Hello, ofbg-ga!
It sure sounds like you have been through the ringer looking for a
solution that you can tolerate.
After having a good look around, I have found only one alternative
that you have not mentioned which may turn out to be viable for you -
sacral nerve stimulation as offered by Medtronic's Interstim
neurostimulator device.
Please read through the following references about InterStim and
determine, along with your physician, whether it is a viable option
for you. Since your urinary retention is apparently caused by
neurological disruption due to a bone spur, and not an actual
obstruction, you might be a very good candidate.
==
"Medtronic Receives FDA Approval for InterStim II System for Treatment
of Overactive Bladder, Urinary Retention." July 5, 2006
http://www.leaddiscovery.co.uk/pr/Medtronic_Receives_FDA_Approval_for_InterStim_II_System_for_Treatment_of_Overactive_Bladder,_Urinary_Retention.html
"Medtronic, Inc. (NYSE: MDT), today announced that the U.S. Food and
Drug Administration (FDA) has approved the company?s InterStim® II
system for the treatment of intractable cases of overactive bladder
and urinary retention.
"InterStim Therapy for Urinary Control uses sacral nerve stimulation
to improve bladder function. Originally approved by the FDA in 1997,
it is indicated in the United States for the treatment of
non-obstructive urinary retention and the symptoms of overactive
bladder, including urinary urge incontinence and significant symptoms
of urgency-frequency alone or in combination, when more conservative
treatments fail or cause intolerable side-effects."
"The InterStim II system adds a new implantable neurostimulator (INS),
a new improved patient programmer and upgraded software for the
clinician programmer. These advancements offer a choice of
neurostimulation devices to accommodate more patients, streamline the
implant procedure, and simplify programming and follow-up care. The
improved patient programmer also gives patients more control of their
therapy."
"This new smaller, lighter device - combined with the array of smart
design changes to other components of the implantable system - will
make InterStim Therapy more attractive to both physicians and
patients," said Dr. Steven W. Siegel, director of Metropolitan
Urologic Specialists? Center for Continence Care in St. Paul, Minn.
"The new patient programmer and physician programmer software upgrade
represent a significant step forward for this treatment option for
overactive bladder and urinary retention. With all of these
enhancements, InterStim Therapy deserves a fresh look from physicians
and patients alike."
The InterStim II system consists of:
InterStim II Implantable Neurostimulator (INS).
Ideally suited for patients with lower energy requirements (as
determined during the therapy trial) or smaller bodies, the InterStim
II INS is nearly 50 percent smaller by displaced volume and nearly 50
percent lighter by weight than the original device - the InterStim
INS, which continues to be available."
InterStim iCon Patient Programmer.
The InterStim iCon Patient Programmer offers many new features to
improve patient management for physicians and provide greater therapy
control for patients. Patients can use their InterStim iCon programmer
to select from four available programs and adjust the stimulation
amplitude (only) for each of them. The InterStim iCon programmer
offers these new programming features to patients and physicians,
regardless of whether they are using the original InterStim INS or the
new InterStim II INS.
N?Vision® Clinician Programmer.
The N?Vision clinician programmer works with all Medtronic
neuromodulation therapies. The new software allows the physician to
design and track the utilization of up to four stimulation programs
for patients equipped with the InterStim iCon patient programmer. When
coupled with the InterStim iCon programmer, the new InterStim software
enables improved clinical management of patient therapy.
==
More about InterStim:
From "InterStim Therapy in Voiding Dysfunction." Kristin Sanderson, M.D.
http://www.medcompare.com/spotlight.asp?spotlightid=192
"Voiding dysfunction, either urinary incontinence or retention, can
have a debilitating effect upon the individual?s daily quality of
life."
"Equally difficult to manage satisfactorily are patients suffering
from non-obstructive urinary retention for whom few therapeutic
options exist. Until the introduction of sacral neuromodulation, these
patients, managed primarily with intermittent or indwelling
catheterization, had little hope of regaining volitional voiding
function."
"In 1997, InterStim Therapy, the sacral nerve stimulation device
produced by Medtronic, Inc., gained FDA approval as a therapy for
individuals with urinary urge incontinence and in 1999, went on to
receive FDA approval for frequency-urgency syndrome and
non-obstructive urinary retention for patients who fail standard
therapies. Currently, more than 600 urologists and urogynecologists
worldwide have adopted SNS as a treatment, and more than 8000 devices
have been implanted successfully."
Read further..
