Urinary retention in certain positions
Posted: Tue Nov 01, 2016 10:37 pm
I wonder if others have experienced this. I've experienced some degree of retention for as long as I've experienced incontinence but it's been quite specific. If I stayed in my powerchair then I would quite often end up in retention and not experience any incontinence. If I transferred from my chair to the toilet using a transfer board or without standing then I, wouldn't usually leak at all. Whilst sitting on the toilet I would have to lean forwards and to the side in order to put pressure on my bladder to pee. However if I stood up to transfer then the flood gates would open. Didn't feel so much like urge incontinence as it did my sphincter had just opened followed by a release of pressure. Sometimes whilst lying down I would also just feel the internal sphincter open and it all start pouring out. Other times I would end up with my bladder spasming but my sphincters clamping shut painfully so that the pressure was really painful until at some point the sphincter might give in. This could be a violent enough spasm to almost fold me in half from a lying position.
Fast forward to a few years ago and I become entirely bedbound and only able to lie flat. At first I was incontinent since it started with a nasty nfection which usually made my bladder open as a reflex. However a few months in and it just stopped. No incontinence but also even if i was desperate I couldn't pee lying down - whether in a pad or a bedpan. The only time I could pee is if someone moved my legs for me so that my feet were flat on the bed with my knees up and bent, then things relaxed enough to let me pee. Didn't matter if my bladder was seriously fully nothing would come out otherwise...so I ended up with a foley. Interestingly I still had some issues when I got the foley where it just wouldn't empty sometimes. A district nurse helped me work out that the problem was likely that my bladder neck (internal sphincter?) was spasming shut around the eyelets of the catheter stopping it from draining. I was given more baclofen to help and now it is only an issue occasionally.
For context I am a transgender make i.e I was born female and have not had any genital or urological surgery (though I was about too when I became bedbound. Just as well I didn't as it would have meant having to go to hospital to see a urologist for any catheter insertion and changes since the neo urethra is so small. This would have been dangerous for me).
So anyone else experienced this? I wonder if it could be Bladder sphincter Dyssynergia but the postural aspect seems quite odd. Could something about the positioning affect the function of the bladder?
Fast forward to a few years ago and I become entirely bedbound and only able to lie flat. At first I was incontinent since it started with a nasty nfection which usually made my bladder open as a reflex. However a few months in and it just stopped. No incontinence but also even if i was desperate I couldn't pee lying down - whether in a pad or a bedpan. The only time I could pee is if someone moved my legs for me so that my feet were flat on the bed with my knees up and bent, then things relaxed enough to let me pee. Didn't matter if my bladder was seriously fully nothing would come out otherwise...so I ended up with a foley. Interestingly I still had some issues when I got the foley where it just wouldn't empty sometimes. A district nurse helped me work out that the problem was likely that my bladder neck (internal sphincter?) was spasming shut around the eyelets of the catheter stopping it from draining. I was given more baclofen to help and now it is only an issue occasionally.
For context I am a transgender make i.e I was born female and have not had any genital or urological surgery (though I was about too when I became bedbound. Just as well I didn't as it would have meant having to go to hospital to see a urologist for any catheter insertion and changes since the neo urethra is so small. This would have been dangerous for me).
So anyone else experienced this? I wonder if it could be Bladder sphincter Dyssynergia but the postural aspect seems quite odd. Could something about the positioning affect the function of the bladder?