HomeAnswersInternal Medicineunderactive bladderI have an underactive bladder. Kindly help.

I have underactive bladder. Kindly advice how I can have normal urination.

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Published At June 14, 2018
Reviewed AtJanuary 25, 2024

Patient's Query

Hello doctor,

I am suffering from OAB, UTI and pus cells 30 to 40. I have been under treatment for past two years by a urologist, surgeon, and an infection specialist. In recent urodynamic test after removal of the catheter, I am unable to void means suffering now by UAB. I do not know how I became patient of OAB to UAB. I have doubt of faulty treatment. Kindly advice how can I have normal urination. I am in need of very expert urological doctor treatment.

Hi,

Welcome to icliniq.com.

Both are opposite conditions. If you mean overactive and underactive bladders from these abbreviations, (these were not standard abbreviations) it is fairly possible that you might have over treated for overactive bladder, you can stop the treatment, and can be restarted in a week at lower doses. I would like to know the medication you were taking for overactive bladder and at what doses. What symptoms you have now and before? UTI can be treated with antibiotics but it is very important in your case to see either it is a true infection or just a colonization of bacteria in urine, that do not need a treatment. Kindly send me your laboratory reports and urodynamic study report to comment better on your condition.

For more information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

Patient's Query

Thank you doctor,

For OAB, the doctor gave me Flavospas 200 mg three times a day for 15 days. I am on a catheter for last three weeks. During urodynamics, the doctor gave me 10 minutes for urination without catheter where I was not able to do urination. In urine culture report, Proteus Mirabilis bacteria was found and the doctor gave me antibiotic injections like Meropenem, Ertapenem, Magnex Forte for three weeks. Right now for infection Cranmed (three times a day) and Zifi-CV 200 (three times a day), I am taking. I am attaching latest urine culture, USG KUB, and urodynamics report. I want to ask what are the treatment for UAB like medications and exercise. The prostate operation is needed or not which will solve this urine blockage problem?

Hi,

Welcome back to icliniq.com.

You have a chronic Foley, definitely you will have bladder under activity, before discontinuing Foley catheter sometimes we give a voiding trial, means remove Foley and check residual every six hours with bladder scanner, if patient is not able to pee and residual is more than a certain amount, remove urine with temporary catheter, this is a kind of bladder exercise, and patient in 2 to 3 days usually gets action of bladder back.

Also, you have hypertrophy of prostate, I would recommend taking a combination of Temsolusin 4 mg and Dutasteroid 0.4 mg once daily while discontinuing Foley, this will help reducing obstruction and size of the prostate.

Third, your klebsiella in urine is very resistant as per report (attachment removed to protect patient identity), although the antibiotic may help I believe as far you have Foley, this bacteria will not go away. Plan with your urologist to get rid of Foley with voiding trail with a straight catheter, start above combination right now (I just mentioned generic names of drugs, trade names may be different). Continue antibiotics and recheck your urine in 2 to 3 weeks. I would not recommend surgery unless everything is failed.

For more information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Hafiz Muhammad Hassan Shoukat
Dr. Hafiz Muhammad Hassan Shoukat

Internal Medicine

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