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Forum Name: Urology Topics

Question: The dumbest test i've ever had-- flow study/cystometrolgram


 problems101 - Sun Sep 16, 2007 5:17 pm

40yr old female, period lasted 30 days, after all the tests my body has no desire to pee.

My tests were fine, ultra sound, pap, endo biopsy, blood work were all normal.

I know your not an obgyn, but is there a connection, I had heavy period & then 1/2 way through I got heavy bleeding, & pain between my belly button & hip,

If I push really really hard, I can pass a few drops.

I finally peed a little today after 2 days, I'm wondering if I should be searching out a cause or just wait & see if things normalize.

I do have an appointment with my family dr. but i don't know what really to ask, I don't have pain

Thanks
 Dr. Chan Lowe - Sun Sep 16, 2007 10:54 pm

User avatar Hi Problems101,

I would suggest you see a urologist about this. Seeing your regular doctor is still a good idea. Being unable to urinate can lead to pressure on the kidneys and other problems. If the inability to urinate persists for more than a day you may need to use urinary catheterization to relieve the pressure.

When you see your doctor it may be a good idea to ask about having your electrolytes and kidney function checked to make sure everything is OK.

I am a little suspicious your issues may be due to underlying endometriosis. Follow up with your gynecologist can help evaluate for this also.

Best wishes.
 problems101 - Tue Sep 18, 2007 4:44 pm

I went to my family physician, He called an urologist, He seen me immediately. He did examine me. He gave me an "in/out" fluid list to keep. He told me to drink 2 liters of water a day.

That surprised me. I thought since I'm not uinating my bladder would be too full to drink that much. so far I have 1 liter in & 50 ML out.

He thought about catherizing me but I was sick & dizzy when I got there & put it off. He said he wanted to see me in 3 days, the office couldn't fit me in they put me off 1 week,

He sent me for x-rays of my back, I'm not sure what for-- I know he told me but I wasn't feeling to good-- I should have had someone with me.

Thanks for your help.
Any thoughts would be appreciated
Diane -40 yr old female
 Debbie Miller, RN - Wed Sep 19, 2007 12:34 am

User avatar It sounds like you are with the right specialty now. If the office put you off and the doctor wanted to see you in three days, I would call the doctor back, ask to have him return your call (as opposed to speaking with the receptionist) and let him know they could not accommodate his wishes. He may feel it is more urgent than the staff is aware about. If so, he will arrange for you to get an appointment. If it is not so urgent, he will let you know that too.

I still have no idea what is happening but I'm sure he will stay on the trail until he figures it out. Best wishes.
 problems101 - Wed Sep 19, 2007 6:41 pm

(40 yr old woman) it was a bad day for me, my family physician, wanted another internal ultrasound but I haven't voided in a few days, to do the test they told me to drink 40 oz of water, I reminded them of my problem & they said to do it.

So I did & I was so full I couldn't stand up & walk to the car. I was sick. Lucky for me this ultrasound was suppose to take place in the same building as my new urologist. I needed to drop off my in/out chart so I went to do that first & doubled over in pain, I started crying & asked to see my dr. He took me & had me immediately catherized. He got a quart & we emptied 3 of the leg bags of urine out of me.

My in/out chart was only for 1 1/2 day but my water intake was 3407ml /640 ml out

so now I wear a bag, we're still in search for the cause. My blood work, ultrasounds are all normal, he even took xrays of my back to see if something happened there.

How do people determine when the bag isn't necessary any more? I know I need it now,but I'm hoping not for forever.

He's thinking part of the problem is due to when i was a child I didn't use the school bathroom & have kind of trained myself to hold it. The last few months, I've had problems with my menstrual cycle, & considered female issues & started a college class -- could stress be a cause? my blood pressure was 162 over108. so now I'm on blood pressure pills.

Diane

Thanks
D
 Dr. Chan Lowe - Wed Sep 19, 2007 11:06 pm

User avatar Hi Diane,

Learned voiding avoidance may cause increasing volumes of urine in the bladder. However, learned avoidance should not prevent voiding when the bladder is extremely full as you are describing.

If you are physically unable to void I would be strongly concerned that there is an obstruction of the urethra or possibly a nerve or muscle problem not allowing the bladder to contract.

I would recommend that you continue to follow up with your urologist for further evaluation and testing.

Regarding knowing when to stop the bag collection is often a bit of trial and error. After a certain period of time the catheter is removed and voiding is assessed to see if you can void without it.

Best wishes.
 problems101 - Thu Sep 20, 2007 3:32 pm

prior to getting bagged. my dr wanted input/ out put record. I guess I should ask him, but I wouldn't see why he'd need that now. If I was your patient would that info be helpful to you?