MEDTRONIC WEBSITE - INTERSTIM
==============================
"Medtronic Interstim Therapy."
http://www.medtronic.com/neuro/interstim/
What is InterStim Therapy for Urinary Control?
"Medtronic InterStim® System for Urinary Control is indicated for the
treatment of urinary retention and the symptoms of overactive bladder,
including urinary urge incontinence and significant symptoms of
urgency-frequency alone or in combination, in patients who have failed
or could not tolerate more conservative treatments."
"InterStim Therapy uses a small device to send mild electrical pulses
to a nerve located in the lower back (just above the tailbone). This
nerve, called the sacral nerve, influences the bladder and surrounding
muscles that manage urinary function. The electrical stimulation may
eliminate or reduce certain bladder control symptoms in some people.
The system is surgically placed under the skin."
Read further....
You can fill out the following questionnaire to see if you are a good candidate:
Self-Assessment Survey
http://www.medtronic.com/servlet/ContentServer?pagename=Medtronic/Website/StageArticle&ConditionName=Urgency-Frequency&Stage=Diagnosis&Article=urinary_art_selfassessment
Physician Locator
http://www.mymedpages.com/pf/search.do?actionCode=1&websiteParm=interstim.com
==
The MidWest Urology website also has a good overview of the Interstim
System. You can click on each page to read all about the device and
and how it is used.
InterSTim Therapy
http://www.midwesturologycenter.com/interstim.asp
FORUMS
=======
Here is an old posting about InterStim from the Urology Forum
http://www.medhelp.org/forums/Urology/messages/30216.html
Though not focused on urinary retention, the following thread has
numerous posts about the InterStim
http://www.ic-network.com/forum/archive/index.php/f-110.html
More postings that may, or may not, help!
http://www.medhelp.org/HealthTopics/Retention.html
==
I hope the Interstim device turns out to be a viable alternative for
you. As I noted early, it is the ONE procedure that you did not
mention having tried already. I am hoping it might allow you to avoid
a stent at this point in time.
Rooting for you!
umiat
urinary retention
urinary retention AND spinal bone spur
herbs to help relax bladder sphincter muscles
herbs to help urinary retention
alternative therapies for urinary retention
interstim for urinary retention
Forum and urinary retention |
Request for Answer Clarification by
ofbg-ga
on
15 Sep 2006 19:14 PDT
Your answer would be great if i had not posted my question in the
alternative section. The Medtronic InterStim is a non reversible
extreme measure. I am looking to induce short term enuresis to give my
kidneys a chance to recover (hopefully}. If i do not recover more
extreme measures may be needed. I was looking for naturopathic /
Chinese herbal / herbal /or something similar. Thank-you.
|
Clarification of Answer by
umiat-ga
on
15 Sep 2006 21:47 PDT
Thank you for your clarification.
I certainly understand that you feel the InterStim system is too
extreme at this point. I thought it might allow you more control than
a bad and a shunt.
Perhaps you can focus on regaining urinary tract health with some
herbal formulations and forgo that route altogether.
I hope the following suggestions are more along the lines of what you are seeking.
==
Ayurvedic remedies are one route, but they usually do not "isolate"
one function of an entire system. For example, an Ayurvedic remedy for
urinary health tries to balance the whole system as opposed to "just"
promoting urination, for example.
You might want to take a look at the Ayurvedic product, Genitrac. This
is an entire spectrum of natural ingredients, including Indian
Gooseberry. - "Indian Gooseberry is especially supportive to the
urinary system. It supports natural diuretic action, but does not
force water from the body like diuretic pills. In other words, it
helps eliminate waste from the body but does not over-stimulate the
urinary system."
See http://www.mapi.com/en/1-800-255-8332/products/genitrac.html
==
You might also want to try a natural, herbal diuretic in the late
afternoon or early evening to completely flush the bladder. It might
be easier on you than traditional diuretics.
Gotta Pea Tea:
"All herbs in this blend are diuretic in nature and will increase
urination....Also good for those that cannot or do not urinate alot
during the day.
http://www.localharvest.org/store/item.jsp?id=5706
==
The herbs Rau Rom (Vietnamese Coriander) and Red Hogwood have
properties of inducing urination, but I would hesitate to use such
herbs without going to an herbalist who has expertise in using such
remedies.
