littleQ
10-10-2004, 01:54 PM
Hi All,
I was symptom-free for only one day after cysto/hypro. According to my uro, he strongly believe that I don't have IC. So it is comforting to know that. But at the same time, it is so frustrating that doctors don't know what is really wrong with me. After two urologists have given up on me, I decided to figure things out on my own. Here is my theory, as crazy as it may sound, on the cause and treatments of my problem. I am a software engineer. I am using my engineering mind to solve a medical problem. And this may not make any sense at all, but please tell me what you think!
* My Main Symptoms:
1) Always feel like I have to go all time. The urge is not near the bladder region, but around the urethral.
2) Urine flow is weak. Feel like I have to push a little bit to get the urine going.
3) Feel pain/irritation during and after urination.
* The Normal Voiding Process:
Storing and emptying of the bladder are regulated by the internal and external urethral sphincters. During the bladder filling phase, the internal urethral sphincters are in a closed position and the external urethral sphincters are relax. At a certain point during the bladder filling, the internal pressure within the bladder becomes strong enough to activate stretch receptors in the bladder wall and eventually cause small contractile waves occur in the detrusor muscle of the bladder. Then the internal urethral sphincters automatically relaxes. The external sphincter must now be consciously tightened and urge to urinate become strong. To urinate, a person must relax the external sphincter and urine flow smoothly without any hesitation.
*Causes of My Symptoms
I think most of my symptoms are causing by the external sphincters been too tight and never relax. I don't think my external sphincters relax during urination. That is why I feel I have to push a little to get the urine start flowing. And the flow is very weak. I think the bladder muscles squeeze the urine through the tight external sphincters and narrow urethral. The friction causes urethral irritation and pain. In addition, the increased pressure inside the bladder forces urine into the bladder wall, which causes inflammation. This constant force into the bladder wall cause more and more inflmmations, which eventually will become IC. So, I guess it makes sense why they say urethral syndrome is an early stage of IC. Since my external sphincters rarely relax after urination, the urge to urinate never disappear after urination.
* Evidences that Support My Theory:
1)The cystoscopy report written by my first urologist shows that my urethral sphincters are incredibly tight.
2) I have noticed that each time I had a procedure in which a tube is inserted into my urinary tract, my urine flow got better for day or two. And most of my symptoms were gone during those time. I think each time a scope is inserted into my urethral, it naturally relaxes the urethral sphincters a little bit. But not soon after, they tighten up again.
3) I have tried Flomax. It helps a little bit with flow but it does not help with the urge. I think the reason is that flomax is an alpha receptor blocking. It helps to relax internal urethral sphincter muscle, but not the external urethral sphincter muscle.
* Possible Treatments
External urethral sphincter muscle is made up of smooth muscle mixed with striated, or striped, muscle of the pelvic floor. I think muscle relaxants like Valium probably will work. Also the right PT to relax the pelvic muscle probably will help to relax the external urethral sphincters.
Thank you all for reading!
LittleQ
I was symptom-free for only one day after cysto/hypro. According to my uro, he strongly believe that I don't have IC. So it is comforting to know that. But at the same time, it is so frustrating that doctors don't know what is really wrong with me. After two urologists have given up on me, I decided to figure things out on my own. Here is my theory, as crazy as it may sound, on the cause and treatments of my problem. I am a software engineer. I am using my engineering mind to solve a medical problem. And this may not make any sense at all, but please tell me what you think!
* My Main Symptoms:
1) Always feel like I have to go all time. The urge is not near the bladder region, but around the urethral.
2) Urine flow is weak. Feel like I have to push a little bit to get the urine going.
3) Feel pain/irritation during and after urination.
* The Normal Voiding Process:
Storing and emptying of the bladder are regulated by the internal and external urethral sphincters. During the bladder filling phase, the internal urethral sphincters are in a closed position and the external urethral sphincters are relax. At a certain point during the bladder filling, the internal pressure within the bladder becomes strong enough to activate stretch receptors in the bladder wall and eventually cause small contractile waves occur in the detrusor muscle of the bladder. Then the internal urethral sphincters automatically relaxes. The external sphincter must now be consciously tightened and urge to urinate become strong. To urinate, a person must relax the external sphincter and urine flow smoothly without any hesitation.
*Causes of My Symptoms
I think most of my symptoms are causing by the external sphincters been too tight and never relax. I don't think my external sphincters relax during urination. That is why I feel I have to push a little to get the urine start flowing. And the flow is very weak. I think the bladder muscles squeeze the urine through the tight external sphincters and narrow urethral. The friction causes urethral irritation and pain. In addition, the increased pressure inside the bladder forces urine into the bladder wall, which causes inflammation. This constant force into the bladder wall cause more and more inflmmations, which eventually will become IC. So, I guess it makes sense why they say urethral syndrome is an early stage of IC. Since my external sphincters rarely relax after urination, the urge to urinate never disappear after urination.
* Evidences that Support My Theory:
1)The cystoscopy report written by my first urologist shows that my urethral sphincters are incredibly tight.
2) I have noticed that each time I had a procedure in which a tube is inserted into my urinary tract, my urine flow got better for day or two. And most of my symptoms were gone during those time. I think each time a scope is inserted into my urethral, it naturally relaxes the urethral sphincters a little bit. But not soon after, they tighten up again.
3) I have tried Flomax. It helps a little bit with flow but it does not help with the urge. I think the reason is that flomax is an alpha receptor blocking. It helps to relax internal urethral sphincter muscle, but not the external urethral sphincter muscle.
* Possible Treatments
External urethral sphincter muscle is made up of smooth muscle mixed with striated, or striped, muscle of the pelvic floor. I think muscle relaxants like Valium probably will work. Also the right PT to relax the pelvic muscle probably will help to relax the external urethral sphincters.
Thank you all for reading!
LittleQ