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Jef Burk
Jef Burk, Doctor
Category: Medical
Satisfied Customers: 2639
Experience:  MBBS. I've been teaching,practicing and learning since 1985.
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Yesterday my friend had a grueling test to determine why her

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Yesterday my friend had a grueling test to determine why her bladder will not empty completely upon urination. (She gets frequent infections.) She was told she would, from now on, have to catheterize herself every day, at which suggestion, she told me, she nearly screamed. She asked for an alternative and was given something like "a device which can be implanted on her back to stimulate her bladder". I may not be describing that quite correctly. Are those the only two alternatives? I'm trying to help her. Are there medicines? Can you help me help her? Joy Stocking



There are several other options..




Bladder retraining and biofeedback can help the patient with a spastic pelvic floor and external urinary sphincter to relearn how to relax during micturition. This technique is typically performed with perineal electromyographic electrodes connected to an electronic biofeedback machine. Over several sessions, patients get visual and auditory signals of what it feels like when they contract the pelvic floor muscles. Positive and negative feedback then can be used to teach the patient to relax specific muscles.


Drug Treatment


Bethanechol chloride, 25 mg tid/qid, is the only drug available for the treatment of urinary retention. Bethanechol is an agonist for the parasympathetic nerve-mediated, acetylcholine-mediated detrusor muscle contraction.It helps to increase bladder muscle tone and contractility. Bethanechol works within an hour after the pill is administered. Therefore, it takes only a few days to determine whether the medication is effective for a particular patient. Because of absorption issues, bethanechol generally should be taken on an empty stomach. Adverse effects include upset stomach, vomiting, dizziness, wheezing, sweating, and flushing.


Urethral Botulinum Toxin Injection


Another method of treating refractory sphincter spasticity is injection of botulinum toxin into the spastic pelvic floor.The technique is simple to perform and has been described in a previous issue of Reviews in Urology


Sacral Nerve Stimulation


Dr Jef



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