I have poor bladder control even after undergoing ureter lengthening surgery. Why?

Question

Hello doctor,

I have poor bladder control for about fourteen years. I underwent bladder surgery to lengthen ureters at the age of five. Medication for bladder spasms taken as needed. I have frequent bladder infections and poor bladder control when laughing or moving. Sometimes it is impossible to control when laughing.

Answer 1

Hello,

Welcome to icliniq.com.

I understand it must be really distressing for you. You have regular cystitis, and incontinence. You also have a history of bladder surgery in the past. Incontinence (poor bladder control) can be due to a lot of causes: neuropathy, stress incontinence, urge incontinence, cystitis, and bladder diseases. But the good news is it can be controlled with some lifestyle modifications. You need to consult a urologist who can guide you with some pelvic muscle training exercises, also famously known as the kegel exercises. You can even youtube it and practice regularly. It is better to get yourself evaluated since the cause has to be located. You can go for a cystoscopy test or an x-ray of the bladder (cystogram), and PVR test (post voidal residue test). All these will give a better picture of why you have repeated infections and also guide in the further course of management. There are certain medicines such as anticholinergics (Oxybutinine), Imipramine (Tricyclic antidepressants), which have some positive effects in incontinence. However, please consult your urologist before taking any medicine. Also, there are some surgical options such as sling procedure, which helps in bladder control, especially in situations where there is some increased abdominal pressure like laughing or straining. So you have plenty of options, but first, get the investigations done and then consult your urologist.