http://www.herbnet.com/Herb%20Uses_RST.htm
==
The following Chinese herbal formulation called Ba Zheng San is used
to promote urination in cases of obstruction (which is not the cause
of your problem) but you would certainly need to consult an
experienced herbalist to see if it could be used to promote urination
in your situation
Ba Zheng San - low Jiao Damp/Heat, clear Heat & Fire, promote
urination to remove obstruction
Mu Tong (caulis mutong)-3-6g
Hua Shi (talcum)-12-30g
Che Qian Zi (semen plantaginis)-9-15g
Qu Mai (herba dianthi)-6-12g
Bian Xu (herba polygoni avicularis)-6-12g
Zhi Zi (fructus gardeniae jasminoidis)-3-9g
Zhi Da Huang (treated radix and rhizoma rhei)-6-9g
Deng Xin Cao (medulla junci effusi)-3-6g
Gan Cao (radix glycyrrhizae uralensis)-3-9g
==
The following herbs and formulations I found which "might" also be
helpful should also be prescribed ONLY through an herbalist. You
mentioned that you had seen an acupuncturist. Perhaps they have a good
recommendation for an herbalist in your area.
ASTRAGALUS LEGUMINOSAE - aka Chinese Milk Vetch, Membranous Milk
Vetch, Milk Vetch
(Astragalus membranaceus
"In Chinese medicine it is used to invigorate vital energy (chi) and
strengthen body resistence and promote tissue regeneration, promote
diuresis, and disperse poisons."
http://earthnotes.tripod.com/astragalus.htm
==
The following formulation is profiled on the International Academy of
Medical Acupunture site:
http://www.iama.edu/
DI-221 is a modified Hoelen Five Herb Formula. Hoelen Five Herb
Formula is a classic herbal combination for promoting water
metabolism. The ingredients, Alismatis Rhizoma, Poria, Polyporus and
Plantaginis Semen promote diuresis and remove water from the body. The
research data from China and Japan shows this formula has the effects
of promoting blood circulation, inducing diuresis and reducing edema.
For 1800 years, it has been widely used to treat edema, difficult
urination, nephritis, edema of the scrotum, retention of urine, acute
gastroenteritis and cardiac edema.
http://www.iama.edu/Herbs/Formulas/di-221.htm
Indications:
Edema, difficult urination and retention of urine.
Dosage:
4-6 tablets three times per day, before meals.
Functions:
Traditional:
Induces diuresis, eliminates dampness, warms yang qi and activates the
functional activity of qi.
Modern:
Promotes blood circulation, induces diuresis and reduces edema.
Ingredients:
Alisma Alismatis Rhizoma Ze Xie
Polyporus Polyporus Zhu Ling
Hoelen Poria Fu Ling
Plantago Plantaganis Semen Che Qian Zi
Atractylodes Atractylodis Rhizoma Bai Zhu
Cinnamon Cinnamomi Ramulus Gui Zhi
==
Apocynum venetum:
Traditional Chinese uses - Calm the liver to extinguish internal
wind, lower blood pressure, ** promote diuresis **
http://www.senhealth.com/vsite/vcontent/page/xmlcontent/0,11740,4822-129322-130630-19339-68896-xmlcontent-item,00.html
==
Job's Tears / Coix Lacryma-Jobi (yi yi ren)
THERAPEUTIC EFFECTS:
Promote diuresis and invigorate the spleen
http://www.foodsnherbs.com/job's_tears_(yi_yi_ren).htm
==
Again, I hope this offers you some extra help!
Sincerely,
umiat
|
Request for Answer Clarification by
ofbg-ga
on
18 Sep 2006 17:46 PDT
Thanks for the extra input. But i am unable to use a diuretic because
they put extra pressure on my kidneys. This is what i am trying to
avoid. Checking on your suggestions they are diuretics. I need some
thing that will relax my interior and exterior bladder sphincter
muscles. Sorry to be such a nitpicker.
|
Clarification of Answer by
umiat-ga
on
19 Sep 2006 14:31 PDT
Hello again,
I certainly understand your desire to find an alternative method to
solve your bladder dysfunction. And no, you are not nit-picking. Your
condition must be extremely frustrating.
However, I have to admit, I am getting more and more confused as are
some of my colleagues who work in the medical profession. At this
point, I am not sure I am understanding exactly what you want, or more
precisely, why you want it - but it may be a matter of your choice of
words.
Your term of "inducing enuresis" essentially mean "wetting the bed."
You have stated that you want your bladder muscles to relax to induce
"nocturnal enuresis" - yet you don't want to have to wake up or get up
at night. Therefore, from your initial question and subsequent
clarifications, it sounds like you are looking for something to allow
your bladder muscles to relax so completely that you will essentially
wet the bed at night without getting up or waking, or without having
to use a catheter or a stent. Is this actually what you are asking?
