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Dr. David
Dr. David, Physician Experienced in Urology
Category: Urology
Satisfied Customers: 49156
Experience:  Board Certified Physician with extensive experience in Urology
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I have had cystoscopy and found tight bladder neck. I am on

tamsulosin and mirabegron. My frequency... Show More
tamsulosin and mirabegron. My frequency has reduced on these medicines but I always have a feeling of needing go toilet constant. It's worse after I have just been it makes me go back 2 or more times I get what feels like sure muscle in bladder area. Sometimes my urine can be slightly solo especially if I'm slightly erect. My urologist thinks I may now also have overactive bladder and suggested Botox injections to stop this constant feeling of peeing. It's strange as I can feel my bladder is not full but my or is feels like needs to empty. Can you help me or make any guess as to what it may be?
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This is Dr. David

I would not jump to botox yet

I would avoid all caffeine and alcohol in your diet which can irritate your bladder and urethra and can cause frequent and urgent urination.

if that doesn't work, there are medicaitons to help decrease overactive bladder muscles such as Detrol and vesicare and hyoscyamine which can help

I would try all of those before botox

let me know if you have questions.
Customer reply replied 2 years ago.

I am currently taking mirabegron have been for a number of months it has helped as I can hold my bldder for longer but that feeling of always need to urinate has not gone. It does feel like uretha irritation. Is this normal for OAB? Also does tight bladder neck cause this or can it be other way around? Finally can OAB be c or do you need treatment forever

yes, this is normal sensation for overactive bladder.also avoid alcohol and caffeine.if you have excessive anxiety symptoms, it can lead to nervous bladder symptoms and urinary urgency as well.overactive bladder symptoms can be treated and the symptoms improved. cure is not usually a word used for overactive bladder.tight bladder neck doesn't usually cause these issues. tight bladder neck can cause symptoms similar to enlarged prostate which is difficulty with urine flow, poor stream, frequent urination at night time.
Customer reply replied 2 years ago.

Tanks my urologist thinks I have both tight bladder neck and OAB. Last questions are after suffering so long with feeling urge in uretha is it likely it could just stop with retraining for a longer time? Like I said I go toilet have to go back sometimes once twice to feel empty. Then I get urge straight after all say. I can ignore for 2 hours but uncomfortable does this sound like OAB and can go with time? Like said been in mirablegroom now and tamusolin for 4-6 months

Customer reply replied 2 years ago.

If I did have Botox would I need that for rest of my life? Same with medications

you should get an ultrasound of your bladder after you void to see if you have residual urine in your bladder and how much.

if you have residual urine in your bladder, it could be due to outflow obstruction causing post void residual urine in your bladder

and your symptoms could be due to not emptying your bladder completely when you urinate.

botox only works for aobut 6 months.

you can have surgery like TURP to open up a wider channel for urine to flow out easier out of your bladder.

you need urodynamic studies to see if the issues is due to prostate size or due to bladder muscle spasms and overactivity.

you shouldn't be uncomfortable.
Customer reply replied 2 years ago.

i had ultrasound and i have what is considered normal amount of urine left in the bladder after voiding. Sometimes i just need to go back as feeling of not finished - take it this is OAB also?

i had urodynamics but almost feint during test so they cancelled and didnt want me to re-do this procedure.

I have been told my prostrate is small and no issues with it and i cant have turp as im only 32.

sorry for additional q's could you answer them? ALso your final advice would be...?

is to try overactive bladder medication and see if they help.
Customer reply replied 2 years ago.

I forgot to ask ; if I end up with Botox treatment as my urologists suggests, will I need the injections troughout rest of my life every 6-9months or will it eventually retrain the bladder? What are my ch of this thing going away for good and being better?

botox only works for 6 months.
Customer reply replied 2 years ago.

Yes I'm aware of that does this mean I have to take forever to stop symptoms or can my bladder recover using this?

your bladder can recover
Customer reply replied 2 years ago.

So my bladder to confirm after Botox therapy could return to a non OAB bladder after it?You have been v helpful and patient with me thank you

yes, it could recover.