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Date of last update: 8/13/2017.

Forum Name: Urology Topics

Question: Bladder Problems caused by Bulging Disc

 acrunyan - Mon Nov 16, 2009 4:36 pm

Never had problems with urination in the past. About two weeks ago it began getting hard to urinate. I felt like I had to go, but nothing would come out. Eventually, I couldn't urinate at all and wound up in the emergency room to get a catheter.

Since then, the catheter has been removed and I have been able to urinate, but sometimes it's easy and other times I must strain really hard. I had a CT scan done this past Friday. They called today and said I had a disc out of place (They said something about my L4-L5 disc if I'm not mistaken) and that the disc could be causing problems with my bladder.

They also said the radiologist mentioned that I had a pelvic abnormality. Honestly, I'm just totally confused. Does this sound serious? Does it happen a lot? I am worried, but don't know if it's over nothing.
 Dr.M.Aroon kamath - Thu Nov 26, 2009 9:31 am

User avatar Hi,
Central disc prolapse causing cauda equina syndrome is rare (only present in about 2% of all cases of herniated lumbar discs and in only 0.04% of all patients with low back pain).Usually, a massive, central disc prolapse (L4/L5) is involved in this situation.

Because the reflex arc for micturition reflex is inturrupted, an 'areflexic' urinary bladder develops.

Clinically, a history of unilateral or bilateral leg pain and finding of numbness in the perineum, leg or both and 'saddle anaesthesia' as well as decreased sphincter tone on rectal examination should make one to suspect central disc prolapse (L4/L5) with involvement of the 'cauda equina'. I do not know if you have any of these signs.

'Areflexic bladder' may be managed by the early institution of intermittent self-catheterisation.

Prior to the era of intermittent self catheterization, prognosis for this condition was regarded as dismal.

Intermittent self-catheterization permits the patient to obtain a balanced bladder condition in most cases, and upper urinary tract condition remains good. Close follow-up is mandatory however.
Best wishes!

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