Drugs to treat Chr Urinary retention.

Bethanechol chloride : when to use cholinergic agonist intelligently in Chr urinary retention?? We have heard a great deal about “overactive” bladder (OAB) recently. But what if our  patients have the opposite problem—a bladder that “won’t go”( Flaccid bladder) ? How  we should  evaluate the patient whose bladder does not empty(Chr retention without any organic cause) ? What are the most common and effective forms of therapy for impaired bladder emptying That is Bethanechol chloride, 25 mg tid/qid, are 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 contractile. But a previous work up under guii Differential Diagnosis and Treatment of Impaired Bladder Emptying.

Although much attention is paid to urinary incontinence, the condition of incomplete bladder emptying is becoming more common with the aging of the US population and the widespread use of anticholinergic drugs to treat overactive bladder. This disorder can often be silent until end-stage presentation of overflow incontinence. In this article, we review the pathophysiologic conditions of the bladder and urethra that can cause impaired bladder emptying and discuss how to evaluate and screen the patient with a bladder that does not empty. In addition, we provide an overview of treatment options available for impaired bladder emptying and consider the research that is under way to find the best therapies for the failing bladder.

Key words: Bladder, Urethra, Urinary retention, Ultrasound, Bethanechol

? There is an important bladder-to-urethra reflex that is mediated by sympathetic efferent pathways to the urethra. This is an excitatory reflex that contracts the urethral smooth muscle and, thus, is called a guarding reflex. The positive reflex is not activated during maturation but activates when bladder pressure is increased, such as during a cough or exercise.

• Catheterization: indwelling urethral or suprapubic catheters or clean intermittent catheterization
• Biofeedback to teach the patient to relax his or her spastic sphincter muscle
• Drug: bethanechol chloride, 25 mg tid/qid, is the only drug approved for urinary retention
• Urethral sphincter botulinum toxin injection
• Neuromodulation with sacral nerve stimulation
• Basic research
• Muscle cell transplantation to reengineer The failing bladder

Gene therapy to repair the damaged nerve to the bladder