Overactive Bladder Condition with Small Fiber PN

@furdog, I have frequency and emptying the bladder issues but I'm not sure it's related to my small fiber PN. I do take the generic tamsulosin that helps some. While you wait for others to respond, here are a few references I found about the topic.

-- Overactive Bladder Symptoms Within Nervous System: A Focus on Etiology:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8703002/
-- Neuropathy & Your Bladder: https://neuropathycommons.org/neuropathy/neuropathy-your-bladder

There is a discussion on Myofascial Release Therapy that may be a treatment option. One of the conditions it can treat is listed in the discussion description - "Bladder Problems (Urgency, Frequency, Incontinence, Overactive Bladder, leakage".
-- Myofascial Release Therapy (MFR) for treating compression and pain:
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
Have you talked with your doctor about the new symptoms and possible treatments?

I have small fiber neuropathy and yes it does affect your bladder. I have extreme bladder pressure and incontinence and was told by both my neurologist and urogyno that it was most likely more intense because of the sfn. Oddly I notice that while I’m sleeping mostly and have to go relieve my bladder it’s not the feeling of having to go to the bathroom that wakes me but it’s my heart racing! Everytime without fail my heart races (other times as well and is an autonomic symptom of sfn). Anyway just another lovely side effect of this ongoing nightmare.

@furdog
I also have SFN and overactive bladder plus many other sensory/autonomic nervous system symptoms. I also have cervical spondylitic myelopathy, cervical/lumbar spinal stenosis, DDD, and peripheral neuropathy affecting arms/hands, legs/feet causing numbness, pins and needles and weakness. There are many impacts to organs/glands, heart/lungs/digestion, etc. from SFN. I had ACDF surgery on C5C6 to relieve pressure from spinal cord which helped reduce bladder leakage, incontinence, urgency, etc. My doctor had prescribed oxybutinin to help with bladder control and not sure if an option for you. I no longer take it. Also, I take alpha Lipoic acid and Acetyl l Carnitine supplements for SFN which helps some of my symptoms like burning feet, pins and needles, etc. Best wishes finding answers for and help with your symptoms.

Yes... I have small fiber neuropathy, which is thought to be the contributing factor to POTS, and bladder issues can be a symptoms.

The #1 thing that helped me was consulting a pelvic floor PT. They specialize in pelvic and back pain, including nerve pain, and bowel and bladder issues. My completely unhelpful Neurology NP told me there was "not much that could be done" except refer me to a urogynecologist and perhaps try medications that have many side effects. That was totally untrue. I mean, it might have made sense to see a urogynecologist if we needed to rule out other problems,but at the time, that was unlikely.

My pelvic PT was able to test me for nerve compression (which we ruled out), teach me pelvic floor exercises, urge suppression techniques, basically how to retrain my bladder and adjust to my condition.