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#28732

So I’ve had urinary problems since a couple months after herniating my L4-L5 disc. I had urgency and frequency and sometimes pain. I ended up with foot and big toe weakness too. I had microdisctomy on May 8 and for 2 weeks my urinary symptoms were gone until I reherniated my disc which was confirmed on a MRI May 28.
Since then things have gotten worse where I leak urine when I sit or stand up sometimes and have more than usual dribbling after going.
I’ve also started to have some rectal pain and pressure feeling.
Yesterday I went to ER for this and had another MRI done but they said this stuff isn’t from my spine. Below is the MRI report. Isn’t it likely this is from my spine even though the MRI is definitive?

MR LUMBAR SPINE WO W CONTRAST

CLINICAL INFORMATION: incontinence;

COMPARISON: None.

FINDINGS:

L1-L2: Normal disc signal and height. No significant spinal canal, lateral recess or neural foraminal narrowing. Mild facet arthritis.

L2-L3: Normal disc signal and height. No significant spinal canal, lateral recess or neural foraminal narrowing. Mild facet arthritis.

L3-L4: Normal disc signal and height. No significant spinal canal, lateral recess or neural foraminal narrowing. Mild facet arthritis.

L4-L5: Degenerative disc signal. Mild disc height loss. Diffuse broad-based disc bulge which along with facet and ligamentous hypertrophy accounts for moderate right lateral recess narrowing with abutment or mild impingement of the traversing right L5 nerve root. No significant neural foraminal narrowing. Moderate facet arthritis. Bone marrow edema involving the articular process at L4 on the left (series 7, image 11) were there is suggestion of the fracture line (series 6, image 11). Status post of her changes hemilaminectomy at L4 on the left.

L5-S1: Bilateral L5 pars defects with grade 1 anterolisthesis of L5 on S1. Bone marrow edema about the left L5 pars defects suggest acuity. No significant spinal canal or lateral recess narrowing. Moderate bilateral neural foraminal narrowing with abutment or mild impingement of the exiting bilateral L5 nerve roots. Mild – moderate facet arthritis.

OTHER: None.

IMPRESSION: Lateral recess narrowing at L4-L5 on the right accounts for traversing right L5 nerve root impingement. Bilateral L5 pars defects with grade 1 anterolisthesis of L5 on S1. Neural foraminal narrowing at L5-S1 bilaterally accounts for abutment or mild impingement of the exiting bilateral L5 nerve roots.

[Donald Corenman, MD, DC]

#28756

It is quite difficult to injure the nerves in the lower spinal canal to cause bowel and bladder injury. These nerve (called nervi eregantes) are from the S2-4 segments and sit in the middle of the canal in the lumbar spine. You would need a fracture or massive disc herniation to cause injury to these nerves.

Commonly, pain can cause temporary loss of bladder sphincter tone. This is especially common in women who have delivered a child as pregnancy stretches the sling of muscles that hold the bladder up. Also, the urethra (the connection between the bladder and the outside) is much shorter in women and tends to “leak” more frequently.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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#28828

I’m a male and have leakage when I sit or stand up do squats etc. I’ve been to urologist and had every test done with no answers. He said it may be my spine issues. He did say my pelvic floor muscles are very tense. Could my spine issues (bulging disc and spondy) be causing pelvic floor tension (pudendal nerve??) based on my MRI report?

I’m having a thoracic MRI done next week at my own cost to rule out anything up these as I do have pain when I cough in my mid back. But all this urinary stuff happened well before that.

I originally just had left side L4-L5 herniation then had microdisc on May 8th and rebulged my disc on May 20th and the MRI report above is after that and now shows bulge on right side too. I saw a surgeon who said he would do a L4-S1 fusion to help with my new leg pain and fix the spondy but said he didn’t know if it would help my bladder leakage.

[Donald Corenman, MD, DC]

#28829

Bowel and bladder nerves (nervi érigeantes) are small filamentous nerves in the center of the canal. You would need a very large mass (herniation or tumor) to compress these nerves to cause bowel/bladder dysfunction. It is highly unlikely that spine surgery would change your urinary function.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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#29371

In addition to above symptoms I’ve developed a lot of penile pain at the tip. It isn’t there when I wake up but after getting up and walking and gets bad by afternoon. I’ve taken 800 mg Advil and 1000 mg Tylenol at same time and pain is still there.
Is this from my disc issues?

[Donald Corenman, MD, DC]

#29372

The penis is innervated by the pudendal nerve (S2-4) from the sacrum. It sounds like you have a pudendal neuropathy. This should not originate from the lumbar disc herniation.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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