Experiencing Urinary Incontinence After Back Injury

Patient

Q: I suffered an injury to my lower back about 2 years ago and have since been suffering with bladder control problems. I have seen an urologist and having undergone test has confirmed that I have probably damaged some nerves but also have a small and unstable bladder. I have been wearing padded pants during the day and a terry nappy and pants at night since I had an allergic reaction to the disposable briefs. Although I feel I can cope, I have noticed over the past few weeks that I am now not even waking up to go to the toilet but actually wet myself during my sleep. Is this a natural occurence of having worn a nappy at night or is it linked to my injury.

Doctor

A:   The most probable cause of your urinary incontinence I can think of is a herniated intervertebral disc suffered during the injury to your lower back. The herniated disk might have impinged on the spinal nerve roots supplying the bladder causing your symptoms. Any symptom of bladder or bowel incontinence, numbness in the anal region, back pain associated with fever, weight loss warrants for an immediate visit to a specialist dealing with back injuries.
The treatment of herniated intervertebral disc will depend of the presentation of symptoms and its severity.  Since your symptoms have been longstanding, surgery of the herniated disc might be beneficial. Microdiskectomy and minimally invasive percutaneous arthroscopic diskectomy are viable options. If you are experiencing rashes due the diapers and are unable to use them, I would advise the use of an external male catheter if you are unable to go to the toilet at night.

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