Permanent structural damage to the bladder be caused from more than one disease or disorder.  I have hypertonic floor dysfunction.  You can read more about this condition here.  I also have Acute Bladder Retention. This 5 minute video can explain it way better than I can.  It affects people with a penis and people with a vagina.  A bladder has two functions: store urine and empty urine.  When the bladder is full the brain sends a message to the bladder letting it know it’s time to to go pee.

When I told my pelvic floor specialist I couldn’t empty my bladder no matter how hard I tried, she scheduled a test for me with a Uro-Gynecologist. Undergoing urodynamic testing, was for me, an oxymoron. The testing involves filling the bladder with sterile water. So sure, why not? Fill up the bladder of the chick who can’t take a piss on a good day.  Whatever, I understood it needed to be done. I was not expecting the extent of things I had to go through to have it done.  I was also not expecting the results I received.

A nurse and a licensed tester was assigned to me.  “The Two Heathers” put a catheter in my bladder and a probe in my rectum.  Oh, joy.  Nothing below my waist relaxes so we had some difficulty with the probe staying put.  It’s a tiny wire, but it didn’t stay where it was supposed to stay. Then I had electrodes attached to my butt crack on either side of the rectum.  Ditch the modesty because there is no way to conserve it during this process.  One of the Heathers had the nerve to tell me to relax so she could get the probe up my ass.  Hello?  What part of hypertonic does she not understand?  All of this is then attached to a computer which measures pressure changes.

So in goes the sterile water, stop, cough, repeat several times to make sure there aren’t any leaks.  We knew going in there wouldn’t be any, but sacrifices needed to made for the thoroughness of the process.  Then I was told to void my bladder.  The Two Heathers were serious, too.  Problem one rolls around when I made the switch from exam chair to special toilet.  The probe we fought so hard to insert into my rectum fell out as soon as I moved.  The Two Heathers said nothing could be done about it at this point. It had already hit the floor.  So try to pee. Yeah, right.

You have to take a pee with a tube in your urethra and probe in your rectum (remember mine fell out) sitting on a specially designed toilet that will also measure bladder pressure.  This time going out instead of coming in.  This is referred to as a pressure flow study.  A healthy bladder typically holds 16 ounces of urine (that’s 476.1 ml for my metric loving readers).  We’ll actually be doing metrics for the remainder of the article since that’s the way the medical profession records fluids.


Photo Attribution: Aruku’s Pelvic Health Centre

Permanent Structural Bladder Damage

They flowed a grand total of  487 ml into my bladder.  One hundred eighty seven ml came back out organically with a very slow trickle with a catheter in my urethra tube.  After I tinkled as much as I could The Two Heathers untethered me and allowed me to get dressed.  They explained to me the doctor would be in to see me after she read the results of my testing.

To say I was shocked at what came out of the doctor’s mouth would me an understatement of mass proportions.  The first shock was, “You have severe permanent structural damage to your bladder typically only seen in patients with advance stages of MS.”  Not what I was expecting to hear at all, because a year prior to this, multiple sclerosis was taken completely off the table as a possible diagnosis.  The top of my bladders spasms constantly which causes me have the urge to go pee even when my bladder is empty.  The urethra tube that allows the urine to leave the body won’t relax enough to let it out.

The second thing she said was I needed to repeat the test because the readings she really needed to get was provided by the internal probe in the rectum (which fell out) to determine how severe the damage was.  So lucky me, I got to do that all over again.  This was not something I wanted to repeat. Ever. Again.

The next thing that she did and said reduced me to a quivering mass of tears and fear induced hysteria.  She showed me how to use a catheter on my own and sent me home with a box of 100 of the things.  They are straight urinary catheters designed for patients to perform the catheterization on their own. They are generally used for a quick “in-n-out” and are disposable.  The first time I had to use one at home, I wasn’t seated properly.  I got the catheter in without any assistance. However, the urine didn’t go in the stool.  It went all over the floor.

I have already had an ultrasound of my entire renal system.  There are no abscesses in my kidneys. Everything is connected biologically corrected.  My bladder didn’t show any abnormalities.  I’ve also had a cystoscopy.  That’s a camera small enough to go through a catheter inserted into your urethra. Dr. Lisa wanted to make sure there was no internal scarring.  A team of doctors are of the opinion my permanent structural damage is not related to my pelvic floor dysfunction, nor the bladder itself,  and is more than likely neurological.

I was also referred back to the neurologist. He’s going to perform an other MRI of my brain, my cervical spine and my lumbar spine.  I will also have to have a lumbar puncture.  I have many symptoms of MS.  The structural damage to my bladder, muscle weakness in my limbs and difficulty swallowing are just a few.  However, there are many diseases that mimic symptoms of multiple sclerosis.  If I’m honest with myself, I’m terrified to have these tests performed.