Spastic Urethra

[Parkiewife]

Has any person with pd have botox injections in the urethra to stop spastic voiding? Am having difficulties with my husband urinating all over and is confused in the use of depends. Help!!

[park_bear]

The urethra is merely the channel. If there is something physical causing this problem it could be the urinary sphincters or an overactive bladder. You might want to review male urinary anatomy here:

wellspect.com/education/art...

However, you report he is subject to confusion, so he may also be confused about what to do and where to do it.

Another possibility to check out is urinary tract infection.

[Parkiewife in reply to park_bear]

Thanks for your response. He’s been checked for UTI and PSA level checked. All are good. Am thinking cognitive decline is more of a reason? Have upcoming appointment with neuro/psychologist.

At this point, we will try out all options. He’s had pd for 25 years (young onset at 33)

[Redginger in reply to Parkiewife]

Bless you for your commitment to him "in sickness and in health"! This is rough, this PD, for the patient and the spouse. My husband takes Bladder Control Advantage and has been for dont know how long. They are capsules and he will either swallow or we dump into a shake. You can order at 1.800.888.1415 or healthydirections.com. They advise that more is to be taken for the first two weeks so if you decide to try it be aware of that. I can sort of understand some of what you are dealing with. Hoping you can find some help.

[House2]

I take oxybutynin, it helps.

[kaypeeoh]

I have BPH: Benign Prostate Hypertrophy but it hasn't caused urethral spasms. I get Botox injections for hand tremors. As always there's a trade-off; The tremors are smaller but I can't snap my fingers and can't hold the bar for doing chin-ups. Each injection lasts 3 months. I'd ask about the side effects and decide if you can live with them for 3 months.

[Parkiewife in reply to kaypeeoh]

Thank you for your input! Husband currently gets botox in both jaws to help stop drooling. He gets shots every 3 months.

[gwendolinej]

Hi Parkiewife, my husband was supposed to have Botox for his overactive bladder OAB in November, but we had to cancel because his mental condition deteriorated. He was very confused, which manifested itself finally in refusing to to take his medications or drink any fluids. The neurologist put him into hospital, where he and the psychiatrist tried to get to the bottom of it. He came home this week after 2months. He’s a lot better. The confusion has gone. He’s on 2 antidepressants, which I’m assuming has helped.

We had an appointment with the neurologist on Friday. On questioning, there are a number of possibilities that could have caused this episode. They found he has “vascular problems”, vascular dementia?…. possibly. Could his constipation have caused it…possibly. Could his OAB have caused it..possibly. He also suggested it very likely was

Delirium, caused by any of the above.

When I googled WHAT CAUSES DELIRIUM IN PD, it stated “factors that precipitate delirium can be related to lack of sleep, ongoing presence of dementia, dehydration, or polypharmacy.”

So, in other words, we can’t be sure what caused it. But the neurologist said we have to watch for symptoms, as it can reoccur.

We have to solve the constipation problem at the very least, to eliminate that cause. In hospital, they gave him enemas, which solved it, of course. He’s taking Movicol twice daily and I’ll be trying other ideas, as mentioned by members here. He already has a very high fibre diet, but fluids have been a problem.

Anyway, I pass this on, in case it’s of value.

Gwendoline

[Parkiewife in reply to gwendolinej]

Thank you! This information helps more than you know! We have attended PD support group in the past (I’ve attended caregiver support group). NOTHING like this was ever discussed at either meetings-we stopped going!

[LeharLover62 in reply to gwendolinej]

I just saw this and really hope things are going better. So did the mannitol stop controlling the constipation?

A couple of thoughts, hubby had to stop mannitol because it made him too sensitive to levodopa, and even a small dose of mannitol or levodopa made him hallucinate.

But that said, if he gets a UTI (which I’m sure they checked) or is trying to have a bowel movement it gives him some delirium.

After stopping mannitol, we switched to very low dose Macuna and bacillus subtilis every day. And his bowel movements became normal!!

He is now also scheduled for Botox for

OAB in a couple of weeks and I’ll post an update on how that goes.

[gwendolinej in reply to LeharLover62]

Thanks for your comments. His constipation has been a problem all along. Levadopa has never worked for him. Mannitol has been amazing. At the moment he’s still taking it. Who knows what it’s doing.

His current problem is swollen legs and stomach, only appearing after he left hospital. It also could be caused by a number of things ☹️

The doctors are on it. Let’s hope they solve it soon.

Gwendoline

[LeharLover62 in reply to gwendolinej]

Hubby had the leg swelling also after hospitalization. It was from constipation and immobility. Once he got thing moving again, and drank lots of fluids, it resolved. This would sometimes happen from constipation even when he was moving around.

Hope you figure it out! I think another worry can be congestive heart failure.

[kaypeeoh]

The urethra is not merely anything. It has it's own muscle and nerve endings. Any bladder inflammation can cause spasming of the urethra. I had a long surgery while hooked up to IVs. Once awake I couldn't pee although I wanted to desperately. The nurse offered to use a catheter. Instead I went into the toilet and punched myself in the stomach til the urine came.