Re: bladder neck?
From: james connerth (babydoc@apex.net)
Thu Feb 3 11:45:16 2000
Also saw a similar reaction in a nurse on Desryl---cleared over days after
d/c'd drug.
"art fougner, md" wrote:
> OK - refer for a consult with a uro-gynecologist if your usual w/u is
> inconclusive. rogers' theorem - know when to hold em, know when to fold
> em.
>
> Art
>
> At Thu, 3 Feb 2000, Robert J Woolley wrote:
> >
> >I have a generally healthy (but highly anxious) young woman (age 24) with
> >urinary urgency and frequency for about 10 days, no dysuria, no hematuria,
> >no vaginal symptoms, not pregnant. Urinalysis completely normal, urine
> >culture negative. She saw one of my partners first and was treated with
> >Bactrim and Pyridium, in spite of the negative UA; no change in symptoms
> >with these two meds for 3 days, no change upon discontinuing them,
> >either. She can hold her urine as long as she needs to (no incontinence),
> >but it requires constant voluntary effort, starting roughly 10 minutes
> >after last urination. Urine volume is proportionate to the duration she
> >waits. No problem at night.
> >
> >The best that I could reason from this was that she was having weakness at
> >the bladder neck, akin to stress incontinence, but constant instead of
> >only with stress, but with sufficient reserve in the pelvic floor muscles
> >(she has never been pregnant) to prevent actual loss of urine.
> >
> >Does this sound plausible? If so, is there a name for it?
> >
> >I tried treating her with pseudoephedrine as an alph agonist, no
> >response. Today I told her to try phenylpropanolamine, for the same
> >reason. If this fails, what would you do next (besides send her to a
> >urologist)?
>
> --
> art fougner, md
>
> and what am i gonna do with all this food, bottled water,
> and gasoline now that armageddon was called off for lack
> of interest?
|
|
