Recently there have been several questions from patients about bladder outlet obstruction secondary to changes in bladder function, which I feel are somewhat representative, so while replying to them, I have also put together these responses in the hope that they will be helpful to all patients who are bothered by similar diseases.
1, bladder outlet obstruction will lead to a series of changes in bladder function, after the obstruction is lifted, bladder function will slowly recover, but the time is very slow, and it is useless to be anxious, and there is really no method or drug that can promote bladder function recovery, if you are looking for it hard, I would suggest bladder irrigation with Cetrotide to repair the bladder lining and oral amitriptyline to relieve the symptoms of urinary frequency, while not holding urine. In addition, as long as there is a clear etiology like bladder outlet obstruction, immune, or allergic disease, no matter how much your symptoms resemble interstitial cystitis, it is certainly not a diagnosis of interstitial cystitis and can only be described as a change in bladder function secondary to obstruction or immune disease, a disease whose definition is often ignored by the vast majority of urologists and patients!
2, this is a typical bladder outlet obstruction, the most common is bladder neck obstruction and urethral stricture, this situation does not solve the obstruction, directly eat tolterodine will certainly cause increased difficulty in urination, the drug to eat the opposite, first of all, it is recommended to try to expand the urethra, if the urethral stricture will work, but if the bladder neck obstruction is not very useful, bladder neck obstruction should first take oral a-blockers, such as Halle and so on If this does not work, you can consider performing a bladder neck incision or home catheterization. After the obstruction is lifted, symptoms such as frequent urination, urinary urgency and difficulty in urination will slowly be relieved, but it will take time to wait. Of course, the problem of spasm of the urethral sphincter cannot be excluded, which is relatively rare. These three diseases of bladder outlet obstruction are the three main confusing conditions for women with this type of disease, and if the diagnosis is not clear, the treatment will not work, so women with urinary disorders in our area will choose to do imaging urodynamics or electromyography at the same time to confirm the diagnosis and then talk about treatment.
It is recommended to have an imaging urodynamics first to clarify the location of the bladder outlet obstruction, as normal urodynamics can only qualitatively diagnose bladder outlet obstruction, but cannot locate the location of the obstruction. Cystoscopy is a morphologic diagnosis, and it is simply not possible to arrive at a hydrodynamic diagnosis of bladder outlet obstruction, which is the result of the inherent defects of these two tests. Currently, the most accurate diagnosis of bladder outlet obstruction is imaging urodynamics. Of course, there are very few hospitals in China that can do imaging urodynamics, so if you don’t have the conditions, you can use general urodynamics combined with cystoscopy to get by. It is very likely that you have overactive bladder secondary to obstruction, but this should also be treated after resolving the obstruction, otherwise it will lead to the consequences of increased difficulty in urination and even urinary retention like you had before after taking medication. The following doctors often ignore this order of treatment, thus leading to medical disputes. Urethral stricture is just my guess, you don’t necessarily have it, it needs to be checked to be clear.