In your second clarification, you further stated that you want the
sphincter muscles to "relax the bladder." Again, it appears that you
hoping to relax your bladder so it will simply "spill urine" without
you waking up - almost like you want to induce incontinence. Am I
correct in this assumption?
The only other interpretations I can come up with are that you are
simply hoping to relax your bladder so that it will not spasm and thus
can hold more urine at night? Or, that your sphincters are not
relaxing adequately during the timed voiding at night - forcing you to
attempt voiding several times, without adequate results, so that you
get overly tired.
If you emptied your bladder right before bed, could you manage to
make it through the night, or perhaps get up just one time? Is it
possible that you can change your diet to avoid all diuretic foods and
drinks before bedtime so that your bladder does not fill enough to
have to empty during the night? Most adults can manage to get enough
sleep during the night by holding urine for 5-8 hours. Or, is it
acceptable to have to get up just one time at night if you must,
simply to avoid catheterization?
One of the reasons I mentioned a wide variety of products in my
initial answer and subsequent clarification was so you might tackle
this problem from a variety of angles - perhaps use a product to
strengthen the urinary tract, or use a natural diuretic during the day
that might be far gentler than a traditional diuretic prescription.
After hours and hours of research, I am truly at a loss. I have not
run across a single supplement or medicine that is supposed to make an
individual incontinent by inducing bed-wetting - which is what you
seem to be asking. Most every herb, alternative method like
acupuncture, hypnosis, or even traditional medications, work to help
prevent enuresis - not induce it. Bed-wetting does not appear to be a
desired condition....that is why I wonder about the wording of your
question.
==
I will provide you with the only other suggestions I have run across -
even if they are NOT right on target.
The following two substances are commonly used in natural prostate
supplements but they might be applicable in your case. ** I know you
do not have a prostrate problem but one characteristic of
Beta-sitosterol is to help decrease the amount of urine left in the
bladder.
** Therefore, it might allow complete emptying of your bladder before
you go to bed at night and help you to sleep through the night without
worrying about your bladder becoming too full.
'Beta-sitosterol is a plant's version of cholesterol. It's found in
many foods and herbs used for BPH. Beta-sitosterol is thought to be
beneficial for BPH patients because it seems to have antiproliferative
effects on prostate tissue.
Beta-sitosterol significantly improves urinary symptoms. It increases
maximum urinary flow and decreases the volume of urine left in the
bladder. Like saw palmetto, beta-sitosterol does not affect prostate
size.
http://www.naturaldatabase.com/(S(n2nqfrufpsuolb5543jfzrjq))/ce/ceCourse.aspx?s=ND&cs=&st=0&li=0&pc=04-23&cec=1&pm=5
From a forum post related to flomax:
"forget flomax,try beta sitosterol a natural product with no side
effects. after 2 weeks i stopped getting up at nite
http://www.askapatient.com/viewrating.asp?drug=20579&name=FLOMAX
==
The same article mentions Rye grass as having the ability to relax the
internal and external sphincters:
Anti-inflammatory Supplements
Rye grass pollen extract contains beta-sterols.
*** It seems to relax urethral smooth muscle tone and increase bladder
muscle contractility. It might affect alpha1-adrenergic receptors and
relax both the internal and external bladder sphincter muscles.
It might also decrease inflammation by inhibiting the biosynthesis of
prostaglandins and leukotrienes.
Rye grass pollen extracts seem to improve BPH symptoms...frequency,
nocturia, urgency, decreased urine flow rate, dribbling, and painful
urination in men with mild to moderate BPH. It may also decrease
prostate size, improve urinary flow, and decrease residual urine
volume. But not all research has shown effects on objective BPH
measures.
Rye grass pollen extract is sold as a prescription drug throughout
Western Europe, Japan, Korea, and Argentina.8176 Tell patients that
rye grass pollen extracts appear to be safe and effective for up to 6
months. Cerniltion is the brand of rye grass pollen extract used in
most clinical studies
http://www.naturaldatabase.com/(S(zftiozn1igsei32xdg5zyjrt))/ce/ceCourse.aspx?s=ND&cs=&st=0&li=0&pc=04-23&cec=1&pm=5
==
CystiQuell is an herbal product which is applicable to many
conditions, including neurogenic bladder. It is supposed to help cases
of neurogenic bladder along with other urinary problems, though I have
no real indication of what it does, exactly. Again, this is supposed
to IMPROVE cases of neurogenic bladder - not necessarily relax the
sphincter muscles.
But would it be worth a try?
