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Incontinence

Cannot Feel Any Sensation While Urinating

05/10/2010

Question:

Hello...Following a bad car accident in 2008, I was catheterized in the hospital for more than 2 1/2 months; I was unable to get out of bed or even to move at all due to several spine fractures, so the catheter was a necessity. The fractures were complete to the T-6 and partial to the T-7 and one compression (I forgot where)fracture. There was no spinal cord damage, thank heaven. I did have TBI issues, and a transient focal nerve injuries to the face and eye; these have since nearly cleared up. Ever since the accident, (or at least, since I was urinating on my own), I have had no feeling in the urethral tube at all. If it was not for the sound on the water in the toilet bowl, or a wetness on my leg if I happen to not make it to the toilet (frequently happens), I would not know I was `going`. I cannot tell when I have quit urinating, either.

I saw a urologist, had a lengthy test to see what kind of incontinence I have. (Still no answer, except that it is not stress incontinence.) But the doctor said he had no idea how or why I am numb inside the urethra. I feel certain this is related to, and perhaps causing the incontinence issue; however, the doctor said he had no idea, but had once had another woman describe this numbness to him. Have you any idea what would be causing this, and if so, can it be treated? I did not have this trouble before my accident and hospitalization. Thank you very much.

Answer:

It is difficult to answer why there is not sensation when urinating from the information provided. After major trauma including TBI and back fracture, it is possible that nerves to the bladder can be affected. Urodynamic testing can be helpful in determining if sensation of bladder filling is normal and if the bladder contracts properly. It may be helpful to follow up with both your urologist and a neurologist who can perform a more detailed neurologic examination and shed light on the symptoms you are having.

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Response by:

Donald R Bodner, MD Donald R Bodner, MD
Professor of Urology
School of Medicine
Case Western Reserve University