinence padding has its own disadvantages. First, it requires frequent changing, thus making it both labor intensive and expensive (see appendix A), and, second, wearers risk skin breakdown.

Reflex voiding is suited to those with poor hand function because there is no need to undress or catheterize with this technique. However, some help from a caregiver will be needed if a person does not have enough hand function to change a condom catheter or empty a leg bag. Leg bags need to be emptied periodically; however, there are electronic devices that will allow the bag to empty. Reflex voiding is also suited to those with poor compliance or unwillingness to limit fluid intake because the bladder will contract reflexively and empty whenever it reaches a certain volume. Finally, this method is suited to those with a small bladder capacity, since a large bladder capacity is needed for intermittent catheterization.

 

 

[Enthusi]

4 hours ago, PuraVidaDip said:

However, incontinence padding has its own disadvantages. First, it requires frequent changing, thus making it both labor intensive and expensive (see appendix A), and, second, wearers risk skin breakdown.

I took the liberty of editing this paragraph….
 

However, incontinence padding, (namely DIAPERS) has its own disadvantages.  First, it requires frequent changing, thus making it both labor intensive and expensive (see appendix A), and, second, wearers risk skin breakdown.  On the other hand diapers are delightfully soft and comfortable and are great for making one feel safe and snug and cute.   
 

[Little Cub Pants]

4 minutes ago, Enthusi said:

I took the liberty of editing this paragraph….
 

However, incontinence padding, (namely DIAPERS) has its own disadvantages.  First, it requires frequent changing, thus making it both labor intensive and expensive (see appendix A), and, second, wearers risk skin breakdown.  On the other hand diapers are delightfully soft and comfortable and are great for making one feel safe and snug and cute.   
 

Well even REAL babies can still get skin breakdown. That part can't be helped. That just goes with the territory of wearing and using diapies.? But the benefits DEFINITELY out way the cons!??☺️??♥️???????????☺️