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Detrusor Sphincter Dyssynergia DSD

I am a 29 yr old female. I was Dx in Dec. 2007 w/ Detrusor Sphincter Dyssynergia.  I have never had any children.  I am in the process of having test done for MS, so far there have been some abnormal findings.  I have been trying to get pregnant (which was on hold for a few months for MRI's and a month long dose of Macrobid) and will start trying again after my Spinal Tap on March 14.  My question is basically regarding the treatment of DSD.  My urogynecologist said if MS is the cause the the MS tx usually resolves the problems and if it's not MS my options are Flomax, Hytrin or a device-Interstim.  My main problem is urinary retention (resulting in discomfort and increased risk of cystitis) @ this time.  My Dr. doesn't want me to straight cath because of the increased risk of infection.  Whatever the cause of my DSD is the treatments don't seem like a good idea if I'm pregnant.  Do I have any other options during prenancy?
1 Responses
242593 tn?1313867921
MEDICAL PROFESSIONAL
Hi,
The medication probably would not be a good idea in pregnancy. I have not seen any data on the INTERSTIM used during pregnancy either. But you might consider INTERSTIM and turn it off while you are pregnant. My understanding is that autoimmune disorders like MS can sometimes get better during pregnancy, and that may be to your benefit.

Other options include having  suprapubic bladder tube placed (invasive and reserved for very severe cases of retention). Botox has also been touted for helping to relax the urethral sphincter, but I have not had good success with it for that purpose. Personally, if you can reliably self cath yourself, and your retention requires it, then self cath can be safe and reliable in the long term. I have some patients who have been doing it for many years without problems.

Dr. Hoyte

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