Also just curious, What's the big deal about bowel movements, He asked me all kinds of questions, I don't even look at them that closely ( I don't even think I look at my husband that closely) & my prescriptions are all about BM's

I told him I didn't even think about that my concern was the lack of urination & prior to being bagged. To get urine out of me, I had to push so hard that I got some of both. But what's the big deal?

Thanks
D
 problems101 - Thu Sep 20, 2007 6:21 pm

With all that's going on, I got my period.

Is it ok to use tampons?

thanks
D
 Dr. Chan Lowe - Thu Sep 20, 2007 11:23 pm

User avatar Hi Problems101,

It is fine to use tampons with a catheter in. Just be careful not to pull on the catheter when removing the tampon as this would be painful.

Best wishes.
 Dr. Chan Lowe - Thu Sep 20, 2007 11:26 pm

User avatar Hi Problems101,

It may still be important to track intake and output to be sure the kidneys are making urine properly. Your doctor may or may not need this information.

I suspect your doctor was asking about your bowel movements because constipation is a known cause of urinary retention. Basically the stool impaction begins to compress the bladder and urethra causing obstruction.

Best wishes.
 problems101 - Sat Sep 22, 2007 7:39 am

I never had children & that bothers me sometimes, I hate going to an obgyn's office because of all the pregnant mom's & babys, There are days It just gets to me.

Can a urologist be my obgyn? Do I need an obgyn or can a family physician do the same thing?

Thanks so much for all your help!!!
What I really admire about you Doctors here is how you answer questions, it's hard to get to talk to the ones who are running all the tests, I don't see where you get the time. I want you to know it's apppreciated.
Diane
 Dr. Chan Lowe - Sat Sep 22, 2007 10:47 pm

User avatar Hi Diane,

I think it is unlikely that the urologist will want to follow your regular gynecological issues; however, many family physicians are very comfortable with this and are more than happy to do so.

I would suggest you talk with your family doctor to see if this is the case. There are some that do not do gynecological care but most do.

Best wishes.
 problems101 - Sun Sep 23, 2007 4:11 pm

Sorry for so many questions but prior to my not being able to pee problem, I had my menstrual period for 30 days & had been seeing an obgyn. I had very heavy bleeding for 14 of those days. So I used the largest tampon I could purchase.

If my doctor claims that constipation can put pressure on the urithra & cause it not to work, is it possible that prolonged use of large tampons could cause the urithra to hold back urine?

Just a thought, I appreciate your answere
Diane
 Debbie Miller, RN - Tue Sep 25, 2007 7:17 pm

User avatar This does not seem to be a problem. I haven't been able to find evidence of such a concern. That doesn't mean it couldn't happen but I have not found documentation of it. There are cases where use of a tampon can help with stress incontinence so obviously the urethra can be affected but the cases show this to be a positive benefit; not a negative effect.
 problems101 - Thu Sep 27, 2007 3:50 pm

Just thougtht I'd let you know, today I learned to catheterize myself. They injected me with water & left me alone with the water running to see how much I'd void. I didn't go very much.

All my tests are fine the 2 that aren't back are multiple sclorisis & syphalis? He don't believe either of those are a factor, My spine x-rays are fine,

He just thinks I taught myself to hold things in, since I don't go to bathroom except when I'm home. Why it quit -- he don't know.

So I'm suppose to try to go every 4 hours & if I can't go, I catheterize myself,

I was prescribed cardura & laxatives. my next appt is in 2 months & he wants, inputs & output chart.

He said if I want to I could go to a bladder study or something that sounded like that but insurance doesn't pay for it. but I don't see the point it just gets information it doesn't sound like it can cure anything. Or do you think it's worth it? I'll do what he says for the next 2 months & then decide.

Thanks for all your help here.
It's appreciated
Diane
 Debbie Miller, RN - Thu Sep 27, 2007 5:48 pm

User avatar Hi Diane,
I'm sorry this has been such a pain for you. Good thing there are alternatives while you continue to investigate the solution. Hopefully you will eventually get to the bottom of this problem.

Continuing as your doctor has suggested is a good plan. You're right about some tests - if they don't lead to real solutions you must weight the benefit vs cost.

Take care.
Debbie
 problems101 - Sat Sep 29, 2007 7:47 pm

I think I'm doing something wrong, my instructions are to go as much as I can & then catheterize myself & empty my bladder,

I've been catheterizing & not getting anything, So I'm thinking I'm back to normal,but tonight, after not getting anything from the catheter, I started to pee.

Is it possible my body just sent down new urine or am I doing something wrong with my catheter, Is there any place to get info to make sure I'm doing it right?

