Urologist and continence nurse

Well had an urologist appointment back on the 6 June after being fallen through the cracks since 2011 after my Urodynamic (as GP refused to follow up at my request) my new GP referred me back as I wanted a Continence product assessment as have issues with every Pull up type I have tried due to discomfort with fit.

Back in 2011 someone should have contacted me back regarding a Continence Nurse assessment (for bladder training attempt) but never did the urologist told me it "can't" be Neurological bladder as no obstruction as was quite annoyed with my old urologist for not following it up even more annoyed with old GP that refused.

Saw the Continence Nurse today (as the nurse is tasked with bladder retraining) well she is getting me to do a 3 day diary I see her again in a months time (even though I explained the bladder is never predictable and has a mind of its own) and she stated with the symptoms and timing of when having issues as well as my injury at L4-L5 S1 stated sounds like it could be neurogenic bladder but the urodynamics showed no Obstruction as they thought back in 2011 before urodynamics it could be.

As it is I have accepted the continence issues due to having them since 2009 but wanted a product assessment due to discomfort and skin irritation the continence nurse have given me a few samples of ID Pants Super to try as well as sudocrem as a barrier to try (I tend to hate oily cremes on hands).

The issues incl :-


- Sometimes leaky all day
- Sometimes hard to start voiding
- Sometimes issues emptying completely
- WeakStream so easier and cleaner to sit while peeing

Been wearing pull ups since 2009 since currently wearing Molicare Mobile as the best pull up type I can find myself as never done a proper continence Assessment just a quick assessment for funding (which I saw on a once off)

But find issues with pull ups in general:- padding clumping up, chaffing, non snug fit even while wearing Tena Fix Stretch pants.

Just wondering what else could have caused these issues around the same time I did the nerve impingement in 2009

Also I live in Australia

Three brief points in response to your post:
1. So far as I know, there is no reason to expect that there would be a blockage if your incontinence is causes by a neurological issue.
2. If pull-ups aren’t working satisfactorily for you, try tape-on adult briefs (diapers). You can adjust the fit so that the brief fits snuggly around the legs and waist.
3. When your follow-up medical care “falls through the cracks,” it’s your responsibility to contact the doctors involved and pester them if need be so that you get the follow-up treatment that you need.

I tried to get previous GP as didn't know who to contact also I am bad with verbal communication due to disability unfortunately the old GP refused.

An L5-S1 injury is sort of like a magical point for neurological bladder and phincter issues. I too had this from a bad car wreck. My symptoms were also somewhat similar to yours. And after almost two decades I was finally, properly diagnosed with urge incontinence coupled with both internal (bladder) sphincter and external sphincter dyssynergia.

Although I did not have an actual blockage, it turned out my sphincter muscles were the "blockage" since they were not fully relaxing when they were supposed to. And since I also had the urge incontinence, those spasms would end up hurting real bad since I couldn't go when I needed to (ie, right away).

This may not be what you have, but it's certainly worth researching and following up on (especially since it is difficult for urologists to diagnose). For me, the ultimate "fix" was to try and fully open up my sphincter muscles via multiple sphincterotomy surgeries. Though the multiple surgeries themselves lead to a bad complication of an actual physical stricture blockage, once that was cleared up I became fully urinary incontinent. I now constanty leak in lieu of straining to flood my diaper with each urge. I'm still in diapers 24/7 as I was before, but am at least now free of pain and complications.