Question Title: Confused by urodynamic results & treatment options

I have MS, but while it seems that everyone else with MS has
urge incontinence, dyssynergia, etc., my urodynamic results
revealed detrusor areflexia, large bladder capacity and residual
urine, and severe stress incontinence with open bladder neck,
which is why I sought evaluation. I'm sick of being wet.
Urologist recommends Contigen injections before resorting to
bladder neck surgery or insertion of artificial sphincter. My
research indicates that in the presence of detrusor dysfunction
Contigen is unlikely to be helpful (Stricker PD, Sydney). I rely
on IC and have had 3 episodes of transverse myelitis. Any ideas
and an explanation as to why I differ from all others with MS?

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Multiple sclerosis (MS) may affect bladder function. This neurological disorder ususually causes detrusor hyperreflexia (overactive bladder), but in many patients detrusor areflexia (a bladder that does not contract well) is the presentation. The accompanying residual urine increases the risk of overflow and stress types of incontinence. (Stress incontinence refers to leakage with cough, straining, changing positions etc.)
For detrusor areflexia the usual treatment is clean intermittant catheterization to help prevent urinary tract infections, renal failure, or incontinence. If the incontinence persists, Contigen (collagen) periurethral injections may be added. If this is unsuccessful, more invasive surgery with vesicle urethral slings or artificial urinary sphincters may be discussed with your urologist.
More individualized care is available in person at the Henry Ford Hospital and its urban campuses. Please call (1 800 653 6568) if interested in setting up an appointment to meet with us in person. . We can also arrange local accommodations through this number if this is your need. Please bring any physicians’ notes and lab test results that you may be able to obtain. These will help us greatly. This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. Hope this has helped.
Very Sincerely Yours;
HFHS-M.D. CK
* Keyword: Multiple Sclerosis, detrusor areflexia, incontinence

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