What Causes Bladder Muscle Weakness?

Question : Complete thread below: (Question) I am a 66 year old man, generally fit and healthy with no serious problems. However, for the past few years I have been suffering with nocturia and after tests, my prostate is normal / smooth but my bladder does not empty properly, which has led to a couple of UTIs and now enuresis. I have been offered self-catherisation which I will try, but are there other options? Thank you – XXXXXXX Asked by Me , Fri, 21 Feb 2014 Doctor's reply to your question above... Brief Answer: You have what is called as Neurogenic bladder. Detailed Answer: Hello Thanks for your query,based on the facts that you have posted it appears that you have nocturia since few years.You have been ruled out to have enlarged prostate . Most likely your symptoms are due to what is called as Neurogenic bladder. I shall be happy if you can post me few more details to help me in making comments on your problem. 1) What is the size of your prostate reported on Ultrasound scanning and what is post void urine residue? 2) Have you ever done uroflometry and Urodynaemic study to evaluate bladder function ? 3) Have you ever subjected to endoscopic examination of bladder (Cystoscopy) ? 4) Have you ever tried drugs like Bethanechol to increase bladder muscle power.? Please consult qualified Urologist for evaluation and get above investigations done to confirm the diagnosis. You can have a trial of drugs like Bethionechol which helps to improve power of bladder musculature . You can try self intermittent catheterisation to empty the bladder with accepting the risk of getting UTI due to repeated catheterisation . Other and last option is to get Supra pubic catheterisation (SPC) done where bladder will be drained continuously .This will avoid need to get self catheterisation done every day . Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you Thanks and Regards. Dr XXXXXXX (Question – I answered the questions you asked above) Most likely your symptoms are due to what is called as Neurogenic bladder.I shall be happy if you can post me few more details to help me in making comments on your problem. 1) What is the size of your prostate reported on Ultrasound scanning (answer: 23cc) and what is post void urine residue (answer: 500-700ml)? 2) Have you ever done uroflometry and Urodynaemic study to evaluate bladder function ? Answer - yes, normal kidney function, no outflow obstruction, likely detrusor failure. 3) Have you ever subjected to endoscopic examination of bladder (Cystoscopy) ? Answer - yes, normal looking bladder and urethra, no stricture 4) Have you ever tried drugs like Bethanechol to increase bladder muscle power.? Answer - no. My question - what more can be done? Is the cause just muscle failure or neurogenic? Thank you – XXXXXXX Blackburn