Why do IC'ers retain urine??

[notmybestday]

Hi all --

I have a question about urinary retention. I have never had complete retention but I often cannot empty my bladder completely. After peeing (about 6-7 ozs. normally), my flow just stops even though I know there's something left. And often I'm back in the bathroom less than a half-an-hour later peeing the same amount. Often, urination is accompanied by a weakish stream. I've tried every trick on this board -- tilting forward, standing up and sitting back down, rubbing the area just above the buttocks, nothing works. I notice it's most noticeable when I've been sitting for a long time in class, and everything down there seems kind of numb. This double/triple voiding was actually my very first symptom of IC (officially diagnosed). Peeing a "good" amount, and then suddenly having to rush back to pee a good amount again.

What causes this retention? I've done some internet research on incomplete voiding and retention, and I've come across things like detrusor muscle weakness, bladder neck dyssynergia (I probably butchered that spelling), tight sphincter (anal and urethral), neurological disorders, pudendal neuralgia. Is the bladder muscle so inflamed that it can't properly contract? Is it weak or spasming? Is the inflammation responsible for nerve damage? But, then, I've read here that it's actually muscle tightness that's preventing complete evacuation... My uro says that retention is "typical" in IC patients. But why?

If I have this kind of problem, Detrol LA is pretty much out of the question right? Though I do have frequency, I suspect that it will only make my bladder contractions weaker. I feel like my frequency is chiefly because of this retention and smaller-than-average capacity...though I could probably get 8-10 ozs. out if I could only completely empty.

Has anyone successfully reversed this symptom? How so?

As always, thank you for your help.

[jen74]

I also think I retain some urine as well after I urinate. I think there may be several factors. One being that our bladder are so inflammed as it is and the bladder is going to have a hard time working perfect. I mean when you have the stomach bug, our stomachs do not even work right and cannot work up to par until a few days after the stomach has healed and is not so inflammed. Well with IC the bladder is always inflammed.
Also, when we have to pee, we usually have to pee when we only have a small amount of urine in the bladder( 3 to 8 ounces). This is considered a small amount. In normal people without IC, they usually do not have to pee until the bladder is full( about 12 to 16 ounces). And it is known that the bladder will contract better is the bladder is full, though this is not the case for everyone, especially a person with IC. Maybe when we have to pee out that 8 ounces, it is not enough for the detrusor to have a good contraction in order to empty the bladder fully. I am not sure, this is just an idea.
Anyhow, your not alone. Oh, also, do you drink alot of water? I notice I can pee and then 5 minutes later I have got to go again. Well, I think if you drink alot, your bladder is constantly filling up, and remember, you will feel like you have to pee when there is only 7 ounces where a normal person would not have to go that quickly. Just a thought.
Jen

[notmybestday]

Hey, thanks for the reply.

I buy the inflammation causing bladder muscle malfunction theory.

I don't buy the drinking a lot of water theory though. Can the bladder really fill up with 5-6 ozs. in just 5-10 minutes? I don't think our kidneys excrete urine that quickly...

I think I often have over 8 ozs. in my bladder, but it just doesn't come out in one void, and I find myself having to double void to get it all out. This was my very first symptom. This need to double void with a good amount of urine in the bladder.

Well, thanks very much for your input. My uro's no damn help, so I've gotta figure things out on my own, but I'm glad y'all are here.

[ICNDonna]

I suggest you talk with your doctor about trying one of the medications that help relax the bladder so you can urinate easier. There are several, usually used by men with enlarged prostate glands, that might help. The ones that come to mind are hytrin, cardura, flomax --- there are others as well.

Donna

[jen74]

Actually, your bladder can fill up very fast, even 12 ounces in minutes. There reason I know this is becuase I was talking to my dad about the IC and how I have to go sometimes 5 minutes after I just went, and he said it depends on what you drink and how much and how your body processes it. Everyone is differnet. My dad said that when he drinks a lot of coffee in the morning, he will pee and then sometimes not even 10 minutes later he can go alot again. He also said in his hay day when he was younger, he and the guys use to drink beers and he said they would all be in the john every 5 to 10 minutes sometimes and with a very full baldder each time. So your bladder can fill quickly. I think it also depends on how quick your metabalism is also and how fast you process things.
Jen

[jen74]

Oh, also if you really want to reasure yourself if you are retaining, some uro's have this new bladder scanner that after you pee, they just put this hand held ultrasound unit over your pelvis and it can record how full your bladder is or if you emptied it completely. There is also the other way where you pee and then catheterize right afterwards to see how much is left in there. This is just an option you can ask your doc about. But remember, if you are like me at all, where you change all during the day, it is useless. I know there are times I feel like I know I emptied my bladder, but times I feel like I did not all the way. Now if you have this issue all the time then I would ask your doc about it and see if he has a scanner.
Jen

[notmybestday]

ICNDonna: How do these muscle relaxers differ in mechanism from medicine like Detrol LA and Ditropan? I don't know much about these.

jen74: Thanks for your input again. Well, coffee and beer are diuretics, so that makes sense. As for typical kidney excretion, I have no idea, but I guess it can depend on a lot of factors.
It's not a question of whether or not I do retain. I've had the ultrasound screening thing done before, and they found 100 cc's after a void. When I had the ultrasound (?) of my uterus and bladder, the technician saw a significant post-void residue. What I want to know is why this happens, so I can help fix it. I often feel like my frequency is brought on by this retention, so I feel the former can be reduced by trying to fix the latter. I mentioned it to my uro, but he again said such symptoms were typical and offered no means of finding relief from it.

[Claredale]

I don't know the mechanics that well, but I know that your kidneys are constantly excreting urine into your bladder. And with IC, our nerves just tell us we need to empty well before the average person gets that urge. I know when I used to stop drinking anything at 6:00 in the evening thinking that it would stop me having the urge at night and then waking me up (definitely made no difference). My mom (a retired nurse) told me that it didn't matter because fluides comes from your food and your body is emptying into our bladders.