Thanks
Diane
 Dr. Chan Lowe - Sat Sep 29, 2007 11:48 pm

User avatar Hi Diane,

Bladder catheterization can be a bit tricky at first. The most common reason for failure is actually not getting the catheter in the urethra. The bladder can easily slip down and along the top of the vaginal opening. When self-cathing this is less likely to occur since one would be able to feel this.

The other possible reason for not getting urine return is to not insert the catheter far enough so the catheter stays in the urethra and doesn't enter the bladder. In women, the urethra is typically around 1-2 inches. The catheter needs to be inserted at least this length to get urine return often times.

One other thing would be to flush the catheter and make sure it is open.

It may be, though, that your bladder is empty when you cath. If you had to urinate after the catheterization it may be that you had a small urine pocket that was moved after the catheterization.

If there is still concern, I would recommend you contact your urologist.

Best wishes.
 problems101 - Fri Oct 05, 2007 6:19 pm

My body seems to be back to normal. I'm going on my own & the catheter isn't getting much anymore,

My body is back in it's old routine of 8 hours between needing to go, & I know my urologist didn't like that-- he wants me to try to go every 4 hours.

He didn't ask for updates & my appointment won't be for 6 weeks yet.

I was thinking of updating him & cancelling my appointment because of being in my normal routine.

with your experiences with patients -- is my thinking OK? or should I keep my follow up?

thanks
Diane
 Dr. Chan Lowe - Sat Oct 06, 2007 1:23 am

User avatar Hi Diane,

I would recommend you keep your follow up appointment. This way your doctor can have a chance to review all of the information thus far and be sure that everything is now OK.

These "wrap up" visits can be very important.

Best wishes.
 problems101 - Tue Dec 18, 2007 8:56 pm

I've never been so discusted in my life, I got a call to come into the urologist office for a test, I asked if pelvic pain & urine retention can be somewhat related. My doctor wasn't in, a nurse was giving the test, I just do what she says, but I'm clueless.

I get in there, my blood pressure is 143 over 108 & they fill me up with water I'm suppose to tell them when I feel the urge to go, all I feel is my pelvic pain, they know I have urine retention, I don't feel any pressure, They put the whole bag in me, & she says we have to stop here you need to try to void, I can't I pushed so hard trying to void I pushed the rect catheter out. It was awful, they tried a different potty chair., running water & thought leaving me alone would help

What is this test good for-- I don't want to know the results because I know I failed miserably,

She said he'll call for a follow up-- I don't want to go. I jsut want to know if there is a possiblity if urine retention can be causing pelvic pain, obgyn can't find a problem.

thanks for letting me vent
Diane
 Dr. Chan Lowe - Tue Dec 18, 2007 11:30 pm

User avatar Hi Diane,

From what you are describing the test you were having may have been a test called a VCUG (voiding cystourethrogram). This is a test where they put a dye into the bladder and using x-ray take pictures to help determine if there are blockages.

If x-ray was not used it may have been a test to measure bladder pressures and residual volumes.

Urinary retention can certainly cause abdominal pain. If the bladder is distended it can cause pain.

I'm sorry that the visit was so unpleasant for you. Follow up with the urologist really is important to help determine why you are having urinary retention.

Best wishes.
 problems101 - Wed Dec 19, 2007 7:56 am

There was no x-rays, I guess it was to test the spasms in the bladder, I was wired up though, patches on my thigh & hooked to a comptuer, pottychairs in the room to catch what I void,

I guess I felt it was stupid because I could see what they are putting in me, my brain is saying -- hey that bag is going down & I'm not feeling a thing, or is this so subtle that I missed something.

If I can go at home, & I can keep a catheter in my car, for when I'm away then why do I need a machine to tell me, you can't feel when you have to pee, It's not like there is anything can be done if the nerves are damaged???? correct
 problems101 - Sat Dec 22, 2007 8:47 am

He's really a nice doctor & looks like a young oliver north, but I sent him christmas/thank you card to tell him, I appreciate how they handled me. i'm keeping a file with all these tests obgyn & urology, he was kind enough to give me a letter explaining briefly what I had done during this time.

He told me that I didn't void one drop, but since in my letter to him I told him I only needed to cath myself one time & that was after a hospital test iodine drink, ct scan test that it's psychlogical having something to do with a vaginal fear. I just think I don't like voiding in public places, I never have.

so he told me to get back on my cardura, before, during & after my female ablation, I've been discharged from his care, but he said if I need him for questions after my procedure to call him.

thanks for your help here. You've guided me through alot recently, & helped keep my head on straight

Diane

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