Chemical induced full blown incontinence with doctors help

[Shannara6767]

I might have posted it elsewhere but I have Interstitial cystitis, OAB, thickened bladder wall and a hypertonic pelvic floor/lower bladder spincter.  So anytime I "go" the bladder has to spasm past the hypertonic parts and always cause pain to the point of full body goosebumps.

After reading a ton on here and making/buying a few stents that worked as intended and found out yep free flow eliminated the pain I deal with every day.  So I started working with Gemini advanced new notebook feature and we were/are coming up with a surgical plan to present to my doc to see if I could get Reddy's surgery covered under insurance do to my medical history.

After adding all my info and a ton of back and forth I asked before we go through with this can it be done with standard medication to test before we present this to my PCP to start the process.  Well yes there is come to find out and while I know it all I will let Gemini explain it with a copy paste from my LM notebook.

From Gemini

To address the chronic pain and voiding dysfunction associated with IC/OAB and hypertonic pelvic floor. Many of us are stuck in a cycle where the bladder neck and pelvic floor remain in a constant 'iron grip' or spasm, leading to high-pressure, painful urination and sleep disruption.
We are targeting this through a 'Dual-Gate' chemical approach:

Gate 1: The Internal Sphincter (Bladder Neck): We are using Tamsulosin (Flomax) as a daily maintenance medication. Tamsulosin works on the smooth muscle of the bladder neck to force the 'internal gate' to remain relaxed. This prevents high-pressure backflow, which is a major source of IC pain and urgency.

Gate 2: The External Sphincter & Pelvic Floor: To address the long-term, spastic 'muscle memory' of the pelvic floor, we are utilizing compounded Diazepam suppositories. Unlike oral muscle relaxants, the rectal route delivers the medication directly to the pelvic floor muscles, allowing them to relax without the systemic side effects (like grogginess) of taking a pill.

The Goal: The Tamsulosin is for long-term use, but the suppositories are intended as a short-term 'bridge' or training aid. The goal is to chemically break the 24/7 hypertonic spasm so the pelvic floor can 'unlearn' the clench reflex. Once the hypertonicity is broken, the bladder becomes a passive, low-pressure reservoir, which stops the painful spasms and allows for comfortable, continuous decompression (drip).
If you’re suffering from the same 'iron grip' or painful, high-pressure voiding, this protocol might be worth discussing with your urologist or GP. It’s a mechanical approach to a mechanical problem."

Gemini end

 

My PCP is out on vacation till Friday but he has his own private practice so does not have corporate overlords and gives my whatever I want with in reason so you might have to go to a urologist if you can not find a good PCP private practice.  I messaged him through the portal yesterday and got the flowmax and took my first one yesterday but am waiting till friday to present the document me and Gemini created to get the suppsuppositories.

I will keep you updated if yall want but just wanted to put it out there as a alternative to the Mexico operation and I hope it work. 

 

Note:  Please do your own research if you go this route don't just try to replicate as I am a patient, not a doctor. This protocol involves prescription medication, including a controlled substance, and must be tailored to your specific medical history by a physician.

[ryan87]

Just out of curiosity, have you already tried the “usual” way of incontinence training, where you keep your pelvic floor always relaxed? I also used to have a hypertonic pelvic floor and after about 6 months things started to loosen up significantly, once I could leave my PF relaxed all the time. After 12 months it was even better, I think a bit of muscle atrophy plus the relaxation made a huge change for the better. 

[Shannara6767]

Yea been trying it for quite a while but after 30 years of iron grip it is not working at all.  And am getting reflux back into the kidneys at night most of the time so only get 3-5 hours of sleep a night making my blood pressure crazy high and my flank hurt first few hours of the day.  Me and my doc been trying to get the BP down but still high so going to try this if he goes for it so it just lets itself go when it wants while asleep.

[Shannara6767]

Dang I've been working on my new app I forgot all about posting this.  I did see my PCP, he gave me everything I wanted and I can confirm it works pretty well.  The first day not so much the second day yeah the third day hello sleep, that's just me though.  Now just gotta work on shrinking my bladder.

[Shannara6767]

Ok yea I figured I would let this group know about the app I made and am planning to release.  Go take a look at it over Incontinence - Medical forum.  I just posted the app info I've developed and planning to release in a couple weeks that helps disabled people find a bathroom quick.  I made it to find a place with a single occupant restroom for a change but I've expanded it to so much more.

[steveg]

I take Flowmax what strength did they start you one?

[steveg]

Food For thought
I am on flomax .4 as of now, the baclofen is a good replacement for my CYCLOBENZAPRINE

In clinical practice, a combination like Flomax + Baclofen is sometimes prescribed off-label for structural or neurogenic retention. The alpha-blocker widens the exit gate at the base of the bladder, while the muscle relaxant prevents the pelvic floor and outer sphincter from clamping down.

Why This Combination Requires Close Medical Supervision

While this combination targets the "pipes" directly, it carries significant side effects and structural risks that require a urologist's guidance:

• Opposing Bladder Forces: If a patient is still taking an anticholinergic like Oxybutynin, adding a muscle relaxant can worsen retention. Oxybutynin stops the main bladder muscle from squeezing. If the bladder can't squeeze, relaxing the sphincters won't matter—the urine still won't empty.

• Severe Blood Pressure Drops: Both alpha-blockers and central muscle relaxants can lower blood pressure. Combining them drastically increases the risk of severe dizziness, lightheadedness, and fainting when standing up (orthostatic hypotension).

• Profound Sedation: Baclofen acts directly on the central nervous system, causing drowsiness, fatigue, or confusion, which can be amplified if taken with other medications.

Alternative Advanced Options

If oral medications are ineffective or cause too much dizziness, urologists often pivot to localized treatments:

• Botox Injections: Injecting botulinum toxin directly into the external urethral sphincter paralyzed the overactive muscle temporarily, allowing urine to flow freely without causing systemic side effects like drop in blood pressure.

• Intermittent Catheterization: Often considered the safest gold standard for chronic retention, ensuring the bladder empties fully without stressing the kidneys.

Because navigating bladder coordination requires balancing muscle relaxation against blood pressure safety, any changes or additions to this regimen must be closely managed by a urologist.

[PeterLupus]

On 5/27/2026 at 2:04 AM, Shannara6767 said:

free flow eliminated the pain I deal with every day

I too find that I can eliminate urgency spikes / pain when keeping my bladder empty, such as by continuously draining it using an indwelling catheter.

But I am wondering if you can achieve your goal with meds only. Have you considered surgery or neurolysis?

[Shannara6767]

Yea and trying to get a Urologist right now to try surgery or at least a Memokath, but referral process is slow.

[steveg]

As per my medical records, I am incontinent of both bladder and bowel. My main issue is nighttime. I pee when I wake up in the morning, or if I get up at night and walk around, so I would like to sleep through the night, wake up soaked, and get a full night's rest.