neurogenic bladder as a result of prostate infection/abcess?

neurogenic bladder as a result of prostate infection/abcess?
7/20/2006
CareCure Forums

Moderator- feel free to move this to another forum, as I'm not quite sure where it belongs, thanks.

I've got many questions relating to managing my condition, and my PCP and uro are both pretty useless (and worse yet, due to insurance/$$$ I'm pretty much stuck with them), but for now this will do.

In short - can a severe infection (baseball sized prostate abscess) cause this kind of nerve damage, or is it more likely due to diabetes, or both?

In August 2004 I had a UTI which progressed to pyelonephritis, had to go to ER - IV Levaquin took care of the kidney infection but I didn't know I also had a prostate infection as well. Endured the most horrible pains known to man for more than 2 weeks, then returned to ER - dx'd with prostatitis, switched to Septra. Went downhill, ended up back in hospital after severe dehydration and hypoalkelemica (potassium was 2.6!). Got that taken care of, but then after about a week getting better the pain returned double, this time a prostate abcess. 4 more days in hospital getting it drained, IV antibiotics of all kinds for weeks. Followup CT scans showed it still hadn't resolved and by the end of the year my original urologist said it was getting larger again. So he performed a TUIP, which, so far as I know, resolved it. However, I was incontinent ever since my first hospitalization in Sep '04, and he ordered a urodynamics, which showed a sensory neurogenic bladder, diminished sensation (1400+cc's!), diminished compliance (pressure 45cm at 1400cc's, whereupon I simply started leaking), detrusor very hypocontractile (took 1200 seconds to void 950cc's, residual about 325, rest of it in a bucket elsewhere). So I was started on CIC 4x a day, no problems at first, then my bladder started to change - would frequently get severe spasms, often at the most inconvenient times/places. After about a 1.5 yrs its progressed to what appears to be DHIC - still no sensation filling, when I get full (800-1000cc's), then spasms. Running to the bathroom is out of the question - just end up wet. If I hold on and wait, then go, I can't void. The cycle repeats itself until I either cath or void, usually very poorly with a lot of residual if at all.

I'm a longtime diabetic, very overweight, but otherwise able-bodied. However my bladder and to a lesser extent bowels are simply unmanageable. I get frequent UTI's, I suspect my urinary tract's under really high pressure (back, sides, groin all hurt to one extent or another nearly all the time), and all I could get my uro to do was tell me to cath more often. Refused to prescribe Ditropan, etc - said my bladder was so weak I'd never get rid of the infections. That was way back in January after my new PCP insisted on a urine sample w/o cathing - I strained too hard, and gave myself a whopping case of epidimytis. And now I just got over another symtomatic UTI (vomiting, diarrhea), Cipro and a $1100 ER bill. Help!

Any questions, please feel free to ask. Thanks!

Tom

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