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Incontinence

Neurologic Causes for Bladder Incontinence

05/11/2009

Question:

I have had 2 surgeries for cervical fusion and one lumbar laminectomy. In Aug. 08 I developed peripheral neuropathy. In Dec. I developed bladder control problems which have become more severe. In Jan. I began to experience heart arrythmias (SVT, PVCs, partial right bundle block) and had an episode of severe chest pain that sent me to the ER via ambulance.

I recently visited a urologist who told me that my bladder symptoms and neuropathy symptoms were caused by neurological issues. He ordered a urodynamics study, which won`t be done for over a month because of the long waiting list.

My questions are: What neurological problem is most likely causing my symptoms? Could it be causing my heart symptoms as well? Is a urologist the correct specialist to diagnose and treat the problem if it is neurological? Should I return to the neurologist who diagnosed the idiopathic peripheral neuropathy? Or, do I need a different specialist? Will my problems continue to multiply and affect other body functions? How do I get the help I need?

Answer:

There are several issues which need to be clarified. Although lumbar laminectomy may cause immediate bladder symptoms but usually resoles with time and healing process. It is also true with cervical fusion. However, your symptoms of peripheral neuropathy should be clearly diagnosed and treated. It could be one of the few demyelinizing disease such as MS. Cardiac arrhythmias has nothing to do with peripheral neuropathy unless caused by a systemic illness or hormonal abnormalities such as thyroid or parathyroid.

Your urologist will diagnose neurogenic bladder which easily treatable. Neurologist will help you find the reason for your neurological symptoms and a good internist may discover endocrine problems as well as the cause for your heart irregularity.

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Response by:

Ahmad  Hamidinia, MD Ahmad Hamidinia, MD
Formerly, Professor of Clinical Surgery
College of Medicine
University of Cincinnati