"CystiQuell and Neurogenic Bladder, Bladder Outlet Syndrome &
Interstitial Cystitis."
http://www.bluepoppy.com/herbs/newspdf/hnews_25.PDF#search=%22herbs%20AND%20neurogenic%20bladder%22
CystiQuesll
http://www.bluepoppy.com/cfwebstorefb/index.cfm?fuseaction=category.display&category_id=105&CFID=408730&CFTOKEN=60242030
Product Ingredients
http://www.bluepoppy.com/cfwebstorefb/index.cfm?fuseaction=product.display&Product_ID=380
==
The following excerpt describes "traditional medications" that are
used to "relax the bladder muscle" - have you tried all of them? If
these medications are they type of "bladder relaxers" you are truly
seeking, as opposed to inducing bed-wetting, then perhaps you can try
one that mimics them in a herbal form.
From Nerve Disease and Bladder Control
http://kidney.niddk.nih.gov/kudiseases/pubs/nervedisease/index.htm
"Drugs that relax bladder muscles and prevent bladder spasms include
oxybutynin chloride (Ditropan), tolterodine (Detrol), hyoscyamine
(Levsin), and propantheline bromide (Pro-Banthine), which belong to
the class of drugs called anticholinergics."
"A new patch delivery system for oxybutynin (Oxytrol) may decrease
side effects. Ditropan XL and Detrol LA are time-release formulations
that deliver a low level of the drug continuously in the body. These
drugs have the advantage of once-a-day administration. In 2004, the
FDA approved trospium chloride (Sanctura), darifenacin (Enablex), and
solifenacin succinate (VESIcare) for the treatment of overactive
bladder."
"Drugs for depression that also relax bladder muscle include
imipramine hydrochloride (Tofranil), a tricyclic antidepressant. Side
effects may include fatigue, dry mouth, dizziness, blurred vision,
nausea, and insomnia."
=
"Drug therapy for an uncoordinated bladder and urethra. Scientists
have not yet found a drug that works selectively on the urethral
sphincter muscle, but drugs used to reduce muscle spasms or tremors
are sometimes used to help the sphincter relax. Baclofen (Lioresal) is
prescribed for muscle spasms or cramping in patients with multiple
sclerosis and spinal injuries. Diazepam (Valium) can be taken as a
muscle relaxant or to reduce anxiety. Drugs called alpha-adrenergic
blockers can also be used to relax the sphincter. Examples of these
drugs are alfuzosin (UroXatral), tamsulosin (Flomax), terazosin
(Hytrin), and doxazosin (Cardura). The main side effects are low blood
pressure, dizziness, fainting, or nasal congestion. All of these drugs
have been used to relax the urethral sphincter in patients where the
sphincter does not relax well."
Botox injection -- Botulinum toxin type A (Botox) is best known as
a cosmetic treatment for facial wrinkles. Doctors have also found that
botulinum toxin is useful in blocking spasms like eye ticks or
relaxing muscles in patients with multiple sclerosis. Urologists have
found that injecting botulinum toxin into the tissue surrounding the
sphincter can help the sphincter to relax. Although the FDA has
approved botulinum toxin only for facial cosmetic purposes,
researchers are studying the safety and effectiveness of botulinum
toxin injection into the sphincter for possible FDA approval in the
future."
==
After reading your question over and over, many, many, times, I can
still only assume that you want the bladder sphincters to relax to
promote urine flow at night - yet you originally stated that you do
not want to wake up. For this reason, I wonder if it is better to try
to work on emptying the bladder efficiently BEFORE bedtime with some
of the herbal remedies I have highlighted previously. Please read the
following article and scroll down to the portion on Reflux:
http://www.herbal-treatment.net/article_paraplegic_urinary_tract_infection.html
Sincerely,
umiat
|
Request for Answer Clarification by
ofbg-ga
on
19 Sep 2006 18:31 PDT
I think we are starting to understand each other. I know that inducing
bedwetting is not a normal desired effect. I do not want to relax my
bladder musels i just need to relax my sphincter muscles. We are
trying to keep the urine pressure in my bladder at a minimum. This is
why i void every hour while i am awake. Nocturnal enuresis is
preferable than having a shunt installed because this way i can still
have my day time control. If you can add any more to your answer with
this clarification it would be greatly appreciated. I am going to try
some of the things you mentioned. Thank you.
|
Clarification of Answer by
umiat-ga
on
19 Sep 2006 21:59 PDT
Thanks for getting back to me so quickly. I don't know if I can find
anything else, but I will certainly keep trying!
|
