This topic is about a person named Ed who is experiencing persistent rectal-sphincter spasms that are blocking urination after having a colectomy. Ed had his colon removed 10 years ago and has been dealing with these spasms for the past five years. The spasms cause intense pressure and pain, making it difficult for him to urinate. He is considering surgical options and is seeking advice from others who might have faced similar issues. Here are some insights and advice that might be helpful:

1. Specialist Work-Up
- Consult both a urologist and a colorectal surgeon to rule out any prostate or bladder outlet problems and compare their findings.
- Request imaging or endoscopy to check for adhesions, rectocele, diversion colitis, or other pelvic issues. A simple digital rectal exam can detect a rectocele.

2. Possible Causes
- Pelvic adhesions that might be tethering the bladder to the rectal stump.
- A rectocele that could be bulging against the bladder.
- Diversion colitis or general rectal inflammation.
- "Phantom bottom" or nerve-conduction pain similar to phantom-limb sensations.
- Enlarged prostate or pelvic-floor nerve damage.

3. Conservative/Non-Surgical Measures
- Consider muscle relaxants like prescription Valium (diazepam) or the herb Lobelia as a potent pelvic muscle relaxant.
- Use neuropathic pain agents like Lyrica (pregabalin) for sphincter-related nerve pain.
- Try anti-inflammatory or soothing enemas, such as fatty-acid enemas for diversion colitis or an aloe-based mix.
- Use very warm water in the shower aimed at the perineum to help empty mucus, and consider heating the area with a hair dryer.
- Urinate standing rather than sitting, use cushions or a reclining chair to reduce rectal pressure, and wear pads for unexpected leakage.

4. Adhesion-Focused Alternatives
- Consider surgical lysis of adhesions or an ileorectal anastomosis.
- Explore non-surgical adhesion protocols, such as those in Jini Patel Thompson’s guide on natural treatments for adhesions and scar tissue.

5. Surgical Options and Experiences
- Some have found relief from spasms, discharge, cancer risk, and sitting pain through proctectomy or total proctocolectomy, though recovery can be long and uncomfortable.
- Surgeons may refuse the procedure for very elderly patients or note a 20% chance of unsatisfactory results; the decision is highly individual.
- Some experienced temporary bladder-function loss after sphincter removal but relearned voiding techniques, while others reported permanent resolution of pain and mucus once the stump was removed.

6. Pain-Management Referral
- If structural issues are ruled out, consult a pain specialist about nerve blocks or modern neuropathic pain regimens to manage mis-routed rectal/bladder signals.

7. Moral Support
- Trust your instincts, seek second opinions, and balance potential future reconstruction hopes against current quality-of-life realities.