Q. I was told last week, that I have a herniated disc and am being referred to a Orthopedic Surgeon. I understand that surgery does not automatically need to be done and there are other options such as physical therapy and so on. My concern is at the end of the conversation with the doctor, he said that the only time the Orthopedic doctor should recommend surgery at once is if I cannot hold my urine or bowls.

For about the last month or so, I have been having to get up every night at least once an hour to urinate and my bladder feels full, but when I urinate, it is not full, but the urgency is there, and it definitely feels like if I don't get to the bathroom in time, I would lose some control over it. I have tried things like not drinking any water or any thing after a certain time and no matter what I do, it seems like as soon as there is some urine there, I have to go right away. Is this of concern or what the doctor was talking about? Thank you in advance for your response.

A. A herniated disc can press on the nerves leaving the spinal cord going down to the arms, the legs, the bladder, and the rectum. When the disc is pressing on these nerves, the nerves can either begin to hurt (in the legs and arms) or stop functioning (legs, arms, rectum, and bladder). For the arms and legs, this decrease in function is weakness, whereas with the rectum and the bladder decreased function results in soiling or wetting your pants.

A herniated disc does not usually cause one to get a sense of a full bladder or a sense of urgency. Instead, this is more likely a cause of a urinary tract infection.

I recommend that you bring these symptoms up to the doctor. It may be that your case is in some ways special, or it may mean that you need a urine test to make sure that there¹s nothing going on in the urine to cause these symptoms.

A Web site advertising an individual doctor¹s practice (I do not necessarily recommend this particular doctor since I do not know him, but there are two nice pictures of the spine and a herniated disc pressing on a nerve on the site) is at:

http://www.diagnostico.com/Trejos/herniate.stm

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