Concluded Case

Detrusor underactivity

A 46 years old male with history of incomplete evacuation of bladder since last 20 years with normal USG except significant residual urine - prostate is normal .Uro flowmetry is also done . Treated with various permutation and combinations like Alfuzocin , bethanechol , urinary antibiotics but little relief. MCU is also normal . Apparently it looks like a case of detrusor underactivity . Treatment options welcomed in this case

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Concluded answer
Considering his normal reports i agree with your opinion of detrusor hypotonic status Sir we don't have any medicine to increase the tone of detrusor But some yogic exercises 1 vajroli kriya and mudra 2 ashwa chalan kriya and mudra 3 manduka asana with pressure on hypogastric abdomen with close fists 4 to sit in gomukha asana with ashwa or vajroli mudra And many more
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? Diabetic vesicopathy , suggest to exclude DM Spinal neuro problems have to be excluded by MRI . Old Guillon Bare should be excluded by history . Cystoscopy ,and bladder volume - pressure studies can be helpful . Since this problem exists for the past 20 years without kidney damage , probably it is a mild pathology. Patient may be taught double void micturition technique .
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Considering his normal reports i agree with your opinion of detrusor hypotonic status Sir we don't have any medicine to increase the tone of detrusor But some yogic exercises 1 vajroli kriya and mudra 2 ashwa chalan kriya and mudra 3 manduka asana with pressure on hypogastric abdomen with close fists 4 to sit in gomukha asana with ashwa or vajroli mudra And many more
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Bethanicol can stimulate nerves of bladder Lifestyle modification reduce fluid intake Bladder retraining
Inj Botulism can be given