| Low bladder pressure . | High bladder pressure + DSD* . |
|---|---|
ISC | ISC |
IDC | IDC |
External sphincterotomy—surgical, botox, stent | |
Deafferentation/SARS |
| Low bladder pressure . | High bladder pressure + DSD* . |
|---|---|
ISC | ISC |
IDC | IDC |
External sphincterotomy—surgical, botox, stent | |
Deafferentation/SARS |
Remove stones, if present—cystolitholapxy for bladder stones, PCNL for staghorn stones.
A new potential option for DSD is augmentation of external sphincter nitric oxide (NO), a neuro-transmitter which relaxes the external sphincter, thereby encouraging antegrade flow of urine and potentially, therefore, lowering residual urine volume. NO donors such as nifedipine or GTN can be used. There is theoretical and some experimental evidence to support this.